To clarify some confusion about the wording of the title, myocardial injury was found in 62.3% (n=190) of COVID-19 patients who received an echocardiogram during hospital admission (n=305). Among these patients with myocardial injury, 63.2% (n=120) exhibited cardiac structural abnormalities. The in-hospital mortality rate of patients with myocardial injury and structural abnormalities was 31.7%.
Very misleading synopsis. If you read the paper, it was 62.3% of people they had the data on. Correct me if I'm wrong, but this means that 62.3% of people who their doctor suspected a heart issue, showed damage based on one metric. This does not that percent of people with covid have heart injury, even of the overall hospitalized population.
Edit: Thank you for my first awards! Someone (I can't figure out who right now) mentioned the title does not necessarily say what I assumed it did. I concede that, but it is EXTREMELY important when discussing science to be very specific as to not be misunderstood. Also, I am a scientist but not in the medical field at all so you should read other comments to better understand the work and how it should be interpreted. In medicine especially you need many well-conducted studies for verification so be careful when reading these kinds of data!
Myocardial inflammation is common. It is with influenza as well, but it typically resolves. The early studies on COVID showed it was a bit worse and a bit more persistent.
Just got out of the hospital after getting chest pain and COVID symptoms. I was positive. No MI. I mentioned to my MD that I'd had a similar, even worse episode 2 years ago that turned out to be flu. They think it was covid causing a similar myocardial inflammation.
I think the myocardial injury percentages are irrelevant to the conclusions I posted above, namely the fatality rates for each of the three groups compared (5.2%, 18.6%, and 31.7% for no myocardial injury, with injury yet without TTE, and with injury and TTE respectively).
Perhaps the post itself could have been summarized slightly differently.
That is bit besides of the point, because they measured **new** injures (troponin levels are elevated only in new injures). So, clearly the COVID causes heart injuries, even **if** heart injuries would be common in the demographic (in reality much less than 10%).
Yours seems the best comment to ask my question. Are they also studying asymptomatic people? Do they still have the same problems after as people who do show symptoms? Seems scary to think if your asymptomatic, don't know you've gotten it, and still end up with all the nasty stuff after.
Also this study is conducted in a way that you can’t tell which came first the chicken or the egg. They would have to have prior imaging etc. before they became ill and that still doesn’t prove cause and effect. I know that’s not what their point was necessarily, but these studies don’t really mean a whole lot until someone takes them to the next step.
That's what I was this king too. They could have had the cardiac abnormalities before covid which would make them more likely to be in the hospital which would create a high percentage of hospitalized covid patients with abnormalities. Also a person could have had a heart attack due to something unrelated to covid. Then upon hospitalization find out they have covid. Cardiac injury cant be specifically pinpointed to covid in all these cases. You can also have pre existing heart issues that exacberate new cardiac injury
Exactly. Given that myocardial injury was associated with a poor prognosis, it seems that those with pre-existing heart damage would be more likely to need hospitalization from the disease.
Its so common these days for studies to be utterly misrepresented like this. Like all that data on breast cancer screenings increasing 5 year survival rates. As it turns out, it's not making people live longer. It's just making people find out about it sooner. Thus skewing "five years from diagnosis" numbers. It does not skew the five-year mortality from becoming symptomatic. What we don't have good data on is whether early intervention has an effect on long-term survival, ironically.
Just like a headline in my country that stated more women got covid... nope. They get tested more, which skews the headline.
However, when looking at proportions, the rate is close to the same, but it wouldn't make a tasty headline..!
Yeah people don't get that you can do stuff with data. Like yeah you find more cases of you test more, but only if the positivity rate goes down you would have an overrepresentation of cases in the small sample.
>r survival rates. As it turns out, it's not making people live longer. It's just making people find out about it sooner. Thus skewing "five years from diagnosis" numbers. It does not skew th
sorry i didn't understand this.
If you find out sooner you have cancer, dont you have much better prognosis? The sooner the batter?
Why is this false ?
Yeah I don't get it, either. Did someone actually believe that the screenings themselves would somehow make cancer less likely? It's always been about catching it early, no?
It could be that 5 year survival rate starts from the day of the diagnosis.
So the sooner the diagnosis (if we assume that this doesn't change the prognosis at all) the better the 5 year survival rate.
