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New research: The coronavirus also attacks the heart

The coronavirus not only damages the lungs but also other organs such as the heart. It can infect heart cells, multiply in them, and alter the cells' gene activity. It could have long-term consequences for the health of those affected. | © Corona Borealis - stock.adobe.com

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A surprising finding by scientists from the University Medical Center Hamburg-Eppendorf (UKE) reveals that the coronavirus can attack the heart and alter the gene activity of infected heart cells. That is the result of a recent study by DZHK scientist Prof. Dr. Dirk Westermann from the Department of Cardiology in cooperation with the Institute of Forensic Medicine at the UKE. The study examined 39 deceased heart patients infected with SARS-CoV-2.

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"Until now, it was not known in how many cases SARS-CoV-2 also affects the heart and - if it does - whether it can multiply in heart cells and cause pathological changes there. With the study results now available, we have much more clarity," says principal investigator Prof. Westermann from the University Heart and Vascular Center Hamburg at the UKE. The researchers were able to detect the coronavirus SARS-CoV-2 in the heart tissue of around two-thirds of the patients examined (24 of 39). In 16 cases, they found the virus in quantities that could have had clinical effects (more than 1,000 virus copies per microgram of RNA). In five patients with the highest virus quantities, the researchers identified the plus and minus strands of the virus genome. "This is the sign that the virus also reproduces in the cell in question," said Prof. Westermann.

No typical signs of myocarditis found

The infection causes changes in the heart cells. However, whether this affects the course of the disease cannot yet be fully clarified. The team of scientists examined the activity of six pro-inflammatory genes more closely. In those 16 patients with the highest viral load, the activity of these genes was significantly increased. "This could have indicated the presence of heart muscle inflammation. Nevertheless, we could not find any typical signs of such an inflammation, such as the mition of inflammatory cells from the surrounding tissue into the heart muscle. Our results support the previous observation that myocardial inflammation associated with COVID-19 occurs only very rarely," explains Prof. Westermann. However, the altered gene activity in the heart cells caused by the infection could have long-term consequences. In order to clarify this, the scientist believes that in the future, mass screenings of living COVID-19 patients will be necessary.

Study patients correspond to typical COVID-19 patients

The deceased patients examined for the study (23 women, 16 men) were, on average, 85 years old. All tested positive for the coronavirus SARS-CoV-2 with a throat swab during their lifetime and developed pneumonia typical for COVID-19. After their death, they were examined by forensic medicine between 8 and 18 April. Scientists took tissue samples for the subsequent genetic tests. "With their pre-existing age-related conditions such as high blood pressure and coronary heart disease, the patients represent the typical COVID-19 patients in Germany," explains Prof. Dr. Stefan Blankenberg, co-author of the study and Medical Director of the University Heart and Vascular Center. "One limitation of our study, however, is that we have so far only been able to examine deceased patients. It will be important in the future to validate these findings on survivors of the disease".

Scientific contact: Prof. Dr. Dirk Westermann, Department of Cardiology
University Medical Center Hamburg-Eppendorf (UKE), d.westermann(at)uke.de

Original publication: Lindner D. et al., Cardiac infection with SARS-CoV-2 in confirmed COVID-19 autopsy cases. Submitted and accepted for publication in the journal "JAMA Cardiology."

Source: Press release University Medical Center Hamburg-Eppendorf