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Cardiac involvement in patients recovering from Delta Variant of COVID-19: a prospective multi-parametric MRI study
Lieguang Zhang1, Xiaoyu Wei2, Huimin Wang2,3
1Department of Radiology, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Insights
Cardiac magnetic resonance imaging (MRI) revealed subclinical heart abnormalities in patients recovering from the Delta Variant of coronavirus disease 2019 (COVID-19). These findings suggest MRI can identify individuals at risk for cardiac sequelae.
Area of Science:
- Cardiology
- Infectious Diseases
- Radiology
Background:
- The cardiac sequelae of the Delta Variant of coronavirus disease 2019 (COVID-19) are not well understood.
- Assessing cardiac involvement post-Delta Variant infection is crucial for understanding long-term health outcomes.
Purpose of the Study:
- To evaluate cardiac involvement in patients recovering from the Delta Variant of COVID-19.
- To identify subclinical cardiac abnormalities using multi-parametric cardiac magnetic resonance imaging (MRI).
Main Methods:
- Prospective assessment of 44 patients recovering from Delta Variant COVID-19 using multi-parametric cardiac MRI.
- Comparison with 25 healthy controls.
- Analysis included T1/T2 mapping, extracellular volume, left ventricular (LV) strain, and late gadolinium enhancement.
Main Results:
- 32% of patients showed cardiac tissue abnormalities, and 20% met criteria for myocarditis-like injury.
- Patients exhibited reduced LV global longitudinal and circumferential strain compared to controls.
- Elevated global native T1 values were observed in patients versus controls.
Conclusions:
- Cardiac MRI can detect subclinical functional and myocardial abnormalities in Delta Variant COVID-19 survivors.
- Native T1 mapping and strain imaging are sensitive tools for identifying patients at risk for cardiac damage.
- These imaging techniques may aid in noninvasive detection of cardiac sequelae in COVID-19 survivors.
Aims:
The cardiac injury and sequelae of Delta Variant of coronavirus disease 2019 (COVID-19) remain unknown. This study aimed to evaluate the presence of cardiac involvement in patients recovering from Delta Variant of COVID-19 based on multi-parametric cardiac magnetic resonance imaging (MRI).
Methods And Results:
We prospectively assessed patients recovering from Delta Variant of COVID-19 using multi-parametric cardiac magnetic resonance imaging (MRI) between June 2021 and July 2021. Comparison was made with 25 healthy controls. Forty-four patients (median age 51 years, 28 women) recovering from Delta Variant were recruited and had a median time of 35 days between diagnosis and cardiac MRI. There were no patients with chest pain (0/44, 0%) and high sensitivity cardiac troponin T troponin elevation (median levels 2.20 pg/mL, IQR levels 0.85-4.40 pg/mL). Regarding the cardiac imaging findings, a total of 14 (32%) patients presented cardiac tissue feature abnormalities, and a total of 9 (20%) patients had a myocarditis-like injury based on cardiac MRI 2018 Lake Louise criteria. When we further assessed the T1 and T2 mapping values for of patients' individual, abnormal raised global native T1, T2, and extracellular volume were seen in 6 (14%), 6 (14%), and 4 (9%) patients, respectively. Comparing with controls, the patients had lower LV global longitudinal strain and (-22.2 ± 2.8% vs. -24.6 ± 2.0%, P < 0.001) and global circumferential strain (-20.7 ± 6.8% vs. -24.3 ± 2.9%, P = 0.014), but higher global native T1 (1318.8 ± 55.5 ms vs. 1282.9 ± 38.1 ms, P = 0.006). Four (9%) patients presented myocardial late gadolinium enhancement with subepicardial pattern mostly common seen, and two (5%) patients presented pericardial enhancement.
Conclusions:
The cardiac MRI could detect subclinical functional and myocardial tissue characteristic abnormalities in individuals who were recovering from Delta Variant without cardiac-related clinical findings. The native T1 mapping and strain imaging may be a sensitive tool for the noninvasive detection of a subset of patients who are at risk for cardiac sequelae and more prone to myocardial damage in survivors with Delta Variant.
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