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Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis.
Breitbart, Philipp; Koch, Alexander; Schmidt, Marco; Magedanz, Annett; Lindhoff-Last, Edelgard; Voigtländer, Thomas; Schmermund, Axel; Mehta, Rajendra H; Eggebrecht, Holger.
  • Breitbart P; Cardioangiological Center Bethanien (CCB), Im Prüfling 23, 60389, Frankfurt, Germany. p.breitbart@ccb.de.
  • Koch A; Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, University Hospital Freiburg, Bad Krozingen, Germany. p.breitbart@ccb.de.
  • Schmidt M; AGAPLESION Bethanien Hospital, Frankfurt, Germany. p.breitbart@ccb.de.
  • Magedanz A; Cardioangiological Center Bethanien (CCB), Im Prüfling 23, 60389, Frankfurt, Germany.
  • Lindhoff-Last E; AGAPLESION Bethanien Hospital, Frankfurt, Germany.
  • Voigtländer T; Cardioangiological Center Bethanien (CCB), Im Prüfling 23, 60389, Frankfurt, Germany.
  • Schmermund A; AGAPLESION Bethanien Hospital, Frankfurt, Germany.
  • Mehta RH; Cardioangiological Center Bethanien (CCB), Im Prüfling 23, 60389, Frankfurt, Germany.
  • Eggebrecht H; AGAPLESION Bethanien Hospital, Frankfurt, Germany.
Clin Res Cardiol ; 110(11): 1832-1840, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1375633
ABSTRACT

OBJECTIVES:

We assessed possible myocardial involvement in previously cardiac healthy post-COVID patients referred for persisting symptoms with suspected myocarditis.

BACKGROUND:

Prior studies suggested myocardial inflammation in patients with coronavirus-induced disease 2019 (COVID-19). However, the prevalence of cardiac involvement among COVID patients varied between 1.4 and 78%.

METHODS:

A total of 56 post-COVID patients without previous heart diseases were included consecutively into this study. All patients had positive antibody titers against SARS-CoV-2. Patients were referred for persistent symptoms such as chest pain/discomfort, shortness of breath, or intolerance to activity. All patients underwent standardized cardiac assessment including electrocardiogram (ECG), cardiac biomarkers, echocardiography, and cardiac magnetic resonance (CMR).

RESULTS:

56 Patients (46 ± 12 years, 54% females) presented 71 ± 66 days after their COVID-19 disease. In most patients, the course of COVID-19 was mild, with hospital treatment being necessary in five (9%). At presentation, patients most often reported persistent fatigue (75%), chest pain (71%), and shortness of breath (66%). Acute myocarditis was confirmed by T1/T2-weighed CMR and elevated NTpro-BNP levels in a single patient (2%). Left ventricular ejection fraction was 56% in this patient. Additional eight patients (14%) showed suspicious CMR findings, including myocardial edema without fibrosis (n = 3), or non-ischemic myocardial injury suggesting previous inflammation (n = 5). However, myocarditis could ultimately not be confirmed according to 2018 Lake Louise criteria; ECG, echo and lab findings were inconspicuous in all eight patients.

CONCLUSIONS:

Among 56 post-COVID patients with persistent thoracic complaints final diagnosis of myocarditis could be confirmed in a single patient using CMR.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Magnetic Resonance Imaging / COVID-19 / Heart / Myocarditis Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Clin Res Cardiol Journal subject: Cardiology Year: 2021 Document Type: Article Affiliation country: S00392-021-01929-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Magnetic Resonance Imaging / COVID-19 / Heart / Myocarditis Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Clin Res Cardiol Journal subject: Cardiology Year: 2021 Document Type: Article Affiliation country: S00392-021-01929-5