Cardiovascular Magnetic Resonance for Patients With COVID-19
Steffen E. Petersen (Barts Health National Health Service Trust, London, Queen Mary University of London)
Matthias G. Friedrich (McGill University)
Tim Leiner (Mayo Clinic, University Medical Centre Utrecht)
Matthew D. Elias (Children's Hospital of Philadelphia)
Vanessa M. Ferreira (University of Oxford)
Maximilian Fenski (Deutsches Zentrum für Herz-Kreislaufforschung-Partnersite-Berlin, Charité Universittsmedizin Berlin, Helios Klinikum Berlin Buch)
Scott D. Flamm (Cleveland Clinic, Cleveland)
Mark Fogel (University of Pennsylvania)
Qian Tao (Leiden University Medical Center, TU Delft - ImPhys/Medical Imaging)
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Abstract
COVID-19 is associated with myocardial injury caused by ischemia, inflammation, or myocarditis. Cardiovascular magnetic resonance (CMR) is the noninvasive reference standard for cardiac function, structure, and tissue composition. CMR is a potentially valuable diagnostic tool in patients with COVID-19 presenting with myocardial injury and evidence of cardiac dysfunction. Although COVID-19–related myocarditis is likely infrequent, COVID-19–related cardiovascular histopathology findings have been reported in up to 48% of patients, raising the concern for long-term myocardial injury. Studies to date report CMR abnormalities in 26% to 60% of hospitalized patients who have recovered from COVID-19, including functional impairment, myocardial tissue abnormalities, late gadolinium enhancement, or pericardial abnormalities. In athletes post–COVID-19, CMR has detected myocarditis-like abnormalities. In children, multisystem inflammatory syndrome may occur 2 to 6 weeks after infection; associated myocarditis and coronary artery aneurysms are evaluable by CMR. At this time, our understanding of COVID-19–related cardiovascular involvement is incomplete, and multiple studies are planned to evaluate patients with COVID-19 using CMR. In this review, we summarize existing studies of CMR for patients with COVID-19 and present ongoing research. We also provide recommendations for clinical use of CMR for patients with acute symptoms or who are recovering from COVID-19.