AUTHOR=Doeblin Patrick , Steinbeis Fridolin , Scannell Cian M. , Goetze Collin , Al-Tabatabaee Sarah , Erley Jennifer , Faragli Alessandro , Pröpper Felix , Witzenrath Martin , Zoller Thomas , Stehning Christian , Gerhardt Holger , Sánchez-González Javier , Alskaf Ebraham , Kühne Titus , Pieske Burkert , Tschöpe Carsten , Chiribiri Amedeo , Kelle Sebastian 

TITLE=Brief Research Report: Quantitative Analysis of Potential Coronary Microvascular Disease in Suspected Long-COVID Syndrome

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.877416

DOI=10.3389/fcvm.2022.877416

ISSN=2297-055X

ABSTRACT=Background
Case series have reported persistent cardiopulmonary symptoms, often termed long-COVID- or post-COVID-Syndrome, in more than half of patients recovering from COVID-19. Recently, alterations in microvascular perfusion have been proposed as a possible pathomechanism in long-COVID-syndrome. We examined whether microvascular perfusion, measured by quantitative stress perfusion CMR, is impaired in patients with persistent cardiac symptoms post COVID-19. 

Methods
Our population consisted of 33 patients post COVID-19 examined in Berlin and London, 11 (33%) of which complained of persistent chest pain and 13 (39%) of dyspnea. The scan protocol included standard cardiac imaging and a dual-sequence quantitative stress perfusion. Standard parameters were compared to 17 healthy controls from our institution. Quantitative perfusion was compared to published values of healthy controls.  

Results
Stress MBF was significantly lower (31.8 ± 5.1 [µl/g/beat] vs. 37.8 ± 6.0 [µl/g/beat], P < .001) and T2 relaxation time was significantly higher (46.2 ± 3.6 ms vs. 42.7 ± 2.8 ms, P = .002) post COVID-19 compared to healthy controls. Stress MBF, T1 and T2 relaxation time were not correlated to COVID-19 severity (Spearman r = -.302, -.070 and -.297, respectively) or presence of symptoms. Stress MBF showed a U-shaped relation to time from PCR to MRI, no correlation to T1 relaxation time and a negative correlation to T2 relaxation time (Pearson r = -.446, P = .029). 

Conclusion
While we found a significantly reduced microvascular perfusion post COVID-19 compared to healthy controls, this reduction was not related to symptoms and COVID-19 severity.