tetano
Editor, Senior Moderator
PLoS One
. 2023 Mar 8;18(3):e0282394.
doi: 10.1371/journal.pone.0282394. eCollection 2023.
Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19
Aria Yar[SUP] 1 [/SUP], Valtteri Uusitalo[SUP] 1 2 [/SUP], Satu M Vaara[SUP] 1 [/SUP], Miia Holmström[SUP] 1 [/SUP], Aino-Maija Vuorinen[SUP] 1 [/SUP], Tiina Heliö[SUP] 3 [/SUP], Riitta Paakkanen[SUP] 3 [/SUP], Sari Kivistö[SUP] 1 [/SUP], Suvi Syväranta[SUP] 1 [/SUP], Johanna Hästbacka[SUP] 4 [/SUP]
Affiliations
Abstract
Background: Long-term symptoms are frequent after coronavirus disease 2019 (COVID-19). We studied the prevalence of post-acute myocardial scar on cardiac magnetic resonance imaging (CMR) in patients hospitalized due to COVID-19 and its association with long-term symptoms.
Materials and methods: In this prospective observational single-center study, 95 formerly hospitalized COVID-19 patients underwent CMR imaging at the median of 9 months after acute COVID-19. In addition, 43 control subjects were imaged. Myocardial scar characteristic of myocardial infarction or myocarditis were noted from late gadolinium enhancement images (LGE). Patient symptoms were screened using a questionnaire. Data are presented as mean ± standard deviation or median (interquartile range).
Results: The presence of any LGE was higher in COVID-19 patients (66% vs. 37%, p<0.01) as was the presence of LGE suggestive of previous myocarditis (29% vs. 9%, p = 0.01). The prevalence of ischemic scar was comparable (8% vs. 2%, p = 0.13). Only two COVID-19 patients (7%) had myocarditis scar combined with left ventricular dysfunction (EF <50%). Myocardial edema was not detected in any participant. The need for intensive care unit (ICU) treatment during initial hospitalization was comparable in patients with and without myocarditis scar (47% vs. 67%, p = 0.44). Dyspnea, chest pain, and arrhythmias were prevalent in COVID-19 patients at follow-up (64%, 31%, and 41%, respectively) but not associated with myocarditis scar on CMR.
Conclusions: Myocardial scar suggestive of possible previous myocarditis was detected in almost one-third of hospital-treated COVID-19 patients. It was not associated with the need for ICU treatment, greater symptomatic burden, or ventricular dysfunction at 9 months follow-up. Thus, post-acute myocarditis scar on COVID-19 patients seems to be a subclinical imaging finding and does not commonly require further clinical evaluation.
. 2023 Mar 8;18(3):e0282394.
doi: 10.1371/journal.pone.0282394. eCollection 2023.
Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19
Aria Yar[SUP] 1 [/SUP], Valtteri Uusitalo[SUP] 1 2 [/SUP], Satu M Vaara[SUP] 1 [/SUP], Miia Holmström[SUP] 1 [/SUP], Aino-Maija Vuorinen[SUP] 1 [/SUP], Tiina Heliö[SUP] 3 [/SUP], Riitta Paakkanen[SUP] 3 [/SUP], Sari Kivistö[SUP] 1 [/SUP], Suvi Syväranta[SUP] 1 [/SUP], Johanna Hästbacka[SUP] 4 [/SUP]
Affiliations
- PMID: 36888600
- DOI: 10.1371/journal.pone.0282394
Abstract
Background: Long-term symptoms are frequent after coronavirus disease 2019 (COVID-19). We studied the prevalence of post-acute myocardial scar on cardiac magnetic resonance imaging (CMR) in patients hospitalized due to COVID-19 and its association with long-term symptoms.
Materials and methods: In this prospective observational single-center study, 95 formerly hospitalized COVID-19 patients underwent CMR imaging at the median of 9 months after acute COVID-19. In addition, 43 control subjects were imaged. Myocardial scar characteristic of myocardial infarction or myocarditis were noted from late gadolinium enhancement images (LGE). Patient symptoms were screened using a questionnaire. Data are presented as mean ± standard deviation or median (interquartile range).
Results: The presence of any LGE was higher in COVID-19 patients (66% vs. 37%, p<0.01) as was the presence of LGE suggestive of previous myocarditis (29% vs. 9%, p = 0.01). The prevalence of ischemic scar was comparable (8% vs. 2%, p = 0.13). Only two COVID-19 patients (7%) had myocarditis scar combined with left ventricular dysfunction (EF <50%). Myocardial edema was not detected in any participant. The need for intensive care unit (ICU) treatment during initial hospitalization was comparable in patients with and without myocarditis scar (47% vs. 67%, p = 0.44). Dyspnea, chest pain, and arrhythmias were prevalent in COVID-19 patients at follow-up (64%, 31%, and 41%, respectively) but not associated with myocarditis scar on CMR.
Conclusions: Myocardial scar suggestive of possible previous myocarditis was detected in almost one-third of hospital-treated COVID-19 patients. It was not associated with the need for ICU treatment, greater symptomatic burden, or ventricular dysfunction at 9 months follow-up. Thus, post-acute myocarditis scar on COVID-19 patients seems to be a subclinical imaging finding and does not commonly require further clinical evaluation.