Long-Term Coronary Microvascular and Cardiac Dysfunction After Severe COVID-19 Hospitalization

作者：Rebecka Steffen Johansson, Daniel Loewenstein, Klara Lodin, Judith Bruchfeld, Michael Runold, Marcus Ståhlberg, Hui Xue, Peter Kellman, Kenneth Caidahl, Henrik Engblom, Jannike Nickander · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.14411 · 被引用次数：7 · 研究领域：COVID-19 Clinical Research Studies、Cardiac Imaging and Diagnostics、Long-Term Effects of COVID-19

Importance: COVID-19 can lead to long-term cardiopulmonary symptoms and is associated with coronary microvascular dysfunction (CMD). However, long-term data on CMD after severe COVID-19 are lacking. Objective: To investigate long-term left ventricular function and the presence of CMD after severe COVID-19. Design, Setting, and Participants: This case-control study was conducted among patients at a single center from the prospective Follow-Up of Patients With Severe COVID-19 (UppCov) study, with follow-up multiparametric perfusion cardiovascular magnetic resonance (CMR) at 10 months after discharge from November 2020 to February 2021. Patients previously hospitalized due to severe COVID-19 (ventilatory support, oxygen flow ≥5 L/min, or both) with or without cardiac involvement (troponin t > 14 ng/L, pulmonary artery pressure >34 mm Hg, or both) were compared with historical sex- and age-matched volunteers without symptomatic ischemic heart disease. Standard contraindications to adenosine CMR were applied. Data were analyzed between March 2023 and March 2025. Exposure: Hospitalization due to severe COVID-19. Main Measures and Outcomes: Comprehensive CMR included native T1, native T2, extracellular volume, adenosine stress and rest perfusion mapping, gadolinium enhancement, and cine imaging. Comorbidities, medications, symptoms at follow-up, and details regarding hospitalization were obtained from patient records. Results: The study included 37 patients with COVID-19 (mean age, ...