Cardiac MRI Findings in Patients Clinically Referred for Evaluation of Post-Acute Sequelae of SARS-CoV-2 Infection

Abstract

Persistent or recurrent cardiovascular symptoms have been identified as one of the hallmarks of long-COVID or post-acute sequelae of SARS-CoV-2 infection (PASC). The purpose of this study was to determine the prevalence and extent of cardiac abnormalities in patients referred for cardiac MRI due to clinical evidence of PASC. To investigate this, two tertiary care hospitals identified all patients who were referred for cardiac MRI under the suspicion of PASC in a 2-year period and retrospectively included them in this study. Patients with previously known cardiac diseases were excluded. This resulted in a total cohort of 129 patients (63, 51% female; age 41 ± 16 years). The majority of patients (57%) showed normal cardiac results. No patient had active myocarditis or an acute myocardial infarction. However, 30% of patients had evidence of non-ischemic myocardial fibrosis, which exceeds the prevalence in the normal adult population and suggests that a possible history of myocarditis might explain persistent symptoms in the PASC setting.

Community-Based View on Diagnostic Imaging at the End of COVID-19 Pandemic: Online Survey-Assisted Study

“…Indeed, non-ischemic myocardial fibrosis, exceeding the prevalence in the normal adult population, was found in every third patient with clinical suspicion of cardiovascular post-acute sequelae of SARS-CoV-2 infection. A possible history of myocarditis may explain the persistent symptoms [34]. History of COVID-19 has been linked to an increased risk of developing aortic aneurysms [35,36].…”

Community-Based View on Diagnostic Imaging at the End of COVID-19 Pandemic: Online Survey-Assisted Study

“…Indeed, non-ischemic myocardial fibrosis, exceeding the prevalence in the normal adult population, was found in every third patient with clinical suspicion of cardiovascular post-acute sequelae of SARS-CoV-2 infection. A possible history of myocarditis may explain the persistent symptoms [ 49 ]. History of COVID-19 has been linked to an increased risk of developing aortic aneurysms [ 50 , 51 ].…”