Multimodality Cardiac Imaging, Cardiac Symptoms, and Clinical Outcomes in Patients Who Recovered from Mild COVID-19

Background: Many individuals have persistent cardiac symptoms after mild COVID-19 infection. However, studies assessing the relationship between symptoms and cardiac imaging are limited. Purpose: To assess the relationship between multimodality cardiac imaging parameters, cardiac symptoms, and clinical outcomes in patients who recovered from mild COVID-19 compared with COVID-19-negative controls. Materials and Methods: Patients who underwent polymerase chain reaction testing for SARS-CoV-2 from August 2020 to January 2022 were invited to participate in this prospective single-center study. Participants underwent cardiac MRI, echocardiography, and assessment of cardiac symptoms at 3-6 months after SARS-CoV-2 testing. Cardiac symptoms and outcomes were also evaluated at a 12-18-month follow-up time point. Statistical analysis included the Fisher exact test and logistic regression. Results: This study included 122 participants who recovered from COVID-19 (mean age, 42 years +/- 13 [SD]; 73 female) and 22 controls who tested negative for COVID-19 (mean age, 46 years +/- 16; 13 female). At 3-6 months, 20% (24 of 122) and 44% (54 of 122) of participants with COVID-19 had at least one abnormality at echocardiography and cardiac MRI, respectively, which did not differ compared with controls (23% [five of 22], P = .77 and 41% [nine of 22], P = .82, respectively). However, participants with COVID-19 more frequently reported cardiac symptoms at 3-6 months compared with controls (48% [58 of 122] vs 23% [five of 22], P = .04). An increase in native T1 (10 msec) was associated with increased odds of cardiac symptoms at the 3-6-month (odds ratio [OR], 1.09 [95% CI: 1.00, 1.19]; P = .046) and 12-18-month (OR, 1.14 [95% CI: 1.01, 1.28]; P = .028) time points. No major adverse cardiac events occurred during follow-up. Conclusion: Participants who recovered from mild COVID-19 reported increased cardiac symptoms 3-6 months after diagnosis compared with controls, but the prevalence of abnormalities at echocardiography and cardiac MRI did not differ between groups. Elevated native T1 was associated with cardiac symptoms 3-6 months and 12-18 months after mild COVID-19. (c) RSNA, 2023