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Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study.

ABSTRACT: Biological cardiac injury related to the Severe Acute Respiratory Syndrome Coronavirus-2 infection has been associated with excess mortality. However, its functional impact remains unknown. The aim of our study was to explore the impact of biological cardiac injury on myocardial functions in patients with COVID-19. 31 patients with confirmed COVID-19 (CoV+) and 16 controls (CoV-) were prospectively included in this observational study. Demographic data, laboratory findings, comorbidities, treatments and myocardial function assessed by transthoracic echocardiography were collected and analysed in CoV+?with (TnT+) and without (TnT-) elevation of troponin T levels and compared with CoV-. Among CoV+, 13 (42%) exhibited myocardial injury. CoV+/TnT?+?patients were older, had lower diastolic arterial pressure and were more likely to have hypertension and chronic renal failure compared with CoV+/TnT-. The control group was comparable except for an absence of biological inflammatory syndrome. Left ventricular ejection fraction and global longitudinal strain were not different among the three groups. There was a trend of decreased myocardial work and increased peak systolic tricuspid annular velocity between the CoV- and CoV?+?patients, which became significant when comparing CoV- and CoV+/TnT+ (2167?±?359 vs. 1774?±?521%/mmHg, P?=?0.047 and 14?±?3 vs. 16?±?3 cm/s, P?=?0.037, respectively). There was a decrease of global work efficiency from CoV- (96?±?2%) to CoV+/TnT- (94?±?4%) and then CoV+/TnT+ (93?±?3%, P?=?0.042). In conclusion, biological myocardial injury in COVID 19 has low functional impact on left ventricular systolic function.

SUBMITTER: Lairez O

PROVIDER: S-EPMC7479389 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study.

Lairez Olivier O Blanchard Virginie V Houard Valérie V Vardon-Bounes Fanny F Lemasle Maeva M Cariou Eve E Lavie-Badie Yoan Y Ruiz Stéphanie S Cazalbou Stéphanie S Delmas Clément C Georges Bernard B Galinier Michel M Carrié Didier D Conil Jean-Marie JM Minville Vincent V

The international journal of cardiovascular imaging 20200909 2

Biological cardiac injury related to the Severe Acute Respiratory Syndrome Coronavirus-2 infection has been associated with excess mortality. However, its functional impact remains unknown. The aim of our study was to explore the impact of biological cardiac injury on myocardial functions in patients with COVID-19. 31 patients with confirmed COVID-19 (CoV+) and 16 controls (CoV-) were prospectively included in this observational study. Demographic data, laboratory findings, comorbidities, treatm ...[more]

PMID: 32902783

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Project description:ObjectiveThe coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on imaging utilization across practice settings. The purpose of this study was to quantify the change in the composition of inpatient imaging volumes for modality types and Current Procedural Terminology-coded groups during the COVID-19 pandemic.MethodsA retrospective study of inpatient imaging volumes in a large health care system was performed, analyzing weekly imaging volumes by modality types (radiography, CT, MRI, ultrasound, interventional radiology, nuclear medicine) in years 2020 and 2019. The data set was split to compare pre-COVID-19 (weeks 1-9) and post-COVID-19 (weeks 10-16) periods. Further subanalyses compared early post-COVID-19 (weeks 10-13) and late post-COVID-19 (weeks 14-16) periods. Statistical comparisons were performed using χ2 and independent-samples t tests.ResultsCompared with 2019, total inpatient imaging volume in 2020 post-COVID-19, early and late post-COVID-19 periods, declined by 13.6% (from 78,902 to 68,168), 16.6% (from 45,221 to 37,732), and 9.6% (from 33,681 to 30,436), respectively. By week 16, inpatient imaging volume rebounded and was only down 4.2% (from 11,003 to 10,546). However, a statistically significant shift (P < .0001) in the 2020 composition mix was observed largely comprised of radiography (74.3%), followed by CT (12.7%), ultrasound (8%), MRI (2.4%), interventional radiology (2.3%), and nuclear medicine (0.4%). Although the vast majority of imaging studies declined, few Current Procedural Terminology-coded groups showed increased trends in imaging volumes in the late post-COVID-19 period, including CT angiography chest, radiography chest, and ultrasound venous duplex.DiscussionDuring the COVID-19 pandemic, we observed a decrease in inpatient imaging volumes accompanied by a shift away from cross-sectional imaging toward radiography. These findings could have significant implications in planning for a potential resurgence.

Project description:Importance:Coronavirus disease 2019 (COVID-19) continues to cause considerable morbidity and mortality worldwide. Case reports of hospitalized patients suggest that COVID-19 prominently affects the cardiovascular system, but the overall impact remains unknown. Objective:To evaluate the presence of myocardial injury in unselected patients recently recovered from COVID-19 illness. Design, Setting, and Participants:In this prospective observational cohort study, 100 patients recently recovered from COVID-19 illness were identified from the University Hospital Frankfurt COVID-19 Registry between April and June 2020. Exposure:Recent recovery from severe acute respiratory syndrome coronavirus 2 infection, as determined by reverse transcription-polymerase chain reaction on swab test of the upper respiratory tract. Main Outcomes and Measures:Demographic characteristics, cardiac blood markers, and cardiovascular magnetic resonance (CMR) imaging were obtained. Comparisons were made with age-matched and sex-matched control groups of healthy volunteers (n?=?50) and risk factor-matched patients (n?=?57). Results:Of the 100 included patients, 53 (53%) were male, and the median (interquartile range [IQR]) age was 49 (45-53) years. The median (IQR) time interval between COVID-19 diagnosis and CMR was 71 (64-92) days. Of the 100 patients recently recovered from COVID-19, 67 (67%) recovered at home, while 33 (33%) required hospitalization. At the time of CMR, high-sensitivity troponin T (hsTnT) was detectable (3 pg/mL or greater) in 71 patients recently recovered from COVID-19 (71%) and significantly elevated (13.9 pg/mL or greater) in 5 patients (5%). Compared with healthy controls and risk factor-matched controls, patients recently recovered from COVID-19 had lower left ventricular ejection fraction, higher left ventricle volumes, higher left ventricle mass, and raised native T1 and T2. A total of 78 patients recently recovered from COVID-19 (78%) had abnormal CMR findings, including raised myocardial native T1 (n?=?73), raised myocardial native T2 (n?=?60), myocardial late gadolinium enhancement (n?=?32), and pericardial enhancement (n?=?22). There was a small but significant difference between patients who recovered at home vs in the hospital for native T1 mapping (median [IQR], 1122 [1113-1132] ms vs 1143 [1131-1156] ms; P?=?.02) but not for native T2 mapping or hsTnT levels. None of these measures were correlated with time from COVID-19 diagnosis (native T1: r?=?0.07; P?=?.47; native T2: r?=?0.14; P?=?.15; hsTnT: r?=?-0.07; P?=?.50). High-sensitivity troponin T was significantly correlated with native T1 mapping (r?=?0.35; P?<?.001) and native T2 mapping (r?=?0.22; P?=?.03). Endomyocardial biopsy in patients with severe findings revealed active lymphocytic inflammation. Native T1 and T2 were the measures with the best discriminatory ability to detect COVID-19-related myocardial pathology. Conclusions and Relevance:In this study of a cohort of German patients recently recovered from COVID-19 infection, CMR revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), independent of preexisting conditions, severity and overall course of the acute illness, and time from the original diagnosis. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.

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Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study.

Publications

Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study.

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