Cardiologist’s Insights From Treating COVID-19 Patients in China
As the number of COVID-19 cases increases throughout the globe, a picture is emerging as to what the direct cardiovascular effects might be and what the indirect impact will be on cardiologists and the patients in their care.
Junbo Ge, MD, FACC, governor of ACC's China chapter and president of the Chinese Cardiovascular Association spoke with TCTMD about what cardiovascular symptoms he saw in patients with the virus and what life looked like on the ground.
Early warnings suggested myocarditis might be one result from COVID-19, but Ge saw "no signs of direct virus infiltration of the myocardium" in an electron microscope specimen he reviewed from Wuhan. Ge did see an elevation of troponin in patients with the virus, indicating myocardial injury, but he said this does not necessarily mean myocarditis.
In two patients Ge tele-consulted, blood tests indicated elevated C-reactive protein, CD4, CD8 and interleukin-6, pointing to an acute inflammatory response. "This inflammation may cause multiorgan damage, not only myocardial damage," he says.
Ge predicts that patients who recover from COVID-19 will have normal heart function. "There may be some evidence of lung fibrosis, but the myocardial injury we're seeing – the troponin and pro-BNP elevation – I believe they will normalize after discharge," Ge says.
As the epidemic peaked in China, Ge's hospital in Shanghai turned away all patients with chronic heart conditions to make room for patients with COVID-19. He tele-consulted clinicians that needed guidance on treating patients with cardiac symptoms in Wuhan. As of last week, his hospital returned to normal functions.
Keywords: Coronavirus, Myocarditis, Troponin, Troponin T, Interleukin-6, C-Reactive Protein, Patient Discharge, Electrons, Myocardium, Inflammation, Heart Diseases, Pulmonary Fibrosis, Hematologic Tests, CD8 Antigens, China, COVID-19
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