CMR findings:
A total of 480 myocardial segments of the thirty patients were
evaluated. Sixteen patients of the 30 (53.3%) had abnormal CMR findings
in terms of increased T2 signal and/or LGE (Figure 2 and Figure 3).
Myocardial edema was reported in 12 (40%) patients while 10 (33.3%)
patients had LGE. Majority of the patients had a focal linear
sub-epicardial LGE (6/10; 60%) while patchy mid-wall LGE was reported
in 4 (40%) [Figure 3]. Most of the LGE lesions were localized in
the inferior, infero-septal segments at base and mid-LV cavity level.
None of the subjects in the healthy controls had any LGE on CMR. A
diagnosis of active myocarditis based on the revised
LLC14 was made in 7/30 (23.3%) individuals. In terms
of conventional left ventricular CMR parameters such as LVEF, LV end
diastolic volume (EDV), LV end systolic volume (ESV) and stroke volume
(SV), there was no significant difference between patients who recovered
from COVID-19 and healthy controls (Table 2). However, COVID-19
recovered patients had significantly lower RVEF, RV SV and RV cardiac
index (CI) as compared to healthy controls. Follow-up CMR was performed
six months later in sixteen subjects who had an abnormal CMR findings.
All these sixteen patients had been on medical therapy comprising
beta-blockers and ACE inhibitors/ARBs. Of the sixteen subjects,
follow-up scan was abnormal in four of them (25%) with LGE persisting
in three individuals (Figure 4) while one had raised myocardial T2
value. Of the four patients with abnormal CMR on follow-up, moderate
COVID-19 was present in one and severe COVID-19 in three individuals.