tetano
Editor, Senior Moderator
JACC Cardiovasc Imaging
. 2021 May 5;S1936-878X(21)00356-9.
doi: 10.1016/j.jcmg.2021.04.011. Online ahead of print.
Prospective Case-Control Study of Cardiovascular Abnormalities 6 Months Following Mild COVID-19 in Healthcare Workers
George Joy[SUP] 1 [/SUP], Jessica Artico[SUP] 1 [/SUP], Hibba Kurdi[SUP] 1 [/SUP], Andreas Seraphim[SUP] 1 [/SUP], Clement Lau[SUP] 2 [/SUP], George D Thornton[SUP] 1 [/SUP], Marta Fontes Oliveira[SUP] 3 [/SUP], Robert Daniel Adam[SUP] 4 [/SUP], Nikoo Aziminia[SUP] 5 [/SUP], Katia Menacho[SUP] 1 [/SUP], Liza Chacko[SUP] 6 [/SUP], James T Brown[SUP] 6 [/SUP], Rishi K Patel[SUP] 6 [/SUP], Hunain Shiwani[SUP] 1 [/SUP], Anish Bhuva[SUP] 1 [/SUP], Joao B Augusto[SUP] 7 [/SUP], Mervyn Andiapen[SUP] 8 [/SUP], Aine McKnight[SUP] 9 [/SUP], Mahdad Noursadeghi[SUP] 10 [/SUP], Iain Pierce[SUP] 1 [/SUP], Timoth?e Evain[SUP] 11 [/SUP], Gabriella Captur[SUP] 12 [/SUP], Rhodri H Davies[SUP] 1 [/SUP], John P Greenwood[SUP] 13 [/SUP], Marianna Fontana[SUP] 6 [/SUP], Peter Kellman[SUP] 14 [/SUP], Erik B Schelbert[SUP] 15 [/SUP], Thomas A Treibel[SUP] 1 [/SUP], Charlotte Manisty[SUP] 1 [/SUP], James C Moon[SUP] 16 [/SUP], COVIDsortium Investigators
Affiliations
Abstract
Objectives: The purpose of this study was to detect cardiovascular changes after mild severe acute respiratory syndrome coronavirus 2 infection.
Background: Concern exists that mild coronavirus disease 2019 may cause myocardial and vascular disease.
Methods: Participants were recruited from COVIDsortium, a 3-hospital prospective study of 731 health care workers who underwent first-wave weekly symptom, polymerase chain reaction, and serology assessment over 4 months, with seroconversion in 21.5% (n = 157). At 6 months post-infection, 74 seropositive and 75 age-, sex-, and ethnicity-matched seronegative control subjects were recruited for cardiovascular phenotyping (comprehensive phantom-calibrated cardiovascular magnetic resonance and blood biomarkers). Analysis was blinded, using objective artificial intelligence analytics where available.
Results: A total of 149 subjects (mean age 37 years, range 18 to 63 years, 58% women) were recruited. Seropositive infections had been mild with case definition, noncase definition, and asymptomatic disease in 45 (61%), 18 (24%), and 11 (15%), respectively, with 1 person hospitalized (for 2 days). Between seropositive and seronegative groups, there were no differences in cardiac structure (left ventricular volumes, mass, atrial area), function (ejection fraction, global longitudinal shortening, aortic distensibility), tissue characterization (T[SUB]1[/SUB], T[SUB]2[/SUB], extracellular volume fraction mapping, late gadolinium enhancement) or biomarkers (troponin, N-terminal pro-B-type natriuretic peptide). With abnormal defined by the 75 seronegatives (2 SDs from mean, e.g., ejection fraction <54%, septal T[SUB]1[/SUB] >1,072 ms, septal T[SUB]2[/SUB] >52.4 ms), individuals had abnormalities including reduced ejection fraction (n = 2, minimum 50%), T[SUB]1[/SUB] elevation (n = 6), T[SUB]2[/SUB] elevation (n = 9), late gadolinium enhancement (n = 13, median 1%, max 5% of myocardium), biomarker elevation (borderline troponin elevation in 4; all N-terminal pro-B-type natriuretic peptide normal). These were distributed equally between seropositive and seronegative individuals.
Conclusions: Cardiovascular abnormalities are no more common in seropositive versus seronegative otherwise healthy, workforce representative individuals 6 months post-mild severe acute respiratory syndrome coronavirus 2 infection.
Keywords: COVID-19; SARS-CoV-2; cardiovascular magnetic resonance; late gadolinium enhancement; myocardial edema; myocarditis; troponin.