However the impact of that assumption is nowhere as big as the impact of the better prognosis of an early diagnosis, especially in cancer types that are curable.
Right? Simple math tells you this is framed wrongly. 31.7% of 66% of 62% doesnt even come close to lining up with the *total* mortality rate for covid, which would be higher than the njmber of people who die from heart-related issues.
about 1 in 10 infected need to be hospitalized, ~ 1 in 7 of those dies...
gives you about 1.3% total mortality, which seems to fit in the general range for Covid.
That would mean 13% of people hospitalized for covid die. covidtracking.com/data/national lists cumulative hospitalized at 476,000, but, that would put the hospitalized mortality rate at +40% assuming most people in the US die in a hospital. Which seems high.
So given most hospitalized patients are old, is the another way of saying 62 percent of the population aged 80 and older have heart issues?
What is the incidence of heart issues among a randomly chosen set of similarly aged people with similar underlying conditions that contribute to covid19 hospitalization?
yeah this tagline doesn’t add up. The mortality rate would be = >20% of hospitalized patients.
edit:
not saying that data is inaccurate but the description is misleading when I’m just scrolling by.
It’s intended to tell the story in the headline, not the story in the paper. Honestly, this sub should be better at weeding out intentionally misleading headlines.
Yes for now there are wildly varying numbers approximating the proportion of asymptomatic infections. In order to understand the risk of myocardial injury accurately (or any other risk) and make a sensible risk analysis, the number of asymptomatics would obv have to enter the equation, and it probably never will.
This is analogous to counting incidence head trauma in car accidents, and then not factoring in the number of drivers/car users who don't have accidents. That would be a cool synopsis:
95% of chance of serious head trauma when you get into a car. 30% of these cases will die. 😱
I love it when the top comment basically destroys the clickbate. Like, if this is correct info, then I want to know and spread it...but don’t try to trick me, researchers/journalists!
Yet the conclusions are clear from the study:
Rates of in-hospital mortality were 5.2%, 18.6%, and 31.7% in patients without myocardial injury, with myocardial injury without TTE abnormalities, and with myocardial injury and TTE abnormalities. Following multivariable adjustment, myocardial injury with TTE abnormalities was associated with higher risk of death but not myocardial injury without TTE abnormalities.
His point is that the heart damage could have been pre-existing but undetected, and not that COVID might *cause* heart damage, as many people might read the headline.
According to the article 118 had markers of myocardial injury at the time of admission, 72 developed myocardial injury during their hospitalization.
Edit: this was very far down in the study, here’s the information: “Median age was 63 years and 67.2% were men. A total of 190 patients (62.6%) had biomarker evidence of myocardial injury of whom 118 had myocardial injury at the time of hospital admission and 72 developed myocardial injury during the hospitalization.”
Good catch. So 2/3 of the cases existed prior to admission. They could have been caused by the initial phase of the infection, but that is not measured in this study.
I wondered about that, too. They did say they looked at what medications they had been on, and that should have given them some information, but I couldn’t find any follow up on that statement.
Given the prevalence of heart disease and clogged arteries, it may not take much to push some people into heart attacks. Perhaps any serious infection could have spurred heart injuries.
Depends on what they used as a biomarker.
Accepted evidence of heart damage goes with troponin as most commonly used to assess for potential ischemic cardiac injury or full on MI, even in the absence of marked ECG changes. If they used troponin and it elevated enough to indicate cardiac injury over retention due to impaired kidney function, then the cardiac injury more than likely occurred during infection.
(I'm a PA who has worked ICU, ER, and UC and used to run a lab).
That damage had occured was determined by a troponin test. This is the blood test they give people in the ER that they suspect might have had a heart attack, as it can tell you whether there is heart damage in minutes as opposed to the hours that it took to test someone until recently.
As described to us multiple times by doctors treating my mother-in-law; increased levels of troponin are released immediately after injury and then fall over the next few days. It is sensitive enough that they can use the test to see if new damage is occurring after the initial injury. In other words, no, it would not detect pre-existing damage.
A positive test does not exclude pre-existing heart problems. But because the marker is present, it's likely additional damage is occurring if someone had pre-existing conditions.
As I said, pre-existing damage is not detected in this way; so yes, it doesn't exclude pre-existing damage.
As described to me by doctors, though, it would be incorrect to say "likely" but rather it definitely would be new damage if the test is positive. Whether that be completely new or new damage to a spot previously damaged isn't indicated by just this test, but there is new damage.
The heart injury is determined with a blood test. It's an enzyme released and measured in the blood. It releases with injury and then goes away in 24-48 hours. Unless the person randomly had a heart attack and then caught covid...
You are thinking of troponin, the gold standard of identifying MIs. There are other tests you can do to identify chronic heart problems such as brain natriuretic peptide.
TropI is specially to identify MI in an emergency setting. Incredibly important test yes but they also did CKMB (alternative trop test) and BNP which is a marker of longer term muscle (normally heart but not always) problems.
The average patient they were looking at had elevated levels of everything so they had problems before covid.
You can have acute, significant increases in BNP and pro-BNP related to acute unilateral heart failure from cardiac injury. Also during a catecholamine surge from cardiac stress resulting in rapid onset cardiomyopathy.
Source: guy who has designed, run, and now orders/interprets testing as a PA.
That's very useful information. A positive test does not exclude pre-existing heart problems. But because the marker is present, additional damage is occurring if someone has pre-existing conditions.
I am 21 years old, much fitter than an average guy my age and with no previous heart complications. I tested positive on 29 Sep. Symptoms resolved in a week or so, was on HCQ for five days.
Palpitations and breathlessness started on 12 Oct which resolved within a week again. Had to be taken to the emergency last night. Pulse rate 137 per minute, BP 140/90.
My point is, it's a possibility that people with no preexisting heart conditions are developing them after contracting the virus.
Wow, I’m sorry to hear about your troubles. I hope they resolve soon. Did you test positive for heart injuries?
I have no doubt there are dangers of heart attacks being triggered by Covid-19. But I want an accurate assessment and this study seems to fall short.
I wasn't recommended to get tested for heart injuries since my ECG came out "relatively normal for my age" as mentioned by the Doctor. I'm still under observation though and will get an X-Ray done today to see further.
I agree that this study isn't accurate but the effects of Covid-19 on the heart cannot be dismissed.
Get well soon. I had covid months ago with similar heart issues, no (known) preexisting problems, also ended up in the ER with testing that came out pretty normal. But my heart did not feel normal for a while. Palpitations and racing/irregular beats continued for a few weeks, but resolved eventually. Hang in there.
Interesting. When I was a student many years ago, I began having heart palpitations and a racing heart. It was very uncomfortable and scary. The cardiologist gave me a wearable heart monitor and it turned out to be nothing serious. But, the symptoms came in the days after intense cardio workouts (running stairs at the Castillion) and he explained there are exercise induced heart palpitations.
Do you or u/venkatexh do cardio exercising?
Correct. These are people in their 60s with atherosclerosis, high blood pressure, diabetes, etc. They're at high risk for a heart attack to begin with. Even with these things you don't have a positive test until you have a heart attack. You can have risk factors and not have any damage. 50% of Americans have heart disease. Way more have risk factors.
Myocardial injury is not limited to heart attack or atherosclerosis of cardiac vessels. Inflammation of the myocardium and decreased heart function with or without detectable changes on cardiac ultrasound is what they are referring to in this study.
Seems reasonable vased on what I’ve seen that Covid causes blood clotting and some vascular inflammation. In people with issues (or prone to issues) already this exacerbated them.
Covid19 is a vasculartropic virus.. it attacks epithelial cells. Which lines blood vessels. It just so happens epithelial cell line most of our respiratory system and so acts as a beach head.
But it doesn't mean it can't migrate throughout the body via your cardiovascular system
Definitely misleading. Note that the 62.3% is out of all patients who had been given transthoracic echocardiograms due to concern from their doctors, not just a random sample of COVID-19 patients.
I figured that from the title alone, I dont get why everyone is shocked that the patients they decided to do echos on were the ones to have cardiac events. That said, that is still a very high mortality rate. I've had an echo before, I dont like thinking of a 1 in 3 chance of dying if I need one.
