TY - JOUR
T1 - Prospective case-control study of cardiovascular abnormalities 6 months following mild COVID-19 in healthcare workers
AU - Joy, George
AU - Artico, Jessica
AU - Kurdi, Hibba
AU - Seraphim, Andreas
AU - Lau, Clement
AU - Thornton, George D.
AU - Oliveira, Marta Fontes
AU - Adam, Robert Daniel
AU - Aziminia, Nikoo
AU - Menacho, Katia
AU - Chacko, Liza
AU - Brown, James T.
AU - Patel, Rishi K.
AU - Shiwani, Hunain
AU - Bhuva, Anish
AU - Augusto, Joao B.
AU - Andiapen, Mervyn
AU - McKnight, Aine
AU - Noursadeghi, Mahdad
AU - Pierce, Iain
AU - Evain, Timothée
AU - Captur, Gabriella
AU - Davies, Rhodri H.
AU - Greenwood, John P.
AU - Fontana, Marianna
AU - Kellman, Peter
AU - Schelbert, Erik B.
AU - Treibel, Thomas A.
AU - Manisty, Charlotte
AU - Moon, James C.
AU - COVIDsortium Investigators
A2 - Hickling, Lauren M.
PY - 2021/11
Y1 - 2021/11
N2 - 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 (T1, T2, 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 T1 >1,072 ms, septal T2 >52.4 ms), individuals had abnormalities including reduced ejection fraction (n = 2, minimum 50%), T1 elevation (n = 6), T2 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.
AB - 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 (T1, T2, 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 T1 >1,072 ms, septal T2 >52.4 ms), individuals had abnormalities including reduced ejection fraction (n = 2, minimum 50%), T1 elevation (n = 6), T2 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.
KW - cardiovascular magnetic resonance
KW - COVID-19
KW - late gadolinium enhancement
KW - myocardial edema
KW - myocarditis
KW - SARS-CoV-2
KW - troponin
UR - http://www.scopus.com/inward/record.url?scp=85110063626&partnerID=8YFLogxK
U2 - 10.1016/j.jcmg.2021.04.011
DO - 10.1016/j.jcmg.2021.04.011
M3 - Article
C2 - 33975819
AN - SCOPUS:85110063626
SN - 1936-878X
VL - 14
SP - 2155
EP - 2166
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 11
ER -