1 in 5 patients present with abnormal CMR 6 months post-COVID-19

Cardiac pathology 6 months after moderate-to-severe coronavirus disease 2019 (COVID-19) is present in about a fifth of patients, a recent study has found.

The study included 58 COVID-19 survivors (median age 56 years, 56 percent men) who had undergone cardiovascular resonance imaging (CMR) a median of 175 days after recovery. Abnormal CMR findings included the presence of late gadolinium enhancement (LGE), indicative of myocardial scarring, or a left ventricular ejection fraction (LVEF) <50 percent).

After excluding three patients due to unevaluable CMR sequences and underlying kidney disease, the researchers found 12 patients who had abnormal CMR, yielding a prevalence rate of 21 percent.

Three patients had major myocardial pathology: one with both myocardial scarring and LVEF reduction to 38 percent; another without scarring but with LVEF decrease to 37 percent; and the last one with uncertain evidence of LGE along with an LVEF drop to 39 percent. The remaining nine patients were deemed to have minor pathologies.

Compared with controls, patients who developed CMR pathologies had comparable COVID-19 severity. Of the 11 patients who had severe COVID-19 necessitating mechanical ventilation, only one developed CMR abnormalities.

On the other hand, serum levels of cardiac troponin-T (p=0.003) and N-terminal pro-B-type natriuretic peptide (NT-proBNP; p=0.013), though only NT-proBNP remained significant after multivariable adjustment (p=0.03).

“We found no association between markers of disease severity during the index hospitalization and pathology on CMR after 6 months, suggesting that pre-existing subclinical myocardial disease may be more important than COVID-19 for the observed CMR pathology,” the researchers said.