Impression COVID Study

Cardiac Involvement in Patients Recovered from COVID-19

Overview

The Impression COVID Study is an observational longitudinal outcome study investigating cardiac involvement in patients with recent COVID-19 infection and no previously known heart disease or comorbidities.

Background

Early in the COVID-19 pandemic, cardiac involvement was recognized as a potential complication. This study was designed to systematically assess cardiac structure and function using cardiovascular magnetic resonance imaging in recovered COVID-19 patients.

Study Design

  • Design: Prospective observational cohort study
  • Enrollment: 100 patients recently recovered from COVID-19
  • Recruitment period: April - June 2020
  • Source: University Hospital Frankfurt COVID-19 Registry
  • Inclusion criteria: Recent COVID-19 infection, no previously known heart disease

Patient Characteristics

  • 53% male
  • Mean age: 49 years (SD 14)
  • Median time from COVID-19 diagnosis to CMR: 71 days (IQR 64-92)
  • Severity: Range from asymptomatic to hospitalized (33% required hospitalization)

Key Findings

Baseline Assessment

  • Cardiac involvement: 78% of patients showed abnormalities on CMR
  • Ongoing myocardial inflammation: 60% of patients
  • Findings independent of: Pre-existing conditions, illness severity, time from diagnosis

Follow-up Results

  • 73% of patients reported cardiac symptoms at baseline
  • 57% continued to experience symptoms at follow-up
  • Mild but persistent non-ischemic cardiac inflammation observed
  • No association with overt structural heart disease or significant troponin release

Clinical Implications

These findings indicate the need for ongoing investigation of long-term cardiovascular consequences of COVID-19, leading to the initiation of the MYOFLAME-19 treatment trial.

Publications

  1. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, Shchendrygina A, Escher F, Vasa-Nicotera M, Zeiher AM, Vehreschild M, Nagel E. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol 2020;5(11):1265-1273. Read article

  2. Puntmann VO, Martin S, Shchendrygina A, et al. Long-term cardiac pathology in individuals with mild initial COVID-19 illness. Nat Med 2022. Read article

Media Coverage

The study received significant international attention and was covered by major news outlets worldwide, highlighting the importance of understanding COVID-19’s cardiac effects.

Principal Investigators

  • PD Dr. Valentina O. Puntmann — University Hospital Frankfurt
  • Prof. Dr. Eike Nagel — University Hospital Frankfurt

Funding

  • German Centre for Cardiovascular Research (DZHK)
  • Goethe University Frankfurt