There are 3 issues within the COVID19-CMR-Myocarditis drama:

Issue 1 - Screening people without clinical features of myocarditis

My view - No, don’t do it.

Issue 2 – Diagnosis/overdiagnosis of “myocarditis”

COVID-19 myocarditis is often diagnosed based on T1 and T2 abnormalities (inflammation) without LGE (permanent injury).

With a severe inflammatory illness, it is not surprising to see T1/T2 abnormalities in the heart.

Issue 3 – What do the T1/T2 abnormalities mean? Myocarditis sounds bad.

My view - Histopathologic and prognostic data in clinical acute myocarditis are linked only to LGE (i.e., no LGE = good outcomes).

There are no prognostic data on T1/T2 abnormalities without LGE...

... but we know no LGE = good outcomes, so logic mandates that isolated T1/T2 abnormalities without LGE = good outcomes.

Think of them as the fevers of COVID-19 that linger around a bit longer in the heart.