Myocardial injury among U.S. service members recovering from COVID-19

Abstract: Background: Coronavirus disease 2019 (COVID-19) has been a major source of morbidity and mortality worldwide. Long-COVID and individuals with continued cardiorespiratory symptoms after COVID-19 infection remains a poorly understood disease process. It has been hypothesized that COVID-19 infection even in the absence of critical illness and significant comorbidities may cause myocardial injury, potentially explaining these ongoing symptoms, but this has not been definitively shown in the literature. Methods: 36 healthy active-duty service members with no cardiac or pulmonary medical comorbidities and persistent cardiopulmonary symptoms following COVID-19 infection were recruited. Subjects were evaluated for potential myocardial injury with laboratory testing (troponin-T, microRNA), electrocardiogram, transthoracic echocardiography, and cardiac magnetic resonance imaging. 16 asymptomatic healthy control subjects with no cardiac or pulmonary disease unfervent the same testing and served as the control arm. Patients in the comparison group either had no history of COVID-19 infection, or a prior history of COVID-19 infection without cardiovascular symptoms during or after the infection. Results: The study cohort had a median age of 32 years, 63% were men, 67% were white race, and 63% were fully vaccinated against COVID-19 prior to their initial infection. None of the subjects in the cohort exhibited elevated serum troponin-T or microRNA levels indicative of myocardial injury. There were no statistically significant differences in the median left or right ventricular systolic function or chamber dimensions, median left ventricular strain, myocardial work indices, or median T1 or T2 parametric times as assessed by echocardiography and magnetic resonance imaging between the subjects in the two study arms. Conclusion: This prospective cohort study found no evidence of myocardial injury amongst healthy subjects with persistent cardiopulmonary symptoms after COVID-19 infection. No differences were observed in imaging parameters or microRNA data between the study cohort and the asymptomatic control arm.

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