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Coronary microvascular health in symptomatic patients with prior COVID-19 infection: an updated analysis

Ahmed Ibrahim Ahmed1, Mahmoud Al Rifai1, Fares Alahdab1

  • 1Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin St, Houston, TX 77030, USA.

European Heart Journal. Cardiovascular Imaging
|May 31, 2023
PubMed

Insights

Prior COVID-19 infection significantly increases the risk of impaired coronary microvasculature, particularly with severe disease. This effect persists for up to a year post-infection across various SARS-CoV-2 variants.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Biology

Background:

  • Endothelial dysfunction is a known complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
  • Understanding the long-term impact of COVID-19 on coronary microvasculature is crucial for patient management.

Purpose of the Study:

  • To investigate the effects of prior COVID-19 on coronary microvasculature.
  • To analyze these effects considering time since infection, disease severity, SARS-CoV-2 variants, and patient subgroups (diabetes, no known coronary artery disease).

Main Methods:

  • Positron emission tomography (PET) imaging was used to assess myocardial flow reserve (MFR) in patients with prior COVID-19 (cases) and matched controls without infection.
  • MFR was calculated as the ratio of stress to rest myocardial blood flow.
  • Comparisons focused on the odds and prevalence of impaired MFR (MFR < 2).

Main Results:

  • Patients with prior COVID-19 showed significantly higher odds of impaired MFR (adjusted odds ratio 3.1).
  • Impaired MFR prevalence was similar across different SARS-CoV-2 variants and up to one year post-infection.
  • However, impaired MFR prevalence increased with the severity of the initial COVID-19 infection.

Conclusions:

  • Prior COVID-19 infection is independently associated with impaired coronary microvasculature.
  • The severity of COVID-19 illness is a significant factor influencing the degree of microvascular dysfunction.
  • Coronary microvascular function should be considered in the long-term follow-up of patients after COVID-19.
Abstract

Keywords:
COVIDPETcoronary microvascular dysfunction

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