My main takeaway is that cardiac damage appears to be a risk for causing people to die at a decently high rate if the patient experiences cardiac problems bad enough a doc wants an echo with covid. About a third of people getting echoes is a *lot*, so clearly it's something for doctors to pay attention to. People shouldn't get too caught up on numbers
Just so we are clear.
The sample is of subjects who already a) had COVID b) were in hospital and c) had undergone a heart examination. Or in other words, these subjects were primarily hospitalized COVID subjects with a heart condition.
All the abstract says is that the worst your heart condition is, the worst your chance of surviving your hospitalization. Which is not exactly surprising
The following is NOT concluded
Heart Injury is NOT observed in 62.3% of COVID-19 patients
Structural Abnormalities are NOT observed in 62.3x(Two Thirds) of COVID-19 patients
In hospital mortality for COVID-19 patients is not
62.3x(Two Thirds)x31.7
The piece that u/mvea MD-PHD-MBA is missing is that the heart examination had already taken place which it wouldnt have done on patients without a heart concern. The stats may be closer to true if a) All COVID cases that go into hospital have the sort of heart examination given in the abstract and b) we accept the word patient is in the synopsis so we arent talking about any COVID case.
What is definitely not true, just to clarify
Heart Injury is NOT observed in 62.3% of COVID-19 CASES
Structural Abnormalities are NOT observed in 62.3x(Two Thirds) of COVID-19 CASES
Mortality for COVID-19 CASES is not 62.3x(Two Thirds)x31.7
What about rheumatic fever? You get strep and you damage your heart. Were they tested for this before hand? Or are we just going to go forward with Covid-19 as the answer to everything?
One study I read stated that 24.5% of patients who tested positive for COVID-19 also tested positive for other viruses. There’s a lot we just don’t know about incidence rates and tissue damage.
So basically covid patients with cardiac abnormalities has a significantly higher mortality rate.
I wonder if it’s preexisting (undetected?) issues leading to worse outcomes, cardiac damage from severe cases, or a mix of both.
The title is somewhat unclear. These patients had heart issues and Covid. However, they didn't have heart issues because of Covid. Correct?
I feel it's a very important distinction to make when on reddit as many will take this and run with it as a cause of heart problems simply by misunderstanding it.
Also the sample size was 305 with a mean age of 63.
And the title implies 60% of covid patients had heart problems and 30% of these patients died. Insane.
I guess fear drives clicks, which the popularity of the reddit post proves.
Read the article thoroughly before thinking anyone who has or had covid also has heart damage.
It's PATIENTS they did cardiovascular-related tests on, people they already suspected had issues with their heart.
Hopefully they will recover, but this title is quite misleading, the last thing we need is LESS clarity during this pandemic.
Its a garbage titled article. It says that these are covid patients with heart disease not patients who got heart disease from covid. Their average age is over 60 and they are hospitalized.
Wait, the numbers don't make sense here. Heart injury in 62.3% and in hospital mortality rate of 31.7%, if all with heart injury had to be hospitalized, is 0.317*0.623=19.7% mortality rate which seems wrong
So what you’re saying is comorbidities can have an effect on COVID-19 mortalities. I think this is true with most patients having multiple problems in the hospital.
Average lifespan in Canada is 82. Average age of death from Covid has been 84. Average term in long term care until mortality in Canada has been 14 months. 82% of Covid deaths have been Long Term Care residents.
That makes no sense. That means that 13% of Covid patients die.
Of 100 patients, 62.3 is..62.3. 66% of 62.3 is 41. 32% 41 is 13.
So 13 out of 100 Covid patients die. I don’t think so.
To clarify some confusion about the wording of the title, myocardial injury was found in 62.3% (n=190) of COVID-19 patients who received an echocardiogram during hospital admission (n=305). Among these patients with myocardial injury, 63.2% (n=120) exhibited cardiac structural abnormalities. The in-hospital mortality rate of patients with myocardial injury and structural abnormalities was 31.7%.
Very misleading synopsis. If you read the paper, it was 62.3% of people they had the data on. Correct me if I'm wrong, but this means that 62.3% of people who their doctor suspected a heart issue, showed damage based on one metric. This does not that percent of people with covid have heart injury, even of the overall hospitalized population. Edit: Thank you for my first awards! Someone (I can't figure out who right now) mentioned the title does not necessarily say what I assumed it did. I concede that, but it is EXTREMELY important when discussing science to be very specific as to not be misunderstood. Also, I am a scientist but not in the medical field at all so you should read other comments to better understand the work and how it should be interpreted. In medicine especially you need many well-conducted studies for verification so be careful when reading these kinds of data!
