Role of cardiovascular magnetic resonance imaging in COVID‐19 recovered patients: A short‐term follow‐up study

Abstract

Objective Cardiac involvement in recovered COVID‐19 patients assessed by cardiac magnetic resonance imaging (MRI). Methods Subjects recently recovered from COVID‐19 and with an abnormal left ventricular global longitudinal strain were enrolled. Cardiac MRI in all the enrolled subjects was done at baseline (within 30–90 days following recovery from COVID‐19) with a follow‐up scan at 6 months in individuals with an abnormal baseline scan. Additionally, 20 age‐and sex‐matched individuals were enrolled as healthy controls (HCs). Results All the 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 late gadolinium enhancement (LGE). No difference was observed in terms of conventional left ventricular (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 three patients (who had severe COVID‐19 [3/4;75%]). Subjects with severe COVID‐19 had a greater frequency of LGE (53.8%) and myocardial edema (61.5%) as compared to mild and moderate cases. Myocardial T1 (1284 ± 43.8 ms vs. 1147.6 ± 68.4 ms; p < .0001) and T2 values (50.8 ± 16.7 ms vs. 42.6 ± 3.6 ms; p = .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 the recovered patients with persistent abnormality in one‐fourth at 6 months. Our study suggests a need for closer follow‐up among recovered subjects in order to evaluate for long‐term cardiovascular sequelae. COVID‐19 causes structural changes in the myocardium in a small segment of patients with partial spontaneous resolution.

Role of Cardiovascular Magnetic Resonance Imaging in Early Detection of Myocarditis in Patients Recovered from COVID-19

“…In concordance to our study, Huang et al [5] revealed that global native T1, T2, and ECV values were significantly greater in recovered COVID-19 patients with positive conventional CMR findings than in patients without positive findings (native T1 1,271 ms versus 1,237 ms, P=0.002), (T2 42.7± 3.1 ms vs 38.1± 2.4 ms, P=0.005), (ECV 28.2% vs 24.8%, P=0.001). Also, Kunal et al [17] reported significantly elevated native T1 (1301ms Vs 1264 ms, P =0.022) and native T2 (55.62 vs 45.25 ms, P =0.004) in post Covid-19 patients with abnormal CMR group compared to the other one with normal CMR.…”