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Cardiac pathology 6 months after hospitalization for COVID-19 and association with the acute disease severity

Peder L Myhre1, Siri L Heck2, Julia B Skranes1

  • 1Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

American Heart Journal
|August 17, 2021
PubMed

Insights

Twenty-one percent of moderate-to-severe COVID-19 survivors showed abnormal cardiac magnetic resonance imaging (CMR) findings six months post-infection. These cardiac issues did not correlate with disease severity, indicating potential long-term cardiac consequences.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Coronavirus disease 2019 (COVID-19) can lead to myocardial injury and myocarditis.
  • Concerns exist regarding persistent cardiac pathology and long-term cardiac consequences following COVID-19.

Purpose of the Study:

  • To assess cardiovascular resonance imaging (CMR) findings in patients recovered from moderate-to-severe COVID-19.
  • To investigate the association between abnormal CMR findings and markers of disease severity during the acute phase of COVID-19.

Main Methods:

  • Prospective study of 58 COVID-19 survivors who underwent CMR a median of 175 days post-hospitalization.
  • Abnormal CMR defined by left ventricular ejection fraction (LVEF) <50% or myocardial scar.
  • Comparison of CMR indices with healthy controls and circulating biomarkers from the index hospitalization.

Main Results:

  • Abnormal CMR findings were present in 21% of patients, with 3 classified as major pathology.
  • No significant difference in mechanical ventilation, hospital stay, or vital signs between patients with and without abnormal CMR.
  • No association found between SARS-CoV-2 viremia or inflammatory biomarkers and persistent CMR pathology.
  • Higher cardiac troponin T and N-terminal pro-B-type natriuretic peptide on admission in patients with CMR pathology, but not significant after adjusting for confounders.

Conclusions:

  • Six months after moderate-to-severe COVID-19, 21% of patients exhibited CMR pathology unrelated to disease severity.
  • Elevated cardiovascular biomarkers during COVID-19 were observed in patients with CMR pathology, but lacked significant association after adjustments.
Abstract

Keywords:
CMRCOVID-19NT-proBNPbiomarkerscardiac magnetic resonance imagingtroponin

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