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Emerging evidence suggests that COVID-19, the disease caused by SARS-CoV-2, elicits a wide range of cardiovascular-related complications, including myocarditis (inflammation of the heart muscle), ventricular failure, myocardial infarction (heart attack), and others. Findings from a recent study indicate that more than half of hospitalized patients who have severe COVID-19 and elevated troponin levels have heart damage.

Troponin is a group of three proteins that regulate heart and skeletal muscle contractions. Elevated levels of cardiac-specific troponin are indicators of heart muscle damage. Many people who are hospitalized with COVID-19 have elevated troponin levels.

The study involved 148 patients (average age, 64 years) who had recovered from severe COVID-19 illness. Of these, 48 required ventilator support. The authors used a form of magnetic resonance imaging called multi-parametric cardiovascular magnetic resonance imaging to assess heart muscle damage in the patients.

The imaging revealed that more than half (54 percent) of the patients exhibited signs of heart damage, including infarction (tissue death) and/or ischemia (poor blood supply), or both; some showed signs of myocarditis-like scarring. A quarter of the patients had ischemia; of these, two-thirds had no prior history of coronary disease. The majority of patients (88 percent) exhibited limited extent myocarditis-like injury, and nearly one-third (30 percent) of these had active myocarditis.

These findings suggest that COVID-19 exerts deleterious effects on multiple organ systems, including the cardiovascular system, and underscores the need for monitoring COVID-19 patients well after recovery.

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