More than half of patients hospitalized for Covid-19 arrive at the hospital with heart damage caused by the infection that dramatically increases the risk of death. This is what emerges from a study conducted by researchers from the San Raffaele Hospital in Milan and that of Cremona published in the European Journal of Clinical Investigation.
The research considered the data of 750 patients admitted to the two Lombard hospitals during the first wave of the pandemic, between February and April 2020. More than half of the patients (52%) had abnormal levels of troponin, an enzyme that indicates the presence of heart pain. Patients with heart damage were three times more likely to end up in intensive care than those with a healthy heart (26% vs 8.3%) and 4 times higher risk of dying in the three months following hospitalization (40% vs 9.1%) .
"We can identify at least four mechanisms behind Covid-19-related myocardial damage," explain the researchers. "A direct infection through the ACE-2 receptors; an imbalance between the myocardial need for oxygen and its availability; an abnormal coagulation with microcirculation disturbances and, finally, the cytokine storm", that excessive immune response that occurs observed in the most severe Covid patients.
The study also noted that being treated with traditional drugs used in patients with heart or vascular disorders, such as ACE inhibitors, sartans, calcium channel blockers, had no protective effect on myocardial damage.
"Our data support the measurement of cardiac troponin at admission and during admission to identify patients at greatest risk for adverse events," the researchers concluded.
(Unioneonline / vl)