Mild but persistent heart inflammation may explain heart problems after SARS-CoV-2 infection

The research team led by Dr. Valentina Puntmann and Professor Eike Nagel from University Hospital Frankfurt and Goethe University Frankfurt followed around 350 study participants with no previously known heart problems who had recovered. of SARS-CoV-2 infection. They found that more than half of them were still reporting heart symptoms almost a year later, such as exercise intolerance, tachycardia and chest pain. According to the study, these symptoms can be attributed to mild but persistent heart inflammation. Pronounced structural heart disease is not a feature of the syndrome.

After recovering from SARS-CoV-2 infection, many people complain of persistent heart problems, such as poor exercise tolerance, palpitations or chest pain, even if the infection was mild. and that there were no known heart problems in the past. Previous studies, mainly in young, physically fit individuals, have already been able to show that mild heart inflammation can occur after COVID-19. However, the underlying cause of the persistent symptoms, and whether this changes over time, was unknown.

A team of medical scientists led by Dr Valentina Puntmann and Professor Eike Nagel from the Institute for Experimental and Translational Cardiovascular Imaging at Frankfurt University Hospital followed 346 people – half of whom were women – aged 18 to 77 years old, in each case approximately four and eleven months after documented SARS-CoV-2 infection. To this end, the team analyzed the study participants’ blood, performed cardiac MRIs, and recorded and classified their symptoms using standardized questionnaires.

Result: 73% reported heart problems at the start of the study and 57% of these symptoms persisted 11 months after infection with SARS-CoV-2. The research team measured mild but persistent heart inflammation that was not accompanied by structural changes in the heart. Blood levels of troponin – a protein that enters the blood when heart muscle is damaged – were also unremarkable.

Dr Puntmann, who led the Impression COVID&Heart study, explains: “The patients’ symptoms match our medical findings. Importantly, although triggered by the SARS-CoV-2 virus, post-COVID cardiac inflammatory involvement differs significantly from classic viral myocarditis. Extensive damage to the heart muscle leading to structural changes in the heart or impaired function is not characteristic at this stage in the course of the disease.” The clinical picture is more reminiscent, she says, of the findings of chronic inflammatory syndromes diffuse such as autoimmune diseases.” Although most likely driven by a virus-triggered autoimmune process, much more research is needed to understand the underlying pathophysiology. Likewise, the long-term effects of cardiac inflammation following mild COVID infection need to be clarified in future studies..”

Because the study is limited to a select group of individuals who participated because they had symptoms, the prevalence of the results cannot be extrapolated to the general population. Bayer AG, the German Heart Foundation and the German Center for Cardiovascular Research supported the study.


Goethe University Frankfurt am Main

Journal reference:

Puntmann, VO, et al. (2022) Long-term heart disease in people with mild initial COVID-19 disease. Natural medicine.

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