MRI and CT coronary angiography in survivors of COVID-19

Singh, Trisha; Kite, Thomas A; Joshi, Shruti; Spath, Nick; Kershaw, Lucy; Baker, Andrew H.; Jordan, Helen; Gulsin, Gaurav S; Williams, Michelle; Beek, Edwin Jacques Rudolph van; Arnold, Jayanth R.; Semple, Scott; Moss, Alastair J; Newby, David E.; Dweck, Marc R; McCann, Gerry P

doi:10.1136/heartjnl-2021-319926

Cited by 28 publications

(34 citation statements)

References 27 publications

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“…Furthermore, we assumed that our patients had no cardiovascular diseases prior to the illness because they had a previous echocardiographic exam performed sometime, but it was in most cases an abbreviated exam, recording only "within normal limits" or "without significant pathological findings", without accurate measurements. Another limitation was that we could not compare our TTE findings with the results of other imagistic examinations, especially with magnetic resonance imaging [35], due to the delay caused by the scheduling of this procedure considering the difficulties raised by the pandemic.…”

Section: Discussionmentioning

confidence: 99%

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Evolution of Echocardiographic Abnormalities Identified in Previously Healthy Individuals Recovering from COVID-19

Tudoran

Cuț

et al. 2022

JPM

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(1) Background: Although the infection with the SARS-CoV-2 virus affects primarily the lungs, it is well known that associated cardiovascular (CV) complications are important contributors to the increased morbidity and mortality of COVID-19. Thus, in some situations, their diagnosis is overlooked, and during recovery, some patients continue to have symptoms enclosed now in the post-acute COVID-19 syndrome. (2) Methods: In 102 patients, under 55 years old, and without a history of CV diseases, all diagnosed with post-acute COVID-19 syndrome, we assessed by transthoracic echocardiography (TTE) four patterns of abnormalities frequently overlapping each other. Their evolution was followed at 3 and 6 months. (3) Results: In 35 subjects, we assessed impaired left ventricular function (LVF), in 51 increased systolic pulmonary artery pressure, in 66 diastolic dysfunction (DD) with normal LVF, and in 23 pericardial effusion/thickening. All TTE alterations alleviated during the follow-up, the best evolution being observed in patients with pericarditis, and a considerably worse one in those with DD, thus with a reduction in severity (4) Conclusions: In patients with post-acute COVID-19 syndrome, several cardiac abnormalities may be assessed by TTE, most of them alleviating in time. Some of them, especially DD, may persist, raising the presumption of chronic alterations.

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Section: Discussionmentioning

confidence: 99%

“…Doppler and considering the right atrial pressure, appreciated by measuring the inferior vena cava diameter and its respiratory variations. In our research, we considered that sPAP values of ≥35 mmHg at rest indicate PH[14,16], with severity ranging from mild(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) to moderate (45-60 mmHg) to severe (>60 mmHg)[17,19]; •…”

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confidence: 99%

Evolution of Echocardiographic Abnormalities Identified in Previously Healthy Individuals Recovering from COVID-19

Tudoran

Cuț

et al. 2022

JPM

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“…Troponin elevation was not an eligibility criterion and renal dysfunction was not an exclusion criterion. Our study stands apart from other studies, including those which had target populations with myocardial injury de ned by troponin elevation (COVID-HEART 49 and COVIDsortium 50 ), retrospective case selection 18,19 or a sample size limiting generalizable conclusions 11 .…”

Section: Discussionmentioning

confidence: 96%

“…At the outset of the COVID-19 pandemic, clinical studies lacked a prospective evaluation of disease pathogenesis and/or health status, and selectively recalled patients 3,7 . Few prospective studies have been reported [8][9][10][11][12] , and multisystem imaging with clinical outcomes and contemporary controls were lacking. Pre-existing disease complicates attribution of causal inferences in COVID-19 and, since the heart, lungs and kidneys are deep organs, clinical evaluation is challenging.…”

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confidence: 99%

Post-COVID-19 illness trajectory: a multisystem investigation.

Berry

Morrow

Sykes

et al. 2021

Preprint

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Background: The pathophysiology and trajectory of multiorgan involvement in post-COVID-19 syndrome is uncertain. Methods: A prospective, multicenter, longitudinal, cohort study involving post-COVID-19 patients enrolled in-hospital or early post-discharge (visit 1) and re-evaluated 28-60 days post-discharge (visit 2). Multisystem investigations included chest computed tomography with pulmonary and coronary angiography, cardiovascular and renal magnetic resonance imaging, digital electrocardiography, and multisystem biomarkers. The primary outcome was the adjudicated likelihood of myocarditis.Results: 161 patients (mean age 55 years, 43% female) and 27 controls with similar age, sex, ethnicity, and vascular risk factors were enrolled from 22 May 2020 to 2 July 2021 and had a primary outcome evaluation. Compared to controls, at 28-60 days post-discharge, patients with COVID-19 had persisting evidence of cardio-renal involvement, systemic inflammation, and hemostasis pathway activation. Myocarditis was adjudicated as being not likely (n=17; 10%), unlikely (n=56; 35%), probable (n=67; 42%) or very likely (n=21; 13%). Acute kidney injury (odds ratio, 95% confidence interval: 3.40 (1.13, 11.84); p=0.038) and low hemoglobin A1c (0.26 (0.07, 0.87); p=0.035) were multivariable associates of adjudicated myocarditis. During convalescence, compared to controls, COVID-19 was associated with worse health-related quality of life (EQ5D-5L) (p<0.001), illness perception (p<0.001), anxiety and depression (p<0.001), physical activity (p<0.001) and predicted maximal oxygen utilization (ml/kg/min) (p<0.001). These measures were associated with adjudicated myocarditis.Conclusions: The illness trajectory of COVID-19 includes persisting cardio-renal inflammation, lung damage and hemostasis activation. Adjudicated myocarditis occurred in one in eight hospitalized patients and was associated with impairments in health status, physical and psychological wellbeing during community convalescence. Public registration: ClinicalTrials.gov identifier is NCT04403607.

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“…Bruno Ramos Nascimento , 1,2 Craig Sable 3 Since the inception of the COVID-19 pandemic, the identification of factors associated with unfavourable outcomes has been a topic of intense investigation. With limited disease-specific therapies, early stratification of those at highest risk of complications can guide who needs intensive clinical monitoring and supportive management.…”

Section: Cardiac Involvement In Covid-19: Cause or Consequence Of Severe Manifestations?mentioning

confidence: 99%