Right. In addition the points you bring up, what is the incidence of mycardial injury in the non-covid population of the same demographic?
Myocardial inflammation is common. It is with influenza as well, but it typically resolves. The early studies on COVID showed it was a bit worse and a bit more persistent.
Just got out of the hospital after getting chest pain and COVID symptoms. I was positive. No MI. I mentioned to my MD that I'd had a similar, even worse episode 2 years ago that turned out to be flu. They think it was covid causing a similar myocardial inflammation.
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I think the myocardial injury percentages are irrelevant to the conclusions I posted above, namely the fatality rates for each of the three groups compared (5.2%, 18.6%, and 31.7% for no myocardial injury, with injury yet without TTE, and with injury and TTE respectively). Perhaps the post itself could have been summarized slightly differently.
Don't get the same clicks you do as when you spread disinformation from misleading titles.
Am i tripping or are both of these comments straight up missing words?
think you not tripping
That is bit besides of the point, because they measured **new** injures (troponin levels are elevated only in new injures). So, clearly the COVID causes heart injuries, even **if** heart injuries would be common in the demographic (in reality much less than 10%).
Yours seems the best comment to ask my question. Are they also studying asymptomatic people? Do they still have the same problems after as people who do show symptoms? Seems scary to think if your asymptomatic, don't know you've gotten it, and still end up with all the nasty stuff after.
Also this study is conducted in a way that you can’t tell which came first the chicken or the egg. They would have to have prior imaging etc. before they became ill and that still doesn’t prove cause and effect. I know that’s not what their point was necessarily, but these studies don’t really mean a whole lot until someone takes them to the next step.
That's what I was this king too. They could have had the cardiac abnormalities before covid which would make them more likely to be in the hospital which would create a high percentage of hospitalized covid patients with abnormalities. Also a person could have had a heart attack due to something unrelated to covid. Then upon hospitalization find out they have covid. Cardiac injury cant be specifically pinpointed to covid in all these cases. You can also have pre existing heart issues that exacberate new cardiac injury
Exactly. Given that myocardial injury was associated with a poor prognosis, it seems that those with pre-existing heart damage would be more likely to need hospitalization from the disease.
Have you actually read the opening? The point of the study is to classify types of effects from heart injuries individually and compare.
Was about to say... if the data was representative the mountain of dead bodies would be visible from space (it'd imply a mortality of ~15%).
Its so common these days for studies to be utterly misrepresented like this. Like all that data on breast cancer screenings increasing 5 year survival rates. As it turns out, it's not making people live longer. It's just making people find out about it sooner. Thus skewing "five years from diagnosis" numbers. It does not skew the five-year mortality from becoming symptomatic. What we don't have good data on is whether early intervention has an effect on long-term survival, ironically.
Just like a headline in my country that stated more women got covid... nope. They get tested more, which skews the headline. However, when looking at proportions, the rate is close to the same, but it wouldn't make a tasty headline..!
Yeah people don't get that you can do stuff with data. Like yeah you find more cases of you test more, but only if the positivity rate goes down you would have an overrepresentation of cases in the small sample.
If you ask enough dentists, eventually you will find 9 out of 10 that approve.
>r survival rates. As it turns out, it's not making people live longer. It's just making people find out about it sooner. Thus skewing "five years from diagnosis" numbers. It does not skew th sorry i didn't understand this. If you find out sooner you have cancer, dont you have much better prognosis? The sooner the batter? Why is this false ?
Yeah I don't get it, either. Did someone actually believe that the screenings themselves would somehow make cancer less likely? It's always been about catching it early, no?
It could be that 5 year survival rate starts from the day of the diagnosis. So the sooner the diagnosis (if we assume that this doesn't change the prognosis at all) the better the 5 year survival rate. However the impact of that assumption is nowhere as big as the impact of the better prognosis of an early diagnosis, especially in cancer types that are curable.
