A recent retrospective study of HCM patients with COVID-19 concluded that HCM patients are at increased risk of hospitalization and death from a COVID-19 infection.
In particular, the study found that the following groups of HCM patients were at increased risk of adverse complications from COVID-19:
- patients with the obstructive form of HCM
- patients with left ventricular systolic dysfunction
- older patients
- patients who also have other high risk conditions for COVID-19 such as hypertension, diabetes, obesity or those who are smokers
Based on this data, the researchers suggest “the need for aggressive and systematic implementation of prophylactic measures for SARS-COV-2 in patients with inherited cardiac disease.”
At this time, such measures include vaccinations, masking, and therapeutic agents such as Paxlovid and monoclonal antibodies.
IMPORTANT NOTE: This study finished enrollment just as COVID-19 vaccines became available. Hence, these results do not take into account the effect of vaccinations or newer COVID-19 therapeutics such as Paxlovid.
Researchers in Norway have demonstrated that patients who carry a HCM gene show reduced cardiac volume when compared to healthy individuals. Patients with overt HCM show even further reduction to their cardiac volume than those who merely carry the gene.
Although the gene positive individuals lacked the characteristic left ventricular wall thickening of HCM, diastolic and systolic volumes were reduced when compared to healthy individuals. Hence, the researchers concluded that a person who is gene positive for the disease may show reduced volume before developing hypertrophy.
The study included 180 patients with left ventricular hypertrophy, 100 patients who carried the HCM gene but did not show signs of left ventricular hypertrophy, and 80 healthy individuals.
The researchers theorize that early changes in HCM result from the gradual stiffening of the left ventricle, which contributes to filling changes before anatomical thickening is apparent. These changes will likely worsen as the disease progresses.
The researchers suggest future long term studies of gene positive individuals with small cardiac volume who show signs of diastolic and systolic dysfunction. These patients, they suggest, are the most likely to go on to develop HCM.