Multiparametric Cardiovascular MRI Assessment of Post-COVID Syndrome in Children in Comparison to Matched Healthy Individuals

Jan Eckstein; Valentina Skeries; Gesa Pöhler; Nigar Babazade; Till Kaireit; Marcel Gutberlet; Norman Kornemann; Susanne Hellms; Alexander Pfeil; Andreas Michael Bucher; Georg Hansmann; Philipp Beerbaum; Gesine Hansen; Frank Wacker; Jens Vogel-Claussen; Martin Wetzke; Diane Miriam Renz

doi:10.1097/RLI.0000000000001048

Multiparametric Cardiovascular MRI Assessment of Post-COVID Syndrome in Children in Comparison to Matched Healthy Individuals

Invest Radiol. 2023 Dec 18. doi: 10.1097/RLI.0000000000001048. Online ahead of print.

Authors

Jan Eckstein¹, Valentina Skeries, Gesa Pöhler, Nigar Babazade, Till Kaireit, Marcel Gutberlet, Norman Kornemann, Susanne Hellms, Alexander Pfeil, Andreas Michael Bucher, Georg Hansmann, Philipp Beerbaum, Gesine Hansen, Frank Wacker, Jens Vogel-Claussen, Martin Wetzke, Diane Miriam Renz

Affiliation

¹ From the Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany (J.E., G.P., N.B., T.K., M.G., N.K., S.H., F.W., J.V.-C., D.M.R.); Clinic for Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany (V.S., G.H., M.W.); Department of Internal Medicine III, University Hospital Jena, Jena, Germany (A.P.); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany (A.M.B.); and Clinic for Pediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany (G.H., P.B.).

PMID: 38117123
DOI: 10.1097/RLI.0000000000001048

Abstract

Background: Post-COVID syndrome (PCS) can adversely affect the quality of life of patients and their families. In particular, the degree of cardiac impairment in children with PCS is unknown.

Objective: The aim of this study was to identify potential cardiac inflammatory sequelae in children with PCS compared with healthy controls.

Methods: This single-center, prospective, intraindividual, observational study assesses cardiac function, global and segment-based strains, and tissue characterization in 29 age- and sex-matched children with PCS and healthy children using a 3 T magnetic resonance imaging (MRI).

Results: Cardiac MRI was carried out over 36.4 ± 24.9 weeks post-COVID infection. The study cohort has an average age of 14.0 ± 2.8 years, for which the majority of individuals experience from fatigue, concentration disorders, dyspnea, dizziness, and muscle ache. Children with PSC in contrast to the control group exhibited elevated heart rate (83.7 ± 18.1 beats per minute vs 75.2 ± 11.2 beats per minute, P = 0.019), increased indexed right ventricular end-diastolic volume (95.2 ± 19.2 mlm-2 vs 82.0 ± 21.5 mlm-2, P = 0.018) and end-systolic volume (40.3 ± 7.9 mlm-2 vs 34.8 ± 6.2 mlm-2, P = 0.005), and elevated basal and midventricular T1 and T2 relaxation times (P < 0.001 to P = 0.013). Based on the updated Lake Louise Criteria, myocardial inflammation is present in 20 (69%) children with PCS. No statistically significant difference was observed for global strains.

Conclusions: Cardiac MRI revealed altered right ventricular volumetrics and elevated T1 and T2 mapping values in children with PCS, suggestive for a diffuse myocardial inflammation, which may be useful for the diagnostic workup of PCS in children.