Key result
CMR-confirmed COVID-19-associated myocarditis was associated with a significantly higher prevalence of pleural effusion (12.9% vs 0%) and a lower prevalence of ground glass opacities (25.8% vs 55.0%) on thoracic CT compared to patients without myocarditis.
Why the study?
The study aimed to determine whether patients at risk for COVID-19-associated myocarditis could be recognized on thoracic CT by comparing thoracic CT and laboratory findings with controls.
Do thoracic CT findings differ between COVID-19 patients with and without CMR-confirmed myocarditis?
Observational (n=51)
No
Do thoracic CT findings differ between COVID-19 patients with and without CMR-confirmed myocarditis?
Absolute Event Rate: 12.9% vs 0%
p-value: p=0.040
Pleural and pericardial effusion on thoracic CT may serve as an alert for myocarditis in COVID-19 patients, even in the absence of distinct lung involvement.
May flag myocarditis in COVID-19 via CT effusions; cross-sectional data leave open prospective validation.
Introductıon: It is known that human coronaviruses cause myocarditis, and during the pandemic, a series of coronavirus disease (COVID-19) related myocarditis cases have been reported.It is stated that cardiac magnetic resonance (CMR) has a specificity of up to 91% and a sensitivity of 67% for the diagnosis of myocarditis.The present study aims to determine whether patients at risk for myocarditis might be recognized on thoracic CT, comparing thoracic computed tomography (CT) and laboratory findings of patients with COVID-19-associated myocarditis that can be a significant consequence for COVID-19 patients and controls.Methods: The study included 51 patients with elevated troponin levels, CMR, and suspected myocarditis to meet this aim.As a result of the evaluation, while myocarditis findings such as a signal change in myocardial contrast involvement on T1 and T2 weighted images and contrast involvement in myocarditis in post-contrast series were detected in 31 patients, no abnormality was detected in the CMRs of 20 patients Results: When the thoracic CT findings of the groups were compared, no significant difference was detected in the volumetric evaluations of infiltration frequency, distribution, lateralization, lobar involvement, and lung involvement.No infiltration related to COVID-19 was observed in most of the patients in both groups.Pleural and pericardial effusion were more frequently observed in the group with myocarditis.Conclusion: The present study revealed that myocardial involvement can occur without COVID-19-related distinct lung involvement and that pleural-pericardial effusion can be an alert for myocarditis diagnosis.
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Köksal et al. (2023) conducted an observational in COVID-19 associated myocarditis (n=51). COVID-19 associated myocarditis vs. COVID-19 patients with suspected myocarditis but normal CMR was evaluated on Pleural effusion on thoracic CT (p=0.040). CMR-confirmed COVID-19-associated myocarditis was associated with a significantly higher prevalence of pleural effusion (12.9% vs 0%) and a lower prevalence of ground glass opacities (25.8% vs 55.0%) on thoracic CT compared to patients without myocarditis.
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