Diagnostic importance of performing myocardial perfusion imaging in COVID-19 patients: A systematic review

Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge to the diagnosis and management of ischemic heart disease (IHD). Myocardial perfusion imaging (MPI) is a non-invasive technique that can assess myocardial ischemia and viability, as well as provide prognostic information for patients with IHD. However, the role of MPI in COVID-19 patients is not well established. Methods: A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify relevant studies published until Aprile 24th, 2024. The inclusion criteria were: (1) studies that performed MPI in COVID19 patients; (2) studies that reported the results of MPI in terms of ischemia, infarction, or perfusion defects; and (3) studies that compared MPI with other diagnostic modalities or clinical outcomes. The quality of the studies was assessed using the QUADAS-2 tool for diagnostic accuracy studies or the ROBIS tool for systematic reviews. A narrative synthesis was performed to summarize the main findings and recommendations. Results: A total of twenty-two studies met the inclusion criteria. The included study information was categorized into the following aspects: Change in the crude number of MPI scans performed, accidental and definite findings in MPI, and the prognostic outcome of COVID patients who underwent MPI. Conclusion: During Covid-19 pandemic, a reduction in the number of MPI studies was seen. Individuals with a history of COVID-19 infection have higher likelihood of developing ischemic heart disease (IHD). SARS-CoV-2 is an independent risk factor for the development of IHD.