Demographic, multi-morbidity and genetic impact on myocardial involvement and its recovery from COVID-19: protocol design of COVID-HEART—a UK, multicentre, observational study

• Published in: Journal of cardiovascular magnetic resonