Impact of SARS-CoV-2 infection on myocardial perfusion in patients referred for cardiac scintigraphy. Analysis of a bicentric cohort

Abstract

Available data on myocardial perfusion status in recovered COVID-19 patients are sparse, limiting
preventive and therapeutic strategies. The following experience characterized myocardial
perfusion in patients with prior SARS-CoV-2 infection referred for vasodilator-stress myocardial
perfusion scintigraphy (MPS). A sample of patients consecutively referred to MPS in two Nuclear
Medicine centers was studied during November 2021-September 2022. Two groups were formed
according to the presence/absence of a history of COVID-19. Following a univariate approach, a
multivariate analysis (multiple logistic regression) was performed to estimate the value of prior
COVID-19 as a predictor of any abnormal CPM result, ischemia-compatible reversible defects, and
scar-compatible fixed defects. A total of 787 patients were included, with a mean age of 63.6
years, 41.8% men and 35.2% diabetics. A total of 217 patients (27.6%) had known CAD. The time
elapsed between the diagnosis of COVID-19 and MPS was 30.51 ± 25.26 weeks. A history of
COVID-19 behaved as an independent predictor of the presence of any perfusion scintigraphic
defect. The multivariate analysis that included those patients without previous coronary disease
verified that SARS-CoV-2 infection was associated with the presence of a scar in the anterior
region. In our bicentric cohort, previous SARS-CoV-2 infection behaves as an independent risk
factor for the development of myocardial perfusion abnormalities evidenced by MPS. The
mechanisms underlying these changes in myocardial perfusion deserve further evaluation.