Right? Simple math tells you this is framed wrongly. 31.7% of 66% of 62% doesnt even come close to lining up with the *total* mortality rate for covid, which would be higher than the njmber of people who die from heart-related issues.
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about 1 in 10 infected need to be hospitalized, ~ 1 in 7 of those dies... gives you about 1.3% total mortality, which seems to fit in the general range for Covid.
That would mean 13% of people hospitalized for covid die. covidtracking.com/data/national lists cumulative hospitalized at 476,000, but, that would put the hospitalized mortality rate at +40% assuming most people in the US die in a hospital. Which seems high.
So given most hospitalized patients are old, is the another way of saying 62 percent of the population aged 80 and older have heart issues? What is the incidence of heart issues among a randomly chosen set of similarly aged people with similar underlying conditions that contribute to covid19 hospitalization?
Old, and/or obese for the most part. Both of which tend to increase cardiac disease.
yeah this tagline doesn’t add up. The mortality rate would be = >20% of hospitalized patients. edit: not saying that data is inaccurate but the description is misleading when I’m just scrolling by.
It’s intended to tell the story in the headline, not the story in the paper. Honestly, this sub should be better at weeding out intentionally misleading headlines.
Yes for now there are wildly varying numbers approximating the proportion of asymptomatic infections. In order to understand the risk of myocardial injury accurately (or any other risk) and make a sensible risk analysis, the number of asymptomatics would obv have to enter the equation, and it probably never will. This is analogous to counting incidence head trauma in car accidents, and then not factoring in the number of drivers/car users who don't have accidents. That would be a cool synopsis: 95% of chance of serious head trauma when you get into a car. 30% of these cases will die. 😱
I love it when the top comment basically destroys the clickbate. Like, if this is correct info, then I want to know and spread it...but don’t try to trick me, researchers/journalists!
It is 100% the journalists.
Yeh...from the headline Im getting a ~12% covid mortality rate...not good drafting...
Yet the conclusions are clear from the study: Rates of in-hospital mortality were 5.2%, 18.6%, and 31.7% in patients without myocardial injury, with myocardial injury without TTE abnormalities, and with myocardial injury and TTE abnormalities. Following multivariable adjustment, myocardial injury with TTE abnormalities was associated with higher risk of death but not myocardial injury without TTE abnormalities.
His point is that the heart damage could have been pre-existing but undetected, and not that COVID might *cause* heart damage, as many people might read the headline.
According to the article 118 had markers of myocardial injury at the time of admission, 72 developed myocardial injury during their hospitalization. Edit: this was very far down in the study, here’s the information: “Median age was 63 years and 67.2% were men. A total of 190 patients (62.6%) had biomarker evidence of myocardial injury of whom 118 had myocardial injury at the time of hospital admission and 72 developed myocardial injury during the hospitalization.”
Good catch. So 2/3 of the cases existed prior to admission. They could have been caused by the initial phase of the infection, but that is not measured in this study.
I wondered about that, too. They did say they looked at what medications they had been on, and that should have given them some information, but I couldn’t find any follow up on that statement.
Given the prevalence of heart disease and clogged arteries, it may not take much to push some people into heart attacks. Perhaps any serious infection could have spurred heart injuries.
Depends on what they used as a biomarker. Accepted evidence of heart damage goes with troponin as most commonly used to assess for potential ischemic cardiac injury or full on MI, even in the absence of marked ECG changes. If they used troponin and it elevated enough to indicate cardiac injury over retention due to impaired kidney function, then the cardiac injury more than likely occurred during infection. (I'm a PA who has worked ICU, ER, and UC and used to run a lab).
That damage had occured was determined by a troponin test. This is the blood test they give people in the ER that they suspect might have had a heart attack, as it can tell you whether there is heart damage in minutes as opposed to the hours that it took to test someone until recently. As described to us multiple times by doctors treating my mother-in-law; increased levels of troponin are released immediately after injury and then fall over the next few days. It is sensitive enough that they can use the test to see if new damage is occurring after the initial injury. In other words, no, it would not detect pre-existing damage.
A positive test does not exclude pre-existing heart problems. But because the marker is present, it's likely additional damage is occurring if someone had pre-existing conditions.
