ASOCIACIÓN DE LA INFECCIÓN PREVIA POR SARS-COV-2 Y DISFUNCIÓN MICROVASCULAR CORONARIA: UN ESTUDIO PILOTO

Cardiovascular complications from COVID-19 contribute to its morbidity. COVID-19 has been associated with coronary microvascular dysfunction (CMD), yet the long-term relationship is not well understood. We aimed to assess changes in CMD status and myocardial flow reserve (MFR) among patients with prior COVID-19 infection using serial cardiac PET/CT imaging.

Single-center study of 35 patients who underwent clinically indicated PET/CT pre- and post-COVID-19 infection were compared with 70 historical COVID-19 negative controls matched 2:1 for age and sex, and cardiovascular risk factors. Myocardial flow reserve (MFR) < 2 was used to define CMD. The primary outcome was the change in global MFR MFR = follow-up - baseline). Linear and conditional logistic regression accounted for matching dependencies.

The median interval between PET/CT studies among COVID-19 patients was 2.8 years. Most patients had mild symptoms, and 94% were immunized. Baseline perfusion abnormalities were similar between groups (13% vs 29%, p = 0.05). There was no significant difference in global MFR between COVID-19 and control groups (0.07 vs -0.10, p = 0.23). CMD status remained unchanged among most participants (83% in the COVID-19 group and 60% in controls).

Despite prior evidence of an association between COVID-19 and CMD, there were no apparent longitudinal changes in MFR and CMD status in patients with recovered COVID-19 infection. These findings suggest that mild COVID-19 infection does not confer persistent coronary microvascular dysfunction detectable by PET/CT.