Cardiac involvement in patients recovered from coronavirus disease-2019 (COVID-19): a systematic review

Shafiabadi, N; Rastad, H; Mozafarybazargany, M; Talakoob, H; Karim, H

BACKGROUND: About 47.3 million people have recovered from coronavirus disease 2019 (COVID-19). Manifestations of cardiac involvement have been noted in a significant number of patients in the acute phase. There are increasing concerns that some of these cardiac sequels may persist beyond the acute phase. If untreated, the sustained cardiac injury, especially myocarditis and fibrosis, could have severe consequences. Recent studies have assessed the presence of cardiac involvement using cardiac magnetic resonance (CMR) imaging during the post-acute phase. PURPOSE: We present a systematic review of studies assessing evidence of cardiac involvement in patients recovered from COVID-19 during the post-acute phase using Cardiac Magnetic Resonance (CMR) Imaging. METHODS: We reported this study in accordance with PRISMA. A systematic search was performed on PubMed, Embase (Elsevier), and Google scholar databases using Boolean operators and the relevant key terms covering COVID-19, Cardiac injury, CMR, and follow-up. Retrieved articles were included based on predefined eligibility criteria. RESULTS: Of 1406 articles retrieved from the initial search, 11 items, 9 cohort, and 2 case series studies met our eligibility criteria. The rate of raised T1 (reported in 6 articles) in patients recovered from COVID-19 varied across studies from 5% to73%. In 4 out of 9 studies, raised T2 was detected in any patients, and in remained studies, its rate ranged from 2% to 60%. In most of the included studies, LGE (myocardial or pericardial) was observed in COVID-19 survivors, ranged from 7.0% to 100%. Myocardial LGE mainly had nonischemic patterns. None of the cohort studies observed myocardial LGE in “healthy” controls. Most studies found that patients who recovered from COVID-19 had significantly a greater mean (SD) T1 and T2 compared to participants in the control group. CONCLUSION: Our systematic review study found evidence of subclinical and clinical myocardial and pericardial involvement in patients recovered from COVID-19. FUNDUNDING ACKNOWLEDGEMENT: Type of funding sources: None.