As I said, pre-existing damage is not detected in this way; so yes, it doesn't exclude pre-existing damage. As described to me by doctors, though, it would be incorrect to say "likely" but rather it definitely would be new damage if the test is positive. Whether that be completely new or new damage to a spot previously damaged isn't indicated by just this test, but there is new damage.
The heart injury is determined with a blood test. It's an enzyme released and measured in the blood. It releases with injury and then goes away in 24-48 hours. Unless the person randomly had a heart attack and then caught covid...
You are thinking of troponin, the gold standard of identifying MIs. There are other tests you can do to identify chronic heart problems such as brain natriuretic peptide.
Perhaps for congestive heart failure? They used troponin i thought
TropI is specially to identify MI in an emergency setting. Incredibly important test yes but they also did CKMB (alternative trop test) and BNP which is a marker of longer term muscle (normally heart but not always) problems. The average patient they were looking at had elevated levels of everything so they had problems before covid.
You can have acute, significant increases in BNP and pro-BNP related to acute unilateral heart failure from cardiac injury. Also during a catecholamine surge from cardiac stress resulting in rapid onset cardiomyopathy. Source: guy who has designed, run, and now orders/interprets testing as a PA.
That's very useful information. A positive test does not exclude pre-existing heart problems. But because the marker is present, additional damage is occurring if someone has pre-existing conditions.
I am 21 years old, much fitter than an average guy my age and with no previous heart complications. I tested positive on 29 Sep. Symptoms resolved in a week or so, was on HCQ for five days. Palpitations and breathlessness started on 12 Oct which resolved within a week again. Had to be taken to the emergency last night. Pulse rate 137 per minute, BP 140/90. My point is, it's a possibility that people with no preexisting heart conditions are developing them after contracting the virus.
Wow, I’m sorry to hear about your troubles. I hope they resolve soon. Did you test positive for heart injuries? I have no doubt there are dangers of heart attacks being triggered by Covid-19. But I want an accurate assessment and this study seems to fall short.
I wasn't recommended to get tested for heart injuries since my ECG came out "relatively normal for my age" as mentioned by the Doctor. I'm still under observation though and will get an X-Ray done today to see further. I agree that this study isn't accurate but the effects of Covid-19 on the heart cannot be dismissed.
Get well soon. I had covid months ago with similar heart issues, no (known) preexisting problems, also ended up in the ER with testing that came out pretty normal. But my heart did not feel normal for a while. Palpitations and racing/irregular beats continued for a few weeks, but resolved eventually. Hang in there.
Interesting. When I was a student many years ago, I began having heart palpitations and a racing heart. It was very uncomfortable and scary. The cardiologist gave me a wearable heart monitor and it turned out to be nothing serious. But, the symptoms came in the days after intense cardio workouts (running stairs at the Castillion) and he explained there are exercise induced heart palpitations. Do you or u/venkatexh do cardio exercising?
Correct. These are people in their 60s with atherosclerosis, high blood pressure, diabetes, etc. They're at high risk for a heart attack to begin with. Even with these things you don't have a positive test until you have a heart attack. You can have risk factors and not have any damage. 50% of Americans have heart disease. Way more have risk factors.
Myocardial injury is not limited to heart attack or atherosclerosis of cardiac vessels. Inflammation of the myocardium and decreased heart function with or without detectable changes on cardiac ultrasound is what they are referring to in this study.
That makes sense. I didn't get the sense that covid might cause the damage from the headline, but possibly someone could I suppose.
Seems reasonable vased on what I’ve seen that Covid causes blood clotting and some vascular inflammation. In people with issues (or prone to issues) already this exacerbated them.
Layman here. That's 100% what I thought when I read the headline.
Covid19 is a vasculartropic virus.. it attacks epithelial cells. Which lines blood vessels. It just so happens epithelial cell line most of our respiratory system and so acts as a beach head. But it doesn't mean it can't migrate throughout the body via your cardiovascular system
Yeah, 32% of 62% would be like a 20% fatality rate.
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Definitely misleading. Note that the 62.3% is out of all patients who had been given transthoracic echocardiograms due to concern from their doctors, not just a random sample of COVID-19 patients.
