Myocardial Injury in Recovered COVID-19 Patients

A multi-parametric cardiovascular magnetic resonance (CMR) assessment revealed myocardial injury in approximately half of hospitalized COVID-19 patients. A total of 148 hospitalized COVID-19 patients (64 ± 12 years, 70% male, 32% requiring ventilatory support) and troponin elevation discharged from six hospitals in the UK underwent convalescent CMR (including adenosine stress perfusion if indicated) at median 68 days. Left ventricular (LV) function was normal in 89% (ejection fraction 67% ± 11%). Late gadolinium enhancement and/or ischemia was found in 54%. This comprised myocarditis-like scar in 26%, infarction and/or ischemia in 22% and dual pathology in 6%. Myocarditis-like injury was limited to three or less myocardial segments in 88% of cases with no associated LV dysfunction; of these, 30% had active myocarditis. Myocardial infarction was found in 19% and inducible ischemia in 26% of those undergoing stress perfusion (including 7 with both infarction and ischemia). Of patients with ischemic injury pattern, 66% had no history of coronary disease. There was no evidence of diffuse fibrosis or edema in the remote myocardium. However, whether these observed findings represent pre-existing clinically silent disease or de novo COVID-19-related changes remain undetermined. Source:https://academic.oup.com/eurheartj/