Key result
Recovered COVID-19 patients had significantly higher myocardial T1 (1284 vs 1147.6 ms; P<0.0001) and T2 values compared to healthy controls, with abnormal CMR findings in 53.3% of patients.
Why the study?
Cardiac involvement needed evaluation in patients who had recovered from COVID-19 using cardiac MRI.
Does cardiac magnetic resonance imaging detect persistent cardiac involvement in patients recovered from COVID-19 with abnormal global longitudinal strain compared to healthy controls?
Observational (n=50)
Does cardiac magnetic resonance imaging detect persistent cardiac involvement in patients recovered from COVID-19 with abnormal global longitudinal strain compared to healthy controls?
Absolute Event Rate: 1284% vs 1147.6%
p-value: p=<0.0001
Cardiac MRI reveals that over half of patients recovered from COVID-19 with abnormal global longitudinal strain have myocardial involvement, which persists in a quarter of these patients at 6 months.
May signal subclinical myocardial involvement post-COVID; leaves open need for prospective outcome studies before clinical adoption.
Objective: To evaluate for cardiac involvement in recovered COVID-19 patients using cardiac magnetic resonance imaging (MRI). Methods: A total of 30 subjects recently recovered from COVID-19 and abnormal left ventricular global longitudinal strain were enrolled. Routine investigations, inflammatory markers and cardiac MRI were done at baseline with follow-up scan at 6 months in individuals with abnormal baseline scan. Additionally, 20 age-and sex-matched individuals were enrolled as healthy controls (HCs). Results: All 30 enrolled subjects were symptomatic during active COVID-19 disease and were categorized as mild: 11 (36.7%), moderate: 6 (20%) and severe: 13 (43.3%). Of the 30 patients, 16 (53.3%) had abnormal CMR findings. Myocardial edema was reported in 12 (40%) patients while 10 (33.3%) had LGE. No difference was observed in terms of conventional LV parameters however, COVID-19 recovered patients had significantly lower right ventricular (RV) ejection fraction, RV stroke volume and RV cardiac index compared to HCs. Follow-up scan was abnormal in 4/16 (25%) with LGE persisting in 3 patients. Myocardial T1 (1284 + 43.8 ms vs 1147.6 + 68.4 ms; P<0.0001) and T2 values (50.8+16.7 ms vs 42.6+3.6 ms; P=0.04) were significantly higher in post COVID-19 subjects compared to HCs. Similarly, T1 and T2 values of severe COVID-19 patients were significantly higher compared to mild and moderate cases. Conclusions: An abnormal CMR was seen in half of recovered patients with persistent abnormality in one-fourth at six months. Our study suggests a need for closer follow-up among recovered subjects in order to evaluate for long term cardiovascular sequalae.
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Gupta et al. (2022) conducted an observational in COVID-19 recovery with abnormal left ventricular global longitudinal strain (n=50). COVID-19 infection vs. Healthy controls was evaluated on Myocardial T1 value (ms) (p=<0.0001). Recovered COVID-19 patients had significantly higher myocardial T1 (1284 vs 1147.6 ms; P<0.0001) and T2 values compared to healthy controls, with abnormal CMR findings in 53.3% of patients.
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