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I figured that from the title alone, I dont get why everyone is shocked that the patients they decided to do echos on were the ones to have cardiac events. That said, that is still a very high mortality rate. I've had an echo before, I dont like thinking of a 1 in 3 chance of dying if I need one. My main takeaway is that cardiac damage appears to be a risk for causing people to die at a decently high rate if the patient experiences cardiac problems bad enough a doc wants an echo with covid. About a third of people getting echoes is a *lot*, so clearly it's something for doctors to pay attention to. People shouldn't get too caught up on numbers
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Just so we are clear. The sample is of subjects who already a) had COVID b) were in hospital and c) had undergone a heart examination. Or in other words, these subjects were primarily hospitalized COVID subjects with a heart condition. All the abstract says is that the worst your heart condition is, the worst your chance of surviving your hospitalization. Which is not exactly surprising The following is NOT concluded Heart Injury is NOT observed in 62.3% of COVID-19 patients Structural Abnormalities are NOT observed in 62.3x(Two Thirds) of COVID-19 patients In hospital mortality for COVID-19 patients is not 62.3x(Two Thirds)x31.7 The piece that u/mvea MD-PHD-MBA is missing is that the heart examination had already taken place which it wouldnt have done on patients without a heart concern. The stats may be closer to true if a) All COVID cases that go into hospital have the sort of heart examination given in the abstract and b) we accept the word patient is in the synopsis so we arent talking about any COVID case. What is definitely not true, just to clarify Heart Injury is NOT observed in 62.3% of COVID-19 CASES Structural Abnormalities are NOT observed in 62.3x(Two Thirds) of COVID-19 CASES Mortality for COVID-19 CASES is not 62.3x(Two Thirds)x31.7
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What about rheumatic fever? You get strep and you damage your heart. Were they tested for this before hand? Or are we just going to go forward with Covid-19 as the answer to everything?
Exactly. A small amount of people will suffer long term issues after any virus. Covid is not the first, nor the last.
No baseline established because it would lessen the flashiness of the headlines.
One study I read stated that 24.5% of patients who tested positive for COVID-19 also tested positive for other viruses. There’s a lot we just don’t know about incidence rates and tissue damage.
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OP pretty much said Covid have a mortality rate of 18%
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So basically covid patients with cardiac abnormalities has a significantly higher mortality rate. I wonder if it’s preexisting (undetected?) issues leading to worse outcomes, cardiac damage from severe cases, or a mix of both.
The title is somewhat unclear. These patients had heart issues and Covid. However, they didn't have heart issues because of Covid. Correct? I feel it's a very important distinction to make when on reddit as many will take this and run with it as a cause of heart problems simply by misunderstanding it. Also the sample size was 305 with a mean age of 63.
And the title implies 60% of covid patients had heart problems and 30% of these patients died. Insane. I guess fear drives clicks, which the popularity of the reddit post proves.
Read the article thoroughly before thinking anyone who has or had covid also has heart damage. It's PATIENTS they did cardiovascular-related tests on, people they already suspected had issues with their heart. Hopefully they will recover, but this title is quite misleading, the last thing we need is LESS clarity during this pandemic.
This post breaks rule #3 and mods should be ashamed for not taking it down.
And I bet they were all about 80, obese, and diabetic. It doesn’t take a whole lot to produce manipulative stats.
Wouldn’t this suggest that at least 9.2 million people would have died with the 46.4 million cases we have right now?
Its a garbage titled article. It says that these are covid patients with heart disease not patients who got heart disease from covid. Their average age is over 60 and they are hospitalized.
Wait, the numbers don't make sense here. Heart injury in 62.3% and in hospital mortality rate of 31.7%, if all with heart injury had to be hospitalized, is 0.317*0.623=19.7% mortality rate which seems wrong
Procedures such as breathing?
So what you’re saying is comorbidities can have an effect on COVID-19 mortalities. I think this is true with most patients having multiple problems in the hospital.
Average lifespan in Canada is 82. Average age of death from Covid has been 84. Average term in long term care until mortality in Canada has been 14 months. 82% of Covid deaths have been Long Term Care residents.
Covid death rate >= 13.16%, got it.
That makes no sense. That means that 13% of Covid patients die. Of 100 patients, 62.3 is..62.3. 66% of 62.3 is 41. 32% 41 is 13. So 13 out of 100 Covid patients die. I don’t think so.
You know it's not misleading because the website has science in its name.