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Cardiovascular Magnetic Resonance Imaging in Physically Fit Young Patients Sans Comorbidities Who Recently Recovered
Agnieszka Pawlak1,2, Mariusz Furmanek1,3, Piotr Szymański1,3
1Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
Insights
Possible COVID-19 related myocardial injury (PCRMI) was frequent in young, fit males after mild illness. Cardiovascular magnetic resonance (CMR) showed abnormalities, but findings were also present in controls, suggesting non-COVID-19 specific causes.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Severe COVID-19 can cause cardiovascular complications.
- Myocardial injury incidence in young, fit males post-COVID-19 is understudied.
- Focus on asymptomatic/mild cases with no comorbidities.
Purpose of the Study:
- Assess myocardial injury incidence post-COVID-19 in young, fit males.
- Evaluate cardiovascular magnetic resonance (CMR) findings.
- Compare with a SARS-CoV-2 negative control group.
Main Methods:
- Prospective, single-center, observational cohort study.
- 75 young, fit males (median age 22) recovered from COVID-19.
- Comparison with age-matched, healthy controls negative for SARS-CoV-2.
Main Results:
- 19% (25%) had possible COVID-19 related myocardial injury (PCRMI) via CMR.
- Includes 1.3% definitive and 4% possible myocarditis.
- Abnormalities like reduced ejection fraction and increased LV volumes noted; PCRMI linked to higher NT-pro-BNP and lower ejection fraction.
Conclusions:
- PCRMI is frequent in young, asymptomatic, fit males post-COVID-19.
- Late findings suggest potential long-term cardiovascular impact.
- Presence of LGE in controls indicates findings may not be COVID-19 specific, requiring further research.
Introduction And Objective:
Multiple studies showed that patients with a severe course of COVID-19 may develop cardiovascular complications. Assessment of the incidence of myocardial injury in young, physically fit male patients with no comorbidities, and asymptomatic/mild course of the disease who recovered from COVID-19.
Material And Methods:
A prospective, single-center, observational cohort study of 75 young (median[IQR] age 22 years) physically fit male patients, without comorbidities and smoking who recently recovered from COVID-19. Results were compared with a control group of age-matched, physically fit men with no comorbidities who tested negative for SARS-CoV-2.
Results:
19(25%) patients had possible COVID-19 related myocardial injury[PCRMI] on cardiovascular magnetic resonance [CMR] including definitive myocarditis (n=1;1.3%) and possible myocarditis (n=3;4%). Other abnormalities: mildly decreased (<50%) left ventricular(LV) ejection fraction (n=4;5%), increased LV end-diastolic volume index (n=8;11%) and LV mass index (n=9;12%). Patients with PCRMI had higher NT-pro-BNP level (29 vs 20pg/mL respectively, P=0.02) and lower LV ejection fraction (55% vs 59% respectively, P=0.03). PCRMI was demonstrated in 3(27%) volunteers from the control group based on the presence of LGE (2/18%) and decreased LV ejection fraction (1/9%). No volunteer from the control group was diagnosed with definitive or possible myocarditis.
Conclusions:
PCRMI was a frequent finding in young, asymptomatic, physically-fit patients sans comorbidities relatively late after recovery from COVID-19. Whereas no definitive or possible myocarditis was found in the control group, LGE was relatively frequent suggesting that our findings might not be COVID-19 specific. This warrants a need for further investigation into the long-term cardiovascular consequences of COVID-19.
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