Cardiac MRI Findings in Symptomatic Post Covid Patients with Suspected Myocarditis

Abstract

Background: Cardiovascular magnetic resonance (CMR) imaging, considered the gold standard for myocarditis diagnosis, presented conflicting results on the prevalence of COVID-19-associated myocarditis. Objective: This study aimed to describe CMR findings in patients with active COVID-19 infection within three months of infection and who had suspected acute myocarditis. Patients and Methods: This was a multi-center cross-sectional study that comprised adult patients with COVID-19 and clinical suspicion of associated myocarditis. Evaluation encompassed history, clinical examination, laboratory investigations, ECG, echocardiography, and CMR using the revised Lake Louise Criteria 2018 for myocarditis diagnosis. Participants (n=100) were divided into three groups based on CMR findings (Group I (n = 6); no myocarditis, Group II (n = 63); suspected myocarditis, and Group III; proved myocarditis. Notably, Group III (n = 31) exhibited distinct characteristics. Results: A multivariate analysis showed that chest pain, ferritin levels, and LAVI significantly predicted proved myocarditis after adjusting the other confounding factors. Conclusions: Active COVID-19 infection within three months showed a high prevalence of suspected and proved myocarditis, with specific characteristics in the proved myocarditis group.