Myocardial perfusion imaging in the era of COVID-19: a systematic review

Sara Hassanzadeh1, Sina Neshat2, Afshin Heidari1

  • 1School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Insights

The COVID-19 pandemic impacted myocardial perfusion imaging single photon emission computed tomography (MPI SPECT) use, decreasing procedures globally. Post-COVID-19 patients may show more MPI SPECT abnormalities, highlighting the need for contextual interpretation.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Infectious Diseases

Background:

  • COVID-19 can lead to persistent multi-organ complications, including cardiovascular issues.
  • Myocardial perfusion imaging single photon emission computed tomography (MPI SPECT) is vital for assessing cardiac conditions, irrespective of their cause.

Purpose of the Study:

  • To analyze the impact of the COVID-19 pandemic on various aspects of MPI SPECT.
  • To quantify the intensity and consequences of these pandemic-related effects on MPI SPECT.

Main Methods:

  • A comprehensive literature search was conducted across major databases (PubMed, SCOPUS, EMBASE, Web of Science, Cochrane).
  • A four-domain search strategy was employed, followed by two levels of screening and citation tracking.
  • The study analyzed 32 papers categorized into case reports, pre- vs. post-pandemic MPI comparisons, and SPECT MPI findings.

Main Results:

  • A global decrease in SPECT MPI procedures was observed during the early pandemic, particularly in low- to middle-income countries.
  • Computed tomography (CT) scans combined with MPI require careful interpretation considering COVID-19 context, especially during outbreaks.
  • Individuals with a history of COVID-19 showed a higher likelihood of abnormal MPI SPECT results, including ischemia.

Conclusions:

  • The COVID-19 pandemic significantly affected the utilization and interpretation of MPI SPECT.
  • Contextual interpretation of MPI SPECT, especially when combined with CT, is crucial during and after COVID-19 outbreaks.
  • Post-COVID-19 patients may exhibit increased MPI SPECT abnormalities, necessitating ongoing surveillance and research.
Abstract

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