. 2021 May 5;S1936-878X(21)00356-9.
doi: 10.1016/j.jcmg.2021.04.011. Online ahead of print.
Prospective Case-Control Study of Cardiovascular Abnormalities 6 Months Following Mild COVID-19 in Healthcare Workers
George Joy[SUP] 1 [/SUP], Jessica Artico[SUP] 1 [/SUP], Hibba Kurdi[SUP] 1 [/SUP], Andreas Seraphim[SUP] 1 [/SUP], Clement Lau[SUP] 2 [/SUP], George D Thornton[SUP] 1 [/SUP], Marta Fontes Oliveira[SUP] 3 [/SUP], Robert Daniel Adam[SUP] 4 [/SUP], Nikoo Aziminia[SUP] 5 [/SUP], Katia Menacho[SUP] 1 [/SUP], Liza Chacko[SUP] 6 [/SUP], James T Brown[SUP] 6 [/SUP], Rishi K Patel[SUP] 6 [/SUP], Hunain Shiwani[SUP] 1 [/SUP], Anish Bhuva[SUP] 1 [/SUP], Joao B Augusto[SUP] 7 [/SUP], Mervyn Andiapen[SUP] 8 [/SUP], Aine McKnight[SUP] 9 [/SUP], Mahdad Noursadeghi[SUP] 10 [/SUP], Iain Pierce[SUP] 1 [/SUP], Timoth?e Evain[SUP] 11 [/SUP], Gabriella Captur[SUP] 12 [/SUP], Rhodri H Davies[SUP] 1 [/SUP], John P Greenwood[SUP] 13 [/SUP], Marianna Fontana[SUP] 6 [/SUP], Peter Kellman[SUP] 14 [/SUP], Erik B Schelbert[SUP] 15 [/SUP], Thomas A Treibel[SUP] 1 [/SUP], Charlotte Manisty[SUP] 1 [/SUP], James C Moon[SUP] 16 [/SUP], COVIDsortium Investigators
Affiliations
- PMID: 33975819
- DOI: 10.1016/j.jcmg.2021.04.011
Abstract
Objectives: The purpose of this study was to detect cardiovascular changes after mild severe acute respiratory syndrome coronavirus 2 infection.
Background: Concern exists that mild coronavirus disease 2019 may cause myocardial and vascular disease.
Methods: Participants were recruited from COVIDsortium, a 3-hospital prospective study of 731 health care workers who underwent first-wave weekly symptom, polymerase chain reaction, and serology assessment over 4 months, with seroconversion in 21.5% (n = 157). At 6 months post-infection, 74 seropositive and 75 age-, sex-, and ethnicity-matched seronegative control subjects were recruited for cardiovascular phenotyping (comprehensive phantom-calibrated cardiovascular magnetic resonance and blood biomarkers). Analysis was blinded, using objective artificial intelligence analytics where available.
Results: A total of 149 subjects (mean age 37 years, range 18 to 63 years, 58% women) were recruited. Seropositive infections had been mild with case definition, noncase definition, and asymptomatic disease in 45 (61%), 18 (24%), and 11 (15%), respectively, with 1 person hospitalized (for 2 days). Between seropositive and seronegative groups, there were no differences in cardiac structure (left ventricular volumes, mass, atrial area), function (ejection fraction, global longitudinal shortening, aortic distensibility), tissue characterization (T[SUB]1[/SUB], T[SUB]2[/SUB], extracellular volume fraction mapping, late gadolinium enhancement) or biomarkers (troponin, N-terminal pro-B-type natriuretic peptide). With abnormal defined by the 75 seronegatives (2 SDs from mean, e.g., ejection fraction <54%, septal T[SUB]1[/SUB] >1,072 ms, septal T[SUB]2[/SUB] >52.4 ms), individuals had abnormalities including reduced ejection fraction (n = 2, minimum 50%), T[SUB]1[/SUB] elevation (n = 6), T[SUB]2[/SUB] elevation (n = 9), late gadolinium enhancement (n = 13, median 1%, max 5% of myocardium), biomarker elevation (borderline troponin elevation in 4; all N-terminal pro-B-type natriuretic peptide normal). These were distributed equally between seropositive and seronegative individuals.
Conclusions: Cardiovascular abnormalities are no more common in seropositive versus seronegative otherwise healthy, workforce representative individuals 6 months post-mild severe acute respiratory syndrome coronavirus 2 infection.
Keywords: COVID-19; SARS-CoV-2; cardiovascular magnetic resonance; late gadolinium enhancement; myocardial edema; myocarditis; troponin.