A 12-month MRI study of 152 patients found that COVID-19 infection does not cause worse heart muscle inflammation than other viral respiratory infections like influenza, providing reassurance that previous COVID patients are unlikely to develop heart inflammation or heart failure.
- MRI scans and blood tests showed no significant differences in cardiac function between COVID-19 and non-COVID viral infection patients at 2 weeks, 3 months, and 12 months post-recovery
- The study included 112 recovered COVID patients compared to 40 non-COVID patients infected with influenza, rhinovirus, RSV, and other respiratory viruses
- Researchers found no signs of myocardial inflammation using advanced MRI measures including native T1/T2 values and extracellular volume quantification
- Cardiac MRI should only be used for suspected active myocarditis, not routine screening of all COVID-19 patients
- This is the first prospective study directly comparing COVID-19 to other viral respiratory infections with 12-month follow-up cardiac assessment
MRI shows that COVID-19 infection does not lead to worse heart muscle inflammatory response than other types of viral respiratory infections, suggest findings published October 16 in the Journal of Cardiovascular Magnetic Resonance.
Blood results and cardiac function parameters on MRI did not significantly differ between COVID and non-COVID patient groups, reported researchers led by Lam Kwok Ho, MBBS, from the University of Hong Kong in China.
“This is reassuring as patients with previous COVID-19 infections will likely not develop inflammation of the heart muscle nor develop heart failure,” Ho and colleagues wrote.
COVID-19 infection is tied to subclinical myocardial inflammation. This raises concerns about heart failure and persistent myocarditis post-infection. Ho et al pointed out a lack of data regarding how COVID-19 infection compares with non-COVID-19 viral infections in terms of myocardial inflammation based on cardiovascular MR assessment.
The researchers led a prospective longitudinal study to find out and compare the extent and severity of myocardial involvement in patients with COVID-19 infection versus a control group of non-COVID-19 viral respiratory infections.
The study included 152 participants, including 112 recovered COVID outpatients and 40 non-COVID inpatients. The patients underwent three cardiac MRI exams for functional assessment, native T1, T2, and extracellular volume quantification, with corroborating blood markers. MRI scans took place at the following time points: within two weeks of confirmed recovery, three months post-recovery, and 12 months post-recovery.
Non-COVID infections included influenza virus, rhinovirus/enterovirus, parainfluenza virus, respiratory syncytial virus, and human metapneumovirus.
At all three MRI exams, blood results and cardiac function parameters did not significantly differ between recovered COVID and non-COVID patient groups (p > 0.05).
At each time point, the researchers also reported no significant differences between the patient groups for the following measures: native T1/T2 values, extracellular volume, late gadolinium enhancement, T2 short tau inversion recovery, and overall fulfilment of the 2018 revised Lake Louise Criteria (diagnostic criteria for myocardial inflammation).
The study authors advised that cardiac MRI should only be used in cases of suspected active myocarditis and not for all patients with COVID-19 infection.
“To the best of our knowledge, there is no other research comparing COVID-19 infection to other non-COVID-19 viral respiratory infection with prospective 12-month follow-up,” they wrote. “This provides a useful comparison for the severity and risks of COVID-19 infection on the heart compared to non-COVID-19 viral respiratory infections including influenza.”
Read the full study here.
