Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank

Raisi‐Estabragh, Zahra; McCracken, Celeste; Fung, Kenneth; Paiva, José Miguel; Khanji, Mohammed Y; Rauseo, Elisa; Biasiolli, Luca; Raman, Betty; Neubauer, Stefan; Munroe, Patricia B.; Harvey, Nicholas C; Petersen, Steffen E.

doi:10.1007/s40520-021-01808-z

Cited by 19 publications

(19 citation statements)

References 39 publications

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“…In addition, none of included studies performed baseline cardiac MRI examination; In this regard, Raisi‐Estabragh et al showed that pre‐existing cardiac MRI abnormalities is associated with greater odds of SARS‐CoV‐2 positivity, independent of cardiovascular risk factors. 57 They concluded that cardiovascular involvement after COVID‐19 may reflect pre‐existing cardiac status rather than COVID‐19‐related cardiac abnormalities. Also, available evidence failed to provide information on correlation of detected cardiac MRI abnormalities with clinical outcomes at long term.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Magnetic Resonance Imaging Findings in 2954 COVID‐19 Adult Survivors: A Comprehensive Systematic Review

Hassani

Talakoob

Karim

et al. 2021

Magnetic Resonance Imaging

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Background Recent studies have utilized MRI to determine the extent to which COVID‐19 survivors may experience cardiac sequels after recovery. Purpose To systematically review the main cardiac MRI findings in COVID‐19 adult survivors. Study type Systematic review. Subjects A total of 2954 COVID‐19 adult survivors from 16 studies. Field Strength/sequence Late gadolinium enhancement (LGE), parametric mapping (T1‐native, T2, T1‐post (extracellular volume fraction [ECV]), T2‐weighted sequences (myocardium/pericardium), at 1.5 T and 3 T. Assessment A systematic search was performed on PubMed, Embase, and Google scholar databases using Boolean operators and the relevant key terms covering COVID‐19, cardiac injury, CMR, and follow‐up. MRI data, including (if available) T1, T2, extra cellular volume, presence of myocardial or pericardial late gadolinium enhancement (LGE) and left and right ventricular ejection fraction were extracted. Statistical Tests The main results of the included studies are summarized. No additional statistical analysis was performed. Results Of 1601 articles retrieved from the initial search, 12 cohorts and 10 case series met our eligibility criteria. The rate of raised T1 in COVID‐19 adult survivors varied across studies from 0% to 73%. Raised T2 was detected in none of patients in 4 out of 15 studies, and in the remaining studies, its rate ranged from 2% to 60%. In most studies, LGE (myocardial or pericardial) was observed in COVID‐19 survivors, the rate ranging from 4% to 100%. Myocardial LGE mainly had nonischemic patterns. None of the cohort studies observed myocardial LGE in “healthy” controls. Most studies found that patients who recovered from COVID‐19 had a significantly greater T1 and T2 compared to participants in the corresponding control group. Data Conclusion Findings of MRI studies suggest the presence of myocardial and pericardial involvement in a notable number of patients recovered from COVID‐19. Level of Evidence 3 Technical Efficacy Stage 3

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Section: Discussionmentioning

confidence: 99%

Cardiac Magnetic Resonance Imaging Findings in 2954 COVID‐19 Adult Survivors: A Comprehensive Systematic Review

Hassani

Talakoob

Karim

et al. 2021

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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“…Future studies with standardized CMR protocols are needed to evaluate the longer-term (1 year or more) effect of COVID-19 disease on the heart. Because of the high sensitivity of CMR for myocardial scar (particularly in patients with cardiovascular risk factors and pre-existing cardiovascular disease), these longer-term follow-up studies should include carefully matched risk factor control groups ( 46 ).…”

