> Details

Nägele, Felix; Graber, Michael; Hirsch, Jakob; Pölzl, Leo; Sahanic, Sabina; Fiegl, Manuel; Hau, Dominik; Engler, Clemens; Lechner, Sophia; Stalder, Anna Katharina; Mertz, Kirsten D.; Haslbauer, Jasmin D.; Tzankov, Alexandar; Grimm, Michael; Tancevski, Ivan; Holfeld, Johannes; Gollmann-Tepeköylü, Can

Correlation between structural heart disease and cardiac SARS-CoV-2 manifestations

Reference
management

Bookmarks

Remove from
bookmarks

Share this on Whatsapp

Close

Bookmarks



You can manage bookmarks using lists, please log in to your user account for this.
  • Media type: E-Article
  • Title: Correlation between structural heart disease and cardiac SARS-CoV-2 manifestations
  • Contributor: Nägele, Felix; Graber, Michael; Hirsch, Jakob; Pölzl, Leo; Sahanic, Sabina; Fiegl, Manuel; Hau, Dominik; Engler, Clemens; Lechner, Sophia; Stalder, Anna Katharina; Mertz, Kirsten D.; Haslbauer, Jasmin D.; Tzankov, Alexandar; Grimm, Michael; Tancevski, Ivan; Holfeld, Johannes; Gollmann-Tepeköylü, Can
  • imprint: Springer Science and Business Media LLC, 2022
  • Published in: Communications Medicine
  • Language: English
  • DOI: 10.1038/s43856-022-00204-6
  • ISSN: 2730-664X
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background:</jats:title> <jats:p>The prognosis of COVID-19 patients with cardiac involvement is unfavorable and it remains unknown which patients are at risk. The virus enters cells via its receptor angiotensin-converting enzyme 2 (ACE2). Myocardial ACE2 expression is increased in structural heart disease (SHD). We, therefore, aimed to analyze correlations between structural heart disease and cardiac SARS-CoV-2 manifestation.</jats:p> </jats:sec><jats:sec> <jats:title>Methods:</jats:title> <jats:p>The clinical course of COVID-19 in patients with structural heart disease was assessed in a prospective cohort of 152 patients. The primary endpoints consisted of hospitalization and survival. Cardiac tissue of 23 autopsy cases with lethal COVID-19 course was obtained and analyzed for (a) the presence of SHD, (b) myocardial presence of SARS-CoV-2 via RT,-PCR, and (c) levels of ACE2 expression using immunofluorescence staining.</jats:p> </jats:sec><jats:sec> <jats:title>Results:</jats:title> <jats:p>Structural heart disease is found in 67 patients, of whom 56 (83.60%) are hospitalized. The myocardium is positive for SARS-CoV-2 in 15 patients (65%) in 23 autopsy cases of lethal COVID-19. Moreover, most hearts with evidence of myocardial SARS-CoV-2 have structural heart disease [11 (91,67%) vs. 1 (8,33%), <jats:italic>p</jats:italic> = 0.029]. Myocardial presence of SARS-CoV-2 is correlated with a significant downregulation of ACE2 compared to negative control hearts (6.545 ± 1.1818 A.U. vs. 7.764 ± 2.411 A.U., <jats:italic>p</jats:italic> = 0.003). The clinical course of patients with cardiac SARS-CoV-2 manifestation is unfavorable, resulting in impaired survival (median, 12 days and 4.5 days, respectively, HR 0.30, 95% CI, 0.13 to 0.73, <jats:italic>p</jats:italic> = 0.0005)</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>We provide evidence for a correlation between SHD, altered ACE2 receptor expression, and cardiac SARS-CoV-2 manifestation. Consequently, structural heart disease may be considered a distinct risk factor for a severe clinical course after infection with SARS-CoV-2.</jats:p> </jats:sec><jats:sec> <jats:title>Registration number local IRB:</jats:title> <jats:p>Ethics Committee of Northwestern and Central Switzerland ID 2020-00629; Ethics Committee of the Medical University Innsbruck EK Nr: 1103/2020.</jats:p> </jats:sec><jats:sec> <jats:title>ClinicalTrials.gov number:</jats:title> <jats:p>NCT04416100.</jats:p> </jats:sec>
  • Access State: Open Access