Severe COVID causes long-lasting coronary microvascular dysfunction, new data show
New MRI data suggest that patients who weathered severe cases of COVID-19 may sustain long-lasting heart damage.
Specifically, researchers have uncovered evidence indicating patients who have been hospitalized with the virus may develop long-term left ventricular systolic dysfunction and coronary microvascular dysfunction. These findings were detailed this week in JAMA Network Open, where experts revealed the damage was evident on imaging nearly one year after patients had recovered from their initial infection.
“In long COVID, or postacute sequelae of SARS-CoV-2 infection, patients commonly experience cardiopulmonary symptoms, including dyspnea, palpitations, chest pain and fatigue, which impair quality of life and functional capacity,” Jannike Nickander, MD, PhD, with the department of clinical physiology at Karolinska University Hospital, in Sweden, and colleagues noted. “The underlying pathophysiological mechanisms are not fully understood but may stem from myocardial injury sustained during acute COVID-19 due to hypoxia, systemic hyperinflammation, hypercoagulability, and direct viral invasion of endothelial cells and cardiomyocytes.”
There are limited data on long-term coronary microvascular dysfunction in patients recovered from severe COVID. As such, researchers sought to gain a better understanding of exactly how common these issues are. To do this, they compared the cases of 37 patients previously hospitalized with severe COVID, which included cardiovascular magnetic resonance scans and 10 months of follow-up data, to that of a group of healthy age- and sex-matched controls.
Compared to the controls, the COVID group displayed multiple signs of coronary microvascular dysfunction, including reduced mean stress perfusion, impaired mean global longitudinal strain and impaired mean global circumferential strain. Researchers did not observe differences in stress perfusion or myocardial perfusion reserve in subgroups of the COVID cohort, who were stratified based on the presence or absence of cardiovascular risk factors or cardiac symptoms; this finding raises questions about of the culprit behind patients’ coronary microvascular dysfunction.
“Lack of variation in stress perfusion between patients with and without cardiovascular risk factors may suggest coronary microvascular dysfunction associated with severe COVID-19, warranting further investigation to elucidate mechanisms and guide potential therapeutic interventions,” the authors wrote.
The group went on to suggest that their findings could change how patients at risk of these complications are managed in the future.
View the detailed study findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.