Conclusions
Patients with moderate to severe COVID-19 have a reduced hyperemic
coronary flow and CFVR indicating presence of CMD. The degree of CMD
correlates with biomarkers of inflammation, fibrin turnover, myocardial
injury and myocyte stretch, though it remains to be determined whether
these associations represent causal relationships between inflammation,
thrombosis, microvascular dysfunction, and finally myocardial injury.
Further work is needed to understand the clinical importance of these
findings, as well as therapeutic approaches to prevent or treat CMD in
COVID-19 patients.