The role of myocardial perfusion imaging in predicting myocardial ischemia in patients diagnosed with long COVID

Objective: Incomplete recovery with long-term complications weeks beyond the acute coronavirus disease 2019 (COVID-19) infection is referred to as long COVID. Among the well-known long-term complications of COVID-19, myocardial damage is a frequently encountered side effect. Yet there is a lack of data for identifying high-risk patients who are more likely to develop long-term cardiovascular complications following COVID-19. Myocardial perfusion imaging (MPI) is the primary functional imaging modality in evaluating myocardial ischemia This study aimed to investigate the role of MPI in predicting myocardial ischemia in patients diagnosed with long COVID.

Methods: Subjects were selected from eligible long COVID patients and control subjects without a prior history of COVID-19 who were referred to the nuclear medicine department for stress and rest single-photon emission computed tomography (SPECT) MPI. All participants' past medical records and clinical, and demographic characteristics were scanned. In addition, patients undergoing coronary angiography (CAG) following SPECT MPI were documented and patients with critical coronary stenosis were identified.

Results: Our results revealed that long COVID patients had higher rates of abnormal summed stress scores compared to the control subjects (p < 0.05). Additionally, serum CRP level, SPECT lung-to-heart ratio (LHR), and the presence of long COVID were independent predictors of ischemia. The presence of long COVID was the best predictor of ischemia among the aforementioned parameters (p < 0.001).

Conclusion: Our data indicate that SPECT MPI provides comprehensive information on myocardial perfusion and left ventricular function in long COVID patients.