Multimodality Cardiac Imaging, Cardiac Symptoms, and Clinical Outcomes in Patients Who Recovered from Mild COVID-19

Background Many individuals have persistent cardiac symptoms after mild COVID-19 infection. However, studies assessing the relationship between symptoms and cardiac imaging are limited. Purpose To assess the relationship between multimodality cardiac imaging parameters, cardiac symptoms, and clinical outcomes in patients who recovered from mild COVID-19 compared with COVID-19–negative controls. Materials and Methods Patients who underwent polymerase chain reaction testing for SARS-CoV-2 from August 2020 to January 2022 were invited to participate in this prospective single-center study. Participants underwent cardiac MRI, echocardiography, and assessment of cardiac symptoms at 3–6 months after SARS-CoV-2 testing. Cardiac symptoms and outcomes were also evaluated at a 12–18-month follow-up time point. Statistical analysis included the Fisher exact test and logistic regression. Results This study included 122 participants who recovered from COVID-19 (mean age, 42 years ± 13 [SD]; 73 female) and 22 controls who tested negative for COVID-19 (mean age, 46 years ± 16; 13 female). At 3–6 months, 20% (24 of 122) and 44% (54 of 122) of participants with COVID-19 had at least one abnormality at echocardiography and cardiac MRI, respectively, which did not differ compared with controls (23% [five of 22], P = .77 and 41% [nine of 22], P = .82, respectively). However, participants with COVID-19 more frequently reported cardiac symptoms at 3–6 months compared with controls (48% [58 of 122] vs 23% [five of 22], P = .04). An increase in native T1 (10 msec) was associated with increased odds of cardiac symptoms at the 3–6-month (odds ratio [OR], 1.09 [95% CI: 1.00, 1.19]; P = .046) and 12–18-month (OR, 1.14 [95% CI: 1.01, 1.28]; P = .028) time points. No major adverse cardiac events occurred during follow-up. Conclusion Participants who recovered from mild COVID-19 reported increased cardiac symptoms 3–6 months after diagnosis compared with controls, but the prevalence of abnormalities at echocardiography and cardiac MRI did not differ between groups. Elevated native T1 was associated with cardiac symptoms 3–6 months and 12–18 months after mild COVID-19.