Cardiovascular Magnetic Resonance for Patients With COVID-19.

Petersen, Steffen E; Friedrich, Matthias G; Leiner, Tim; Elias, Matthew D; Ferreira, Vanessa M; Fenski, Maximilian; Flamm, Scott D; Fogel, Mark; Garg, Ria; Halushka, Marc K; Hays, Allison G; Kawel-Boehm, Nadine; Kramer, Christopher M; Nagel, Eike; Ntusi, Ntobeko A B; Ostenfeld, Ellen; Pennell, Dudley J; Raisi-Estabragh, Zahra; Reeder, Scott B; Rochitte, Carlos E; ... (2022). Cardiovascular Magnetic Resonance for Patients With COVID-19. JACC. Cardiovascular imaging, 15(4), pp. 685-699. Elsevier 10.1016/j.jcmg.2021.08.021

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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.

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