CMR assessment of recovered severe COVID-19 patients with troponin elevation reveals limited myocarditis-like injury and a high rate of previously unrecognized ischaemic heart disease, without diffuse oedema or fibrosis.
During convalescence after severe COVID-19 infection with troponin elevation, myocarditis-like injury can be encountered, with limited extent and minimal functional consequence. In a proportion of patients, there is evidence of possible ongoing localized inflammation. A quarter of patients had ischaemic heart disease, of which two-thirds had no previous history. Whether these observed findings represent pre-existing clinically silent disease or de novo COVID-19-related changes remain undetermined. Diffuse oedema or fibrosis was not detected.
Kotecha et al. (2021) studied this question.