MRI & CT coronary angiography in survivors of COVID-19 Link to paper on Heart Authors Trisha Singh, Thomas A Kite, Shruti S Joshi, Nick B Spath, Lucy Kershaw, Andrew Baker, Helen Jordan, Gaurav Singh Gulsin, Michelle Claire Williams, Edwin J R van Beek, Jayanth Ranjit Arnold, Scott I K Semple, Alastair James Moss, David E Newby, Marc Dweck, Gerry P McCann Abstract Objectives: To determine the contribution of comorbidities on the reported widespread myocardial abnormalities in patients with recent COVID-19. Methods: In a prospective two-centre observational study, patients hospitalised with confirmed COVID-19 underwent gadolinium & manganese-enhanced MRI & CT coronary angiography (CTCA). They were compared with healthy & comorbidity-matched volunteers after blinded analysis. Results: In 52 patients (median age: 54 (IQR 51–57) years, 39 males) who recovered from COVID-19, one-third (n=15, 29%) were admitted to intensive care & a fifth (n=11, 21%) were ventilated. Twenty-three patients underwent CTCA, with one-third having underlying coronary artery disease (n=8, 35%). Compared with younger healthy volunteers (n=10), patients demonstrated reduced left (ejection fraction (EF): 57.4±11.1 (95% CI 54.0 to 60.1) versus 66.3±5 (95 CI 62.4 to 69.8)%; p=0.02) & right (EF: 51.7±9.1 (95% CI 53.9 to 60.1) vs 60.5±4.9 (95% CI 57.1 to 63.2)%; p≤0.0001) ventricular systolic function with elevated native T1 values (1225±46 (95% CI 1205 to 1240) vs 1197±30 (95% CI 1178 to 1216) ms;p=0.04) & extracellular volume fraction (ECV) (31±4 (95% CI 29.6 to 32.1) vs 24±3 (95% CI 22.4 to 26.4)%; p<0.0003) but reduced myocardial manganese uptake (6.9±0.9 (95% CI 6.5 to 7.3) vs 7.9±1.2 (95% CI 7.4 to 8.5) mL/100 g/min; p=0.01). Compared with comorbidity-matched volunteers (n=26), patients had preserved left ventricular function but reduced right ventricular systolic function (EF: 51.7±9.1 (95% CI 53.9 to 60.1) vs 59.3±4.9 (95% CI 51.0 to 66.5)%; p=0.0005) with comparable native T1 values (1225±46 (95% CI 1205 to 1240) vs 1227±51 (95% CI 1208 to 1246) ms; p=0.99), ECV (31±4 (95% CI 29.6 to 32.1) vs 29±5 (95% CI 27.0 to 31.2)%; p=0.35), presence of late gadolinium enhancement & manganese uptake. These findings remained irrespective of COVID-19 disease severity, presence of myocardial injury or ongoing symptoms. Conclusions: Patients demonstrate right but not left ventricular dysfunction. Previous reports of left ventricular myocardial abnormalities following COVID-19 may reflect pre-existing comorbidities. Keywords COVID-19 CT coronary angiography (CTCA) Myocardial abnormalities Related links Link to paper on Heart Professor Marc Dweck Professor David Newby Professor Scott Semple Professor Edwin van Beek Dr Michelle Williams Dr Lucy Kershaw Heart / cardiovascular Coronary artery disease What is a MR scan? What is a CT scan? Social media tags & titles Featured paper: MRI & CT coronary angiography in survivors of COVID-19 @MarcDweck @imagingmedsci @EdinUniCVS Publication date 25 Oct, 2021