The cardiovascular complications of coronavirus disease-2019 (COVID-19) are still being established (1). Expert guidelines recommend the use of cardiac imaging in the management of patients with COVID-19 (2), and cardiac magnetic resonance (CMR) has shown utility in the noninvasive detection of myocardial inflammation (3). We present a case series of 16 patients who recovered from COVID-19 who underwent CMR to assess for evidence of myocardial involvement or ongoing myocarditis. Ethics approval was obtained from the Hong Kong West Cluster (UW20-359) Institutional Review Board for this retrospective study. Inclusion criteria were COVID-19 patients admitted as inpatients to Queen Mary Hospital, referred for outpatient CMR post-recovery for raised troponin levels or electrocardiogram changes during the acute illness. Exclusion criteria were poor-quality CMR preventing assessment of ventricular function and late gadolinium enhancement (LGE). COVID-19 was diagnosed based on reverse transcription polymerase chain reaction test results of nasopharyngeal and throat swabs. Recovered COVID-19 status was based on: 1) 2 negative nasopharyngeal swab reverse transcription polymerase chain reaction results> 24 h apart; and 2) absence of fever and improvement in respiratory symptoms. COVID-19 disease severity was defined according to World Health Organization criteria (4). CMR performed at 1.5-T (GE Healthcare Systems, Chicago, Illinois) included cine, native T1-mapping (SMART1), T2-mapping, and LGE. T1/T2–mapping were analyzed in the mid-ventricular slice for an average value per patient. Images were reviewed independently by 3 cardiac radiologists.

Sixteen patients were identified (median age 68 years [interquartile range: 53 to 69 years]; 7 female subjects). Fifteen (94%) of the 16 patients had mild/moderate World Health Organization–defined disease severity. On admission, 14 (88%) had electrocardiogram changes, and 7 (44%) had raised troponin levels. At $2 weeks’ post-discharge, 11 (69%) patients were asymptomatic. Five (31%) had symptoms such as cough, shortness of breath, and mild chest pain.