Key result
Active COVID-19 infection was associated with acute myocarditis, showing impaired global longitudinal strain, myocardial edema, and gadolinium enhancement on cardiac MRI compared to controls (p<0.01).
Why the study?
Cardiovascular and other extrapulmonary manifestations of COVID-19 emerged alongside ARDS, prompting investigation to detect and evaluate acute myocarditis in patients with active symptomatic infection.
Observational (n=15)
No
p-value: p=< 0,01
Cardiac MRI is an essential tool for detecting and evaluating active myocarditis in patients with symptomatic COVID-19, revealing significant myocardial edema and impaired strain.
Cardiac MRI may identify myocarditis in symptomatic COVID-19; hypothesis-generating and requires larger prospective studies before clinical adoption.
Background: Coronavirus disease 2019 COVID-19 still remains a major cause of morbidity and mortality worldwide, mainly due to Acute Respiratory Distress Syndrome (ARDS). Nevertheless, other extra-pulmonary pathological aspects of COVID-19, notably cardiovascular, were disclosed as the global understanding of the pathogen agent advanced. Objectives: To detect and evaluate acute myocarditis in patients with active and symptomatic COVID-19 infection. Materials and methods: In this prospective analysis, patients presented with active COVID-19 illness and meeting the inclusion criteria were identified at the University Hospital Complex of Rabat between January and September 2021. Results: Fifteen patients (8 males and 7 females) aged from 17 to 52 were included during the analysis period, the average delay between the confirmation of COVID-19 and the onset of myocarditis symptomatology was 17 days. The symptomatology was dominated by chest pain, unexplained cardiogenic shock and palpitations. The ECG showed essentially diffuse repolarization disorders. The inflammatory markers were significantly disturbed with an elevation of ultra-sensitive cardiac troponin I in all patients. Cardiac MRI showed impaired global longitudinal strain (GLS) myocardial edema, early and late subepicardial Gadolinium enhancement, compared to the control group (p < 0,01). Conclusion: Cardiac involvement was detected in a proportion of patients with active COVID-19. Age, gender, clinical and electrical presentations didn't seem to influence the diagnosis. Cardiac MRI played an essential role for detecting and evaluating active myocarditis. Patients who presented myocardial injury had to have a longer follow-up as current understanding of long-term prognosis is still lacking.
No takes yet. Share an insight, caveat, or question.
Bouchaala et al. (2023) conducted an observational in Active and symptomatic COVID-19 infection (n=15). Active COVID-19 infection vs. Control group was evaluated on Cardiac MRI findings (impaired global longitudinal strain, myocardial edema, early and late subepicardial Gadolinium enhancement) (p=< 0,01). Active COVID-19 infection was associated with acute myocarditis, showing impaired global longitudinal strain, myocardial edema, and gadolinium enhancement on cardiac MRI compared to controls (p<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: