Abstract
Introduction: Severe COVID-19 infection is known to alter myocardial perfusion through its effects on the endothelium and microvasculature. However, a significant proportion of the world population suffered from only mild COVID-19 symptoms, and it is unknown if their myocardial perfusion is altered following their recovery. Hypothesis: In this study, we aimed to determine if there are detectable abnormalities to myocardial perfusion using cardiac magnetic resonance (CMR) in individuals who have recovered from mild COVID-19 infection. Methods: We conducted a prospective, comparative study of individuals who have recovered from COVID-19 infection (n=33) and risk-factor matched controls (n=27) using regadenoson stress CMR by a 1.5T MR scanner (GE Signa Artist) (figure). Quantitative stress perfusion images were acquired using the dual sequence technique. MBF was measured during rest (rMBF) and stress (sMBF) using Cvi42 software(figure). Myocardial perfusion reserve (MPR) was calculated as sMBF/rMBF. Unpaired t test or the Mann-Whitney U test was used to test differences between the two groups. Results: The median time interval between COVID-19 infection and CMR was 6 (4, 9) months. 31/33 (94%) patients in COVID-19 infection were not hospitalized. Symptoms including chest pain, shortness of breath, syncope, and palpitations were greater in COVID-19 group than in the matched controls (19/33 (58%) vs 2/27 (7%), p<0.001). No differences in rMBF (1.50 ± 0.47 vs 1.36 ± 0.45ml/g/min, p=0.21), sMBF (2.84 ± 0.56 vs 2.75 ± 0.64ml/g/min, p=0.56), or MPR (1.94 (1.48-2.75) vs 2.0 (1.59-3.05), p=0.34) were observed between the groups(figure). Conclusions: No significant abnormalities in myocardial perfusion during rest or stress conditions were seen in individuals who had recovered from mild COVID-19 infection suggesting that microvascular dysfunction is unlikely to be a common sequela in this patient population.
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