Objectives We assessed possible myocardial involvement in previously cardiac healthy post-COVID patients referred for persisting symptoms with suspected myocarditis. Background Prior studies suggested myocardial inflammation in patients with coronavirus-induced disease 2019 (COVID-19). However, the prevalence of cardiac involvement among COVID patients varied between 1.4 and 78%. Methods A total of 56 post-COVID patients without previous heart diseases were included consecutively into this study. All patients had positive antibody titers against SARS-CoV-2. Patients were referred for persistent symptoms such as chest pain/discomfort, shortness of breath, or intolerance to activity. All patients underwent standardized cardiac assessment including electrocardiogram (ECG), cardiac biomarkers, echocardiography, and cardiac magnetic resonance (CMR). Results 56 Patients (46 ± 12 years, 54% females) presented 71 ± 66 days after their COVID-19 disease. In most patients, the course of COVID-19 was mild, with hospital treatment being necessary in five (9%). At presentation, patients most often reported persistent fatigue (75%), chest pain (71%), and shortness of breath (66%). Acute myocarditis was confirmed by T1/T2-weighed CMR and elevated NTpro-BNP levels in a single patient (2%). Left ventricular ejection fraction was 56% in this patient. Additional eight patients (14%) showed suspicious CMR findings, including myocardial edema without fibrosis ( n = 3), or non-ischemic myocardial injury suggesting previous inflammation ( n = 5). However, myocarditis could ultimately not be confirmed according to 2018 Lake Louise criteria; ECG, echo and lab findings were inconspicuous in all eight patients. Conclusions Among 56 post-COVID patients with persistent thoracic complaints final diagnosis of myocarditis could be confirmed in a single patient using CMR. Graphic abstract
【저자키워드】 COVID-19, myocarditis, Myocardial inflammation, Cardiac imaging, MR-tomography, 【초록키워드】 Treatment, SARS-CoV-2, Inflammation, Biomarkers, fatigue, hospital, Diagnosis, fibrosis, Symptom, ECG, COVID-19 disease, Prevalence, myocardial injury, Chest, Patient, edema, Antibody titer, Mild, disease, patients, heart disease, Thoracic, chest pain, Acute myocarditis, Shortness of breath, Ejection fraction, Abstract, Final, positive, left, myocardial involvement, females, lab, objective, FIVE, Myocardial, Course, Result, healthy, reported, elevated, eight, suggested, cardiac assessment, COVID patient, Lake, ventricular, 【제목키워드】 clinical, Patient,