Section: Cmr Of Acute and Convalescent Patients With Covid-19mentioning

confidence: 99%

Cardiovascular Magnetic Resonance for Patients With COVID-19

Petersen

Friedrich

Leiner

et al. 2022

JACC: Cardiovascular Imaging

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COVID-19 is associated with myocardial injury caused by ischemia, inflammation, or myocarditis. Cardiovascular magnetic resonance (CMR) is the noninvasive reference standard for cardiac function, structure, and tissue composition. CMR is a potentially valuable diagnostic tool in patients with COVID-19 presenting with myocardial injury and evidence of cardiac dysfunction. Although COVID-19–related myocarditis is likely infrequent, COVID-19–related cardiovascular histopathology findings have been reported in up to 48% of patients, raising the concern for long-term myocardial injury. Studies to date report CMR abnormalities in 26% to 60% of hospitalized patients who have recovered from COVID-19, including functional impairment, myocardial tissue abnormalities, late gadolinium enhancement, or pericardial abnormalities. In athletes post–COVID-19, CMR has detected myocarditis-like abnormalities. In children, multisystem inflammatory syndrome may occur 2 to 6 weeks after infection; associated myocarditis and coronary artery aneurysms are evaluable by CMR. At this time, our understanding of COVID-19–related cardiovascular involvement is incomplete, and multiple studies are planned to evaluate patients with COVID-19 using CMR. In this review, we summarize existing studies of CMR for patients with COVID-19 and present ongoing research. We also provide recommendations for clinical use of CMR for patients with acute symptoms or who are recovering from COVID-19.

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“…While the numbers are small, our post hoc exploration of hospitalised vs. non-hospitalised cases provides some evidence that baseline characteristics may determine susceptibility or the course of infection. An earlier preliminary report of relationships between CMR imaging measures from the UK Biobank volunteers at first imaging assessments and likelihood of subsequent SARS-CoV-2 infection also suggested that people with adverse CMR phenotypes have a higher likelihood of SARS-CoV-2 infection, independent of classical cardiovascular risk factors 24 . Other possible explanations of our largely negative findings are that the cases were predominantly milder (not involving hospitalisations) or that CMR abnormalities after infection may be reversible in part (and thus dependent on timing of observations with respect to the acute disease), e.g., lower ventricular circumferential or radial strain measures for COVID patients < 8 weeks after recovery from the acute infection than those for > 8 weeks was reported recently 25 .…”

Section: Discussionmentioning

confidence: 96%

Longitudinal Changes of Cardiac and Aortic Imaging Phenotypes Following COVID-19 in the UK Biobank Cohort

Bai

Raman

Peterson

et al. 2021

Preprint

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Case studies conducted after recovery from acute infection with SARS-CoV-2 have frequently identified abnormalities on CMR imaging, suggesting the possibility that SARS-CoV-2 infection commonly leads to cardiac pathology. However, these observations have not been able to distinguish between associations that reflect pre-existing cardiac abnormalities (that might confer a greater likelihood of more severe infection) from those that arise as consequences of infection. To address this question, UK Biobank volunteers (n=1285; 54.5% women; mean age at baseline, 59.8 years old; 96.3% white) who attended an imaging assessment including cardiac magnetic resonance (CMR) before the start of the COVID-19 pandemic were invited to attend a second imaging assessment in 2021. Cases with evidence of previous SARS-CoV-2 infection were identified through linkage to PCR-testing or other medical records, or a positive antibody lateral flow test; n=640 in data available on 22 Sep 2021) and were matched to controls with no evidence of previous infection (n=645). The majority of these infections were milder and did not involve hospitalisation. Measures of cardiac and aortic structure and function were derived from the CMR images obtained on the cases before and after SARS-CoV-2 infection from images for the controls obtained over the same time interval using a previously validated, automated algorithm. Cases and controls had similar cardiac and aortic imaging phenotypes at their first imaging assessment. Changes between CMR imaging measures in cases before and after infection were not significantly different from those in the matched control group. Additional adjustment for comorbidities made no material difference to the results. While these results are preliminary and limited to imaging metrics derived from automated analyses, they do not suggest clinically significant persistent cardiac pathology in the UK Biobank population after generally milder (non-hospitalised) SARS-CoV-2 infection.

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Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank

Cited by 19 publications

References 39 publications

Cardiac Magnetic Resonance Imaging Findings in 2954 COVID‐19 Adult Survivors: A Comprehensive Systematic Review

Cardiac Magnetic Resonance Imaging Findings in 2954 COVID‐19 Adult Survivors: A Comprehensive Systematic Review

Cardiovascular Magnetic Resonance for Patients With COVID-19

Longitudinal Changes of Cardiac and Aortic Imaging Phenotypes Following COVID-19 in the UK Biobank Cohort

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