Diffused Myocardial Inflammation in COVID-19 Associated Myocarditis Detected by Cardiac Magnetic Resonance Imaging in Post-COVID Patients

Abstract

Objective: To determine the frequency of myocarditis in patients recovered from COVID-19 infection.

Study Design: Analytical Cross-sectional study.

Place and Duration of Study: Cardiac Magnetic Resonance Imaging Department, Armed Forces Institute of Cardiology/
National Institute of Heart Disease, Rawalpindi Pakistan from Jul 2020 till Apr 2022.

Methodology: All patients who underwent Cardiac Magnetic Resonance Imaging after recovery from COVID-19 were enrolled. Non-probability consecutive sampling technique was used for sample selection and was calculated on the basis of Gpower. Data of patients fulfilling the inclusion criteria was selected. All PCR positive cases of COVID-19 who recovered from COVID-19 and completed their 12 days of isolation not exceeding 60 days of 1st Polymerase chain reaction positive, and who have any symptoms of shortness of breath, fatigue and chest pain with reduced left ventricular ejection fraction (LVEF) on 2Dechocardiogram were included in the study. Data was recorded, stored, and analyzed by using SPSS version-21. Quantitative data was reported as Mean±SD. Categorical variables were reported as frequency and percentage. To determine theassociation between different variables Chi square test was used.

Results: Total 83 patients were included in this study who recovered from COVID-19 and underwent Cardiovascular magnetic resonance. Mean age of the patients was 39.17±12.9 years. 67(80.72%) were male while 16(19.28%) were females.50(60%) had myocarditis after recovery from COVID-19. This study showed statistically significant association of all the Cardiovascular magnetic resonance imaging findings with Myocarditis (p<0.05) at 95% confidence interval and 5% margin of error.

Conclusion: Early detection of COVID-19 related myocarditis will help in better management of patient. In such patients,cardiac Magnetic Resonance Imaging is the modality of choice, since it allows for noninvasive assessment of myocardial edema and fibrosis, as well as therapeutic guidance and improved patient outcomes.