Multimodality Cardiac Imaging in COVID

Abstract

Infection with SARS-CoV-2, the virus that causes COVID, is associated with numerous potential secondary complications. Global efforts have been dedicated to understanding the myriad potential cardiovascular sequelae which may occur during acute infection, convalescence, or recovery. Because patients often present with nonspecific symptoms and laboratory findings, cardiac imaging has emerged as an important tool for the discrimination of pulmonary and cardiovascular complications of this disease. The clinician investigating a potential COVID-related complication must account not only for the relative utility of various cardiac imaging modalities but also for the risk of infectious exposure to staff and other patients. Extraordinary clinical and scholarly efforts have brought the international medical community closer to a consensus on the appropriate indications for diagnostic cardiac imaging during this protracted pandemic. In this review, we summarize the existing literature and reference major societal guidelines to provide an overview of the indications and utility of echocardiography, nuclear imaging, cardiac computed tomography, and cardiac magnetic resonance imaging for the diagnosis of cardiovascular complications of COVID.

COVID-19 and the Cardiovascular System: Requiem for a Medical Minotaur

“…Wang and Loscalzo 13 emphasize that during an unexpected pandemic featuring a novel pathogen, there is no time for standard drug development, which may take an average of 15 years from the beginning of Phase 1 clinical trials to FDA approval. 14 In this situation the only viable path forward is repurposing drugs that have already been developed, allowing for trials to begin in Phase 2B or even 3. The authors summarize data from various repurposing efforts including high-throughput drug library screening in cell lines infected with virus or bearing SARS-CoV-2 targets, omics data-based drug re-positioning, and their own network module-based approach.…”

“…Cardiac magnetic resonance imaging is instrumental in the detection of myocardial injury and the clinical diagnosis of myocarditis in COVID-19 patients, in addition to the evaluation of coronary microvascular dysfunction particularly in patients recovered from COVID-19 infection. In this compendium, Holby et al 14 provide an overview of the multimodality imaging that has been used to diagnose and evaluate COVID-19. As we dive deeper into the mechanisms of disease, murine models and mouse adaptable strains have proved valuable, which is briefly discussed by Sciaudone et al 5 However, mice including those that express human ACE2, lack a full set of sequelae presented by human COVID-19.…”