Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19).
Level 3 - non-randomized controlled study
Prospective observational cohort study with matched control groups
PubMed 32730619 · doi:10.1001/jamacardio.2020.3557
What was done
A prospective observational cohort study evaluated 100 patients recently recovered from RT-PCR-confirmed COVID-19 (67 managed at home, 33 hospitalized) from the University Hospital Frankfurt registry between April and June 2020. At a median of 71 days (IQR 64–92) after diagnosis, patients underwent clinical assessment, high-sensitivity troponin T (hsTnT) testing, and cardiovascular magnetic resonance (CMR) imaging with native T1/T2 mapping and late gadolinium enhancement. Results were compared against age- and sex-matched healthy volunteers (n = 50) and risk factor-matched controls (n = 57).
What was found
Abnormal CMR findings were present in 78 of 100 COVID-19 patients (78%), including elevated native T1 in 73, elevated native T2 in 60, myocardial late gadolinium enhancement in 32, and pericardial enhancement in 22. Detectable hsTnT (>3 pg/mL) occurred in 71 patients (71%) and significantly elevated hsTnT (>13.9 pg/mL) in 5 (5%). Compared to healthy and risk factor-matched controls, COVID-19 patients had lower left ventricular ejection fraction, higher left ventricular volumes, and elevated native T1 and T2. Hospitalized patients showed slightly higher native T1 (median 1141 ms vs 1119 ms, P = .008) and hsTnT (6.3 pg/dL vs 4.2 pg/dL, P = .002) than home-managed patients. Time from diagnosis did not correlate with native T1 (r = 0.07, P = .47) or T2 (r = 0.14, P = .15).
Why it matters
This study provided early evidence that COVID-19 can cause persistent subclinical myocardial inflammation and structural imaging abnormalities months after recovery, even among non-hospitalized individuals.
Limits
The study was single-center with a modest cohort size (n = 100 cases). Pre-infection baseline cardiac imaging was unavailable, precluding definitive proof that findings were entirely new. Long-term clinical cardiovascular outcomes and prognostic implications were not reported in the abstract.
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