(P199) MEDIUM TERM CARDIOVASCULAR OUTCOMES AND THEIR RELATIONSHIP WITH CARDIAC MAGNETIC RESONANCE IMAGING ABNORMALITIES IN PATIENTS PREVIOUSLY HOSPITALIZED WITH COVID-19

Background: Past cardiac magnetic resonance imaging (MRI) studies have reported varying prevalence of myocardial injury post COVID-19 infection. However, the clinical significance of these abnormalities is unclear, and there is dearth of cardiovascular outcome data on these patients. Our study aimed to evaluate the cardiovascular outcomes for patients who were hospitalized with COVID-19.

METHODS AND RESULTS: Seventy patients who were hospitalized for COVID-19 and with positive serum troponin levels were prospectively enrolled. Cardiac MRI was performed between June 2020 and July 2021 at Sunnybrook Health Sciences Centre. Cardiac MRI was performed at a mean 136 ± 57 days following COVID-19 infection. Clinical outcomes were ascertained at a mean 28 ± 3 months after enrollment. Specifically, all-cause mortality, emergency department (ED) visits for chest pain and/or palpitations, cardiovascular hospitalizations, and new cardiac diagnoses as well as initiation of any medications were ascertained. Fisher’s exact tests were employed to determine the potential association between patients with cardiac MRI abnormalities and adverse cardiovascular outcomes.
The mean age of our cohort was 75 ± 14 years, and 27 (38.6%) patients were female. In terms of cardiac MRI abnormalities, reduced left and right ventricular ejection fractions were found in three (4.3%) and seven (10.0%) patients respectively. Presence of late gadolinium enhancement was found in six (8.6%) and elevation in T1 and/or T2 values in eight (11.4%) patients. Follow-up was successfully conducted on 69 (98.6%) participants. Table 1 summarizes the patient outcome data. One (1.4%) individual died. Two (2.9%) patients had cardiac related hospitalizations for acute myocardial infarction and acute coronary syndrome. Ten (14.5%) patients had ED visits for chest pain and three (4.3%) for palpitations. New medications were prescribed to seventeen (24.6%) individuals. Four (5.8%) patients were newly diagnosed with coronary artery disease. Patients with cardiac MRI abnormalities were not significantly more likely to experience adverse cardiovascular outcomes when compared to those without abnormalities (see Table 2). Those with cardiac MRI abnormalities were not significantly more likely to die of any cause (p-value = 0.30), visit the emergency department or be admitted to the hospital for cardiovascular causes (p-value = 0.26 - 0.99), or receive a new diagnosis of coronary artery disease (p-value = 0.32).

Conclusion: We found relatively low rates of cardiovascular outcomes more than two years following COVID-19 infection. Importantly, there was no statistically significant association between the presence of cardiac MRI abnormalities and adverse cardiovascular outcomes.