{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:05:16Z","timestamp":1785470716603,"version":"3.56.0"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:00:00Z","timestamp":1678233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019689","name":"Suomen Kardiologinen Seura","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019689","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005633","name":"Syd\u00e4ntutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Government funding for university level research","award":["TYH2021310"],"award-info":[{"award-number":["TYH2021310"]}]},{"name":"Kirsti och Tor Johanssons Hj\u00e4rt och Cancerstiftelse"},{"name":"Nordic Council of Ministers for Education and Research"},{"name":"The Finnish infectious disease research foundation"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term symptoms are frequent after coronavirus disease 2019 (COVID-19). We studied the prevalence of post-acute myocardial scar on cardiac magnetic resonance imaging (CMR) in patients hospitalized due to COVID-19 and its association with long-term symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this prospective observational single-center study, 95 formerly hospitalized COVID-19 patients underwent CMR imaging at the median of 9 months after acute COVID-19. In addition, 43 control subjects were imaged. Myocardial scar characteristic of myocardial infarction or myocarditis were noted from late gadolinium enhancement images (LGE). Patient symptoms were screened using a questionnaire. Data are presented as mean \u00b1 standard deviation or median (interquartile range).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The presence of any LGE was higher in COVID-19 patients (66% vs. 37%, p&lt;0.01) as was the presence of LGE suggestive of previous myocarditis (29% vs. 9%, p = 0.01). The prevalence of ischemic scar was comparable (8% vs. 2%, p = 0.13). Only two COVID-19 patients (7%) had myocarditis scar combined with left ventricular dysfunction (EF &lt;50%). Myocardial edema was not detected in any participant. The need for intensive care unit (ICU) treatment during initial hospitalization was comparable in patients with and without myocarditis scar (47% vs. 67%, p = 0.44). Dyspnea, chest pain, and arrhythmias were prevalent in COVID-19 patients at follow-up (64%, 31%, and 41%, respectively) but not associated with myocarditis scar on CMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Myocardial scar suggestive of possible previous myocarditis was detected in almost one-third of hospital-treated COVID-19 patients. It was not associated with the need for ICU treatment, greater symptomatic burden, or ventricular dysfunction at 9 months follow-up. Thus, post-acute myocarditis scar on COVID-19 patients seems to be a subclinical imaging finding and does not commonly require further clinical evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0282394","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T13:38:31Z","timestamp":1678282711000},"page":"e0282394","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19"],"prefix":"10.1371","volume":"18","author":[{"given":"Aria","family":"Yar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-7122","authenticated-orcid":true,"given":"Valtteri","family":"Uusitalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satu M.","family":"Vaara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miia","family":"Holmstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aino-Maija","family":"Vuorinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiina","family":"Heli\u00f6","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riitta","family":"Paakkanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Kivist\u00f6","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suvi","family":"Syv\u00e4ranta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"H\u00e4stbacka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,3,8]]},"reference":[{"issue":"1","key":"pone.0282394.ref001","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/s40560-020-00508-6","article-title":"Prevalence and prognostic value of elevated troponins in patients hospitalised for coronavirus disease 2019: a systematic review and meta-analysis","volume":"8","author":"BC Zhao","year":"2020","journal-title":"J Intensive Care"},{"issue":"3","key":"pone.0282394.ref002","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.pcad.2020.03.001","article-title":"Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis","volume":"63","author":"G Lippi","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"issue":"15","key":"pone.0282394.ref003","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1136\/heartjnl-2020-317186","article-title":"COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis?","volume":"106","author":"M Imazio","year":"2020","journal-title":"Heart"},{"issue":"10","key":"pone.0282394.ref004","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1093\/cvr\/cvab201","article-title":"COVID-19-related cardiac complications from clinical evidences to basic mechanisms: opinion paper of the ESC Working Group on Cellular Biology of the Heart","volume":"117","author":"M Pesce","year":"2021","journal-title":"Cardiovasc Res"},{"issue":"3","key":"pone.0282394.ref005","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1038\/s41591-022-01689-3","article-title":"Long-term cardiovascular outcomes of COVID-19","volume":"28","author":"Y Xie","year":"2022","journal-title":"Nat Med"},{"issue":"10270","key":"pone.0282394.ref006","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S0140-6736(20)32656-8","article-title":"6-month consequences of COVID-19 in patients discharged from hospital: a cohort study","volume":"397","author":"C Huang","year":"2021","journal-title":"Lancet"},{"issue":"4","key":"pone.0282394.ref007","doi-asserted-by":"crossref","first-page":"2003481","DOI":"10.1183\/13993003.03481-2020","article-title":"Cardiopulmonary recovery after COVID-19: an observational prospective multicentre trial","volume":"57","author":"T Sonnweber","year":"2021","journal-title":"Eur Respir J"},{"issue":"8","key":"pone.0282394.ref008","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.jacc.2010.11.013","article-title":"Assessment of myocardial fibrosis with cardiovascular magnetic resonance","volume":"57","author":"N Mewton","year":"2011","journal-title":"J Am Coll Cardiol"},{"issue":"17","key":"pone.0282394.ref009","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.jacc.2009.02.007","article-title":"International Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis. Cardiovascular magnetic resonance in myocarditis: A JACC White Paper","volume":"53","author":"MG Friedrich","year":"2009","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"pone.0282394.ref010","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.jcmg.2021.08.021","article-title":"Cardiovascular Magnetic Resonance for Patients With COVID-19","volume":"15","author":"SE Petersen","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"issue":"1","key":"pone.0282394.ref011","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12968-020-00607-1","article-title":"Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update","volume":"22","author":"CM Kramer","year":"2020","journal-title":"J Cardiovasc Magn Reson"},{"issue":"1","key":"pone.0282394.ref012","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12968-020-00610-6","article-title":"Standardized image interpretation and post-processing in cardiovascular magnetic resonance\u20142020 update: Society for Cardiovascular Magnetic Resonance (SCMR): Board of Trustees Task Force on Standardized Post-Processing","volume":"22","author":"J Schulz-Menger","year":"2020","journal-title":"J Cardiovasc Magn Reson"},{"issue":"2","key":"pone.0282394.ref013","doi-asserted-by":"crossref","first-page":"343","DOI":"10.2307\/2529990","article-title":"A simple approximation for calculating sample sizes for comparing independent proportions","volume":"36","author":"JL Fleiss","year":"1980","journal-title":"Biometrics"},{"issue":"11","key":"pone.0282394.ref014","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1001\/jamacardio.2020.3557","article-title":"Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19)","volume":"5","author":"VO Puntmann","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"19","key":"pone.0282394.ref015","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1093\/eurheartj\/ehab075","article-title":"Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance","volume":"42","author":"T Kotecha","year":"2021","journal-title":"Eur Heart J"},{"issue":"11","key":"pone.0282394.ref016","doi-asserted-by":"crossref","first-page":"2330","DOI":"10.1016\/j.jcmg.2020.05.004","article-title":"Cardiac involvement in patients recovered from COVID-19-2019 identified using magnetic resonance imaging","volume":"13","author":"L Huang","year":"2020","journal-title":"J Am Coll Cardiol Img"},{"issue":"11","key":"pone.0282394.ref017","doi-asserted-by":"crossref","first-page":"2476","DOI":"10.1016\/j.jcmg.2020.08.012","article-title":"Patients recovered from COVID-19 show ongoing subclinical myocarditis as revealed by cardiac magnetic resonance imaging","volume":"13","author":"MY Ng","year":"2020","journal-title":"J Am Coll Cardiol Img"},{"key":"pone.0282394.ref018","doi-asserted-by":"crossref","first-page":"100683","DOI":"10.1016\/j.eclinm.2020.100683","article-title":"Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge","volume":"31","author":"B Raman","year":"2021","journal-title":"EClinicalMedicine"},{"issue":"2","key":"pone.0282394.ref019","doi-asserted-by":"crossref","first-page":"E230","DOI":"10.1148\/radiol.2021203998","article-title":"Elevated extracellular volume fraction and reduced global longitudinal strains in patients recovered from COVID-19 without clinical cardiac findings","volume":"299","author":"X Li","year":"2021","journal-title":"Radiology"},{"issue":"1","key":"pone.0282394.ref020","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12968-021-00710-x","article-title":"Cardiac involvement in COVID-19 patients: mid-term follow up by cardiovascular magnetic resonance","volume":"23","author":"H Wang","year":"2021","journal-title":"J Cardiovasc Magn Reason"},{"key":"pone.0282394.ref021","article-title":"Cardiac sarcoidosis and giant cell myocarditis after COVID-19 infection","author":"E Bollano","year":"2022","journal-title":"ESC Heart Fail"},{"issue":"24","key":"pone.0282394.ref022","doi-asserted-by":"crossref","first-page":"3158","DOI":"10.1016\/j.jacc.2018.09.072","article-title":"Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations","volume":"72","author":"VM Ferreira","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"13","key":"pone.0282394.ref023","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/j.jacc.2022.02.004","article-title":"Patients With Myocarditis Associated With COVID-19 Vaccination","volume":"79","author":"CM Rosner","year":"2022","journal-title":"J Am Coll Cardiol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0282394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T13:38:56Z","timestamp":1678282736000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0282394"}},"subtitle":[],"editor":[{"given":"Antonio","family":"Cannat\u00e0","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,3,8]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0282394","relation":{"is-referenced-by":[{"id-type":"doi","id":"10.1038\/s41598-025-23486-x","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,8]]}}}