Cardiovascular magnetic resonance imaging and spectroscopy in clinical long-COVID-19 syndrome: a prospective case–control study

Gorecka, Miroslawa, Jex, Nicholas, Thirunavukarasu, Sharmaine, Chowdhary, Amrit, Corrado, Joanna, Davison, Jennifer, Tarrant, Rachel, Poenar, Ana-Maria, Sharrack, Noor, Parkin, Amy, Sivan, Manoj, Swoboda, Peter P., Xue, Hui, Vassiliou, Vassilios ORCID:, Kellman, Peter, Plein, Sven, Halpin, Stephen J., Simms, Alexander D., Greenwood, John P. and Levelt, Eylem (2022) Cardiovascular magnetic resonance imaging and spectroscopy in clinical long-COVID-19 syndrome: a prospective case–control study. Journal of Cardiovascular Magnetic Resonance, 24. ISSN 1097-6647

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Background: The underlying pathophysiology of post-coronavirus disease 2019 (long-COVID-19) syndrome remains unknown, but increased cardiometabolic demand and state of mitochondrial dysfunction have emerged as candidate mechanisms. Cardiovascular magnetic resonance (CMR) provides insight into pathophysiological mechanisms underlying cardiovascular disease and 31-phosphorus CMR spectroscopy (31P-CMRS) allows non-invasive assessment of the myocardial energetic state. The main aim of the study was to assess whether long COVID-19 syndrome is associated with abnormalities of myocardial structure, function, perfusion and energy metabolism. Methods: Prospective case–control study. A total of 20 patients with a clinical diagnosis of long COVID-19 syndrome (seropositive) and no prior underlying cardiovascular disease (CVD) and 10 matching healthy controls underwent 31P-CMRS and CMR at 3T at a single time point. All patients had been symptomatic with acute COVID-19, but none required hospital admission. Results: Between the long COVID-19 syndrome patients and matched contemporary healthy controls there were no differences in myocardial energetics (phosphocreatine to ATP ratio), in cardiac structure (biventricular volumes), function (biventricular ejection fractions, global longitudinal strain), tissue characterization (T1 mapping and late gadolinium enhancement) or perfusion (myocardial rest and stress blood flow, myocardial perfusion reserve). One patient with long COVID-19 syndrome showed subepicardial hyperenhancement on late gadolinium enhancement imaging compatible with prior myocarditis, but no accompanying abnormality in cardiac size, function, perfusion, extracellular volume fraction, native T1, T2 or cardiac energetics. Conclusions: In this prospective case–control study, the overwhelming majority of patients with a clinical long COVID-19 syndrome with no prior CVD did not exhibit any abnormalities in myocardial energetics, structure, function, blood flow or tissue characteristics.

Item Type: Article
Additional Information: Funding Information: EL is funded by a Welcome Trust Clinical Career Development Fellowship (221690/Z/20/Z); JPG receives support from NIHR-UKRI COVID-19 Rapid Response Rolling Call (COV0254); SP and AC receive support from the British Heart Foundation; NJ receives support from Diabetes UK. AMP acknowledges funding received from the European Society of cardiology in form of an ESC Training Grant. Other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Uncontrolled Keywords: 31-phosphorus magnetic resonance spectroscopy,cardiovascular magnetic resonance imaging,covid-19,long covid,post-covid-19 syndrome,cardiology and cardiovascular medicine,radiological and ultrasound technology,radiology nuclear medicine and imaging,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2705
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 20 Sep 2022 12:30
Last Modified: 19 May 2023 09:39
DOI: 10.1186/s12968-022-00887-9

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