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. 2022 Nov;63(11):1475-1480.
doi: 10.1177/02841851211046502. Epub 2021 Oct 8.

COVID-19 myocarditis cardiac magnetic resonance findings in symptomatic patients

Sedat Altay  1
Affiliations

COVID-19 myocarditis cardiac magnetic resonance findings in symptomatic patients

Sedat Altay. Acta Radiol. 2022 Nov.

Abstract

Background: Coronavirus disease 2019 (COVID-19) may cause myocardial damage.

Purpose: To evaluate the short-term and medium-term results, as well as the imaging features of COVID-19 cardiac involvement, using cardiac magnetic resonance (CMR).

Material and methods: In this study, laboratory and CMR findings of 15 patients with COVID-19 between May 2020 and May 2021 were evaluated retrospectively. Late gadolinium enhancement (LGE) imaging was evaluated for myocarditis. Cardiac functions were quantitatively evaluated and compared to the control patient group. High-sensitivity cardiac troponin I (Hs-cTnI), C-reactive protein (CRP) exchange, and LGE were compared.

Results: Fifteen patients (7 women; mean age = 38 years) were evaluated. Six patients were treated at home, while nine patients were treated in the hospital. The patients were given remdesivir and hydroxychloroquine treatment. LGE was detected in 2 (33%) patients treated at home and 5 (55.5%) patients treated in the hospital. In hospitalized patients, levels of Hs-cTnI (mean = 7.8 pg/mL) and CRP (mean = 32.3 mg/L) were elevated. A high correlation was observed between the increase in Hs-cTnI value and LGE (r = 0.63; P < 0.001). A low correlation was observed between an increase in CRP and LGE (r = 033; P < 0.001). There was no statistically significant difference in ventricular functions between the COVID-19 and control groups (P < 0.001).

Conclusion: CMR abnormalities were found in a high percentage (46%) of patients with COVID-19. Myocardial abnormalities in patients with COVID-19 can be detected by CMR. For COVID-19 myocarditis, no specific diagnostic CMR imaging feature was observed.

Keywords: COVID-19; cardiac functions; cardiac involvement; cardiac magnetic resonance imaging; myocarditis.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1.
Fig. 1.
A 48-year-old man with CMR imaging 45 days after COVID-19 diagnosis. He was treated in the hospital for severe dyspnea. Hs-cTnI level when he was in hospital was 15.4 pg/mL. His Hs-cTnI was 5 pg/mL on the day of CMR imaging. PSIR two-chamber image shows intramyocardial LGE (arrows).CMR, cardiac magnetic resonance; Hs-cTnI, high-sensitivity cardiac troponin I; LGE, late gadolinium enhancement.
Fig. 2.
Fig. 2.
A 62-year-old man was treated in his home for COVID-19. (a) Long-axis cine SSFP and (b) T1 sequences showed focal myocardial irregularity (arrows). (c) T1 PSIR short- and (d) long-axis images show focal myocarditis after COVID-19 (arrows).
Fig. 3.
Fig. 3.
44 years old man with myocarditis 2 chamber (A) and 4 chamber(B) PSIR images show focal LGE interventricular septum (arrows).
See this image and copyright information in PMC

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