# Non-Ischemic Pattern of LGE After COVID-19 Correlates More with Severity of Acute Illness than with Long-Term Myocardial Dysfunction

## TL;DR

Non-ischemic LGE after COVID-19 is more linked to the severity of the acute illness than to long-term heart problems.

## Contribution

The study shows that non-ischemic LGE in severe COVID-19 is associated with hospitalization duration, not long-term heart dysfunction.

## Key findings

- LGE was found in 33.3% of patients, mostly in the lateral wall and septum.
- LGE was linked to longer hospital stays but not to heart function decline.
- LGE may represent a residual scar with limited long-term impact.

## Abstract

Background/Objectives: Myocarditis can occur in patients with coronavirus disease 2019 (COVID-19) as part of the systemic involvement of this infectious syndrome. The persistence of this non-ischemic late gadolinium enhancement (LGE) pattern can be considered an indicator of ongoing myocardial involvement or a sequela of myocarditis. We aimed to assess the effects of LGE on cardiac function and morphology in patients with COVID-19 admitted in intensive care unit for acute respiratory distress syndrome. Methods: Fifty patients (age 59 ± 11, female n = 15) were enrolled. Results: The prevalence of LGE was 33.3%. LGE was present in the lateral wall in all patients except for one, with LGE positivity at the interventricular septum. In general, patients with and without LGE had similar CMR variables values. In one case, LGE was associated with regional wall motion abnormality. The factor associated with LGE was the duration of hospitalization (7.97 ± 3.8 and 12.5 ± 6.7 days in patients without and with LGE, p = 0.007). Conclusions: LGE non-ischemic pattern was not associated with left ventricular dilatation or dysfunction or remodeling in patients with severe clinical manifestation of COVID-19. LGE is mainly present in patients with more prolonged duration of hospitalization. LGE may represent a residual scar with limited prognostic impact that larger multicenter studies could confirm.