Abstract
PurposeTo investigate if (i) the risk of ischemia on myocardial perfusion scan (MPS), (ii) number of coronary angiographies (CAG) performed, and (iii) necessity for invasive (stent implantation or coronary artery bypass grafting (CABG)) or medical treatment increased in patients infected with COVID-19.MethodsPatients who were referred to MPS between August 2020 and April 2021 with a history of active symptomatic COVID-19 infection (confirmed by PCR positivity) in the last 6 months were involved in the study group. Age-and gender-matched control group was composed of randomly chosen patients who attended for MPS between January 2019 and September 2019, before pandemic. Frequency of ischemia, CAG, and invasive or medical treatments were compared between groups.ResultsIschemia was reported more frequently in the study group (p < 0.001). In clinical evaluation, regardless of the MPS results, the necessity for invasive evaluation with CAG and treatment (either medical therapy or invasive interventions) was higher in the study group (p = 0.006 and p = 0.015). It was also true for patients with abnormal MPS results (p = 0.008 and p = 0.024) but not for the patients with ischemia (p = 0.29 and p = 0.06).ConclusionThere exists a significant increase in the frequency of ischemia on MPS, undergoing CAG, stent implantation or CABG, and initiation of medical therapy in patients with a history of COVID-19 infection in the last 6 months. MPS is a reliable method in patients who present with cardiovascular symptoms in the late COVID period.
Highlights
COVID-19 has affected healthcare systems and changed paradigms in the whole world in the last 1 year
We investigated if (i) the risk of ischemia on myocardial perfusion scan (MPS), (ii) number of coronary angiographies performed, and (iii) necessity for invasive (stent implantation or coronary artery bypass grafting (CABG)) or medical treatment increased in patients infected with COVID-19
The aim of this study was different than these previous reports; we focused only on patients with COVID-19 history and documented the increase in the incidence of ischemia demonstrable by MPS, compared to non-infected cohort
Summary
COVID-19 has affected healthcare systems and changed paradigms in the whole world in the last 1 year. Different from other upper respiratory tract viruses, COVID-19 appears to act on many systems in the body, inducing the inflammatory cascade and thrombotic process. It has been reported that risk of cardiac events has increased after COVID-19 infection [1]. Sudden cardiac death is reported among young patients, which is soon related with late thrombotic complications. Researchers have demonstrated that there was a significant increase in hospital admission rates due to acute myocardial infarction in the late phase of the first wave of the pandemic, compared to rates before pandemic [2]. Myocardial perfusion scan is the fundamental functional imaging method in evaluation of ischemia and coronary risk assessment. There have been several reports demonstrating the steep decline in the number of myocardial perfusion studies performed in nuclear medicine departments [3]. Its use in patients infected with COVID-19 has not been presented yet
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