Background Recent studies have utilized MRI to determine the extent to which COVID‐19 survivors may experience cardiac sequels after recovery. Purpose To systematically review the main cardiac MRI findings in COVID‐19 adult survivors. Study type Systematic review. Subjects A total of 2954 COVID‐19 adult survivors from 16 studies. Field Strength/sequence Late gadolinium enhancement (LGE), parametric mapping (T1‐native, T2, T1‐post (extracellular volume fraction [ECV]), T2‐weighted sequences (myocardium/pericardium), at 1.5 T and 3 T. Assessment A systematic search was performed on PubMed, Embase, and Google scholar databases using Boolean operators and the relevant key terms covering COVID‐19, cardiac injury, CMR, and follow‐up. MRI data, including (if available) T1, T2, extra cellular volume, presence of myocardial or pericardial late gadolinium enhancement (LGE) and left and right ventricular ejection fraction were extracted. Statistical Tests The main results of the included studies are summarized. No additional statistical analysis was performed. Results Of 1601 articles retrieved from the initial search, 12 cohorts and 10 case series met our eligibility criteria. The rate of raised T1 in COVID‐19 adult survivors varied across studies from 0% to 73%. Raised T2 was detected in none of patients in 4 out of 15 studies, and in the remaining studies, its rate ranged from 2% to 60%. In most studies, LGE (myocardial or pericardial) was observed in COVID‐19 survivors, the rate ranging from 4% to 100%. Myocardial LGE mainly had nonischemic patterns. None of the cohort studies observed myocardial LGE in “healthy” controls. Most studies found that patients who recovered from COVID‐19 had a significantly greater T1 and T2 compared to participants in the corresponding control group. Data Conclusion Findings of MRI studies suggest the presence of myocardial and pericardial involvement in a notable number of patients recovered from COVID‐19. Level of Evidence 3 Technical Efficacy Stage 3
Background: The common variable immune deficiency (CVID) is known as the most prevalent symptomatic primary immune deficiency (PID) diseases, which is characterized by hypogammaglobulinemia with variable infectious and noninfectious manifestations. In this study, the researchers aimed to evaluate the frequency of cardiac disorders and investigate its association with other manifestations in CVID patients. Method: A total of 337 CVID patients registered in the Iranian Primary Immunodeficiency Registry were evaluated in this study. The questionnaire was completed for all patients to collect the participants’ demographic data, clinical manifestations and laboratory finding. The analysis was performed between the two groups of the study including CVID patients with cardiac manifestation and those without it. Results: The prevalence rate of cardiac manifestation was calculated to be 9.1%. pericardial and myocardial diseases and pulmonary hypertension were the most prevalent complications. CVID patients with a history of cardiac problem had significantly higher prevalence rates of otitis media, lymphoproliferative disorders, splenomegaly, hepatomegaly, failure to thrive and lower numbers of CD8+ T cells and CD19+ B cells compared to the patients without cardiac disorders. Notably, no significant differences were observed in immunoglobulins serum levels, CD3+ and CD4+ T cells between the patients with and without cardiac manifestation. Conclusion: Regular echocardiographic evaluation and of CVID patients for cardiac complications especially for inflammatory cardiac disease, heart failure and pulmonary hypertension, is critical to reduce the risk of heart disease.
Background About 47.3 million people have recovered from coronavirus disease 2019 (COVID-19). Manifestations of cardiac involvement have been noted in a significant number of patients in the acute phase. There are increasing concerns that some of these cardiac sequels may persist beyond the acute phase. If untreated, the sustained cardiac injury, especially myocarditis and fibrosis, could have severe consequences. Recent studies have assessed the presence of cardiac involvement using cardiac magnetic resonance (CMR) imaging during the post-acute phase. Purpose We present a systematic review of studies assessing evidence of cardiac involvement in patients recovered from COVID-19 during the post-acute phase using Cardiac Magnetic Resonance (CMR) Imaging. Methods We reported this study in accordance with PRISMA. A systematic search was performed on PubMed, Embase (Elsevier), and Google scholar databases using Boolean operators and the relevant key terms covering COVID-19, Cardiac injury, CMR, and follow-up. Retrieved articles were included based on predefined eligibility criteria. Results Of 1406 articles retrieved from the initial search, 11 items, 9 cohort, and 2 case series studies met our eligibility criteria. The rate of raised T1 (reported in 6 articles) in patients recovered from COVID-19 varied across studies from 5% to73%. In 4 out of 9 studies, raised T2 was detected in any patients, and in remained studies, its rate ranged from 2% to 60%. In most of the included studies, LGE (myocardial or pericardial) was observed in COVID-19 survivors, ranged from 7.0% to 100%. Myocardial LGE mainly had nonischemic patterns. None of the cohort studies observed myocardial LGE in “healthy” controls. Most studies found that patients who recovered from COVID-19 had significantly a greater mean (SD) T1 and T2 compared to participants in the control group. Conclusion Our systematic review study found evidence of subclinical and clinical myocardial and pericardial involvement in patients recovered from COVID-19. FUNDunding Acknowledgement Type of funding sources: None.
Common variable immune deficiency (CVID) is known as the most prevalent symptomatic inborn error of immunity associated with autoimmune and inflammatory complications in addition to recurrent infections. In this study, we investigated the prevalence of acute pericarditis as a complication in the past medical history of 337 CVID patients. We found five patients (1.5%) that had experienced acute pericarditis, and described the medical history of three patients.
Background: Limited data exist on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) presenting with ST-segment-elevation myocardial infarction (STEMI). Methods: This multicenter study, conducted in 6 centers in Iran, aimed to compare baseline clinical and procedural data between a case group, comprising STEMI patients with COVID-19, and a control group, comprising STEMI patients before the COVID-19 pandemic, and to determine in-hospital infarct-related artery thrombus grades and major adverse cardio-cerebrovascular events (MACCEs), defined as a composite of deaths from any cause (cardiovascular and noncardiovascular), nonfatal strokes, and stent thrombosis. Results: No significant differences were observed between the 2 groups regarding baseline characteristics. Primary percutaneous coronary intervention (PPCI) was performed in 72.9% of the cases and 98.5% of the controls (P=0.043), and primary coronary artery bypass grafting was performed in 6.2% of the cases and 1.4% of the controls (P=0.048). Successful PPCI procedures (final TIMI flow grade III) were significantly fewer in the case group (66.5% vs 93.5%; P=0.001). The baseline thrombus grade before wire crossing was not statistically significantly different between the 2 groups. The summation of thrombus grades IV and V was 75% in the case group and 82% in the control group (P=0.432). The rate of MACCEs was 14.5% and 2.1% in the case and control groups, respectively (P=0.002). Conclusion: In our study, the thrombus grade had no significant differences between the case and control groups; however, the in-hospital rates of the no-reflow phenomenon, periprocedural MI, mechanical complications, and MACCEs were statistically significantly higher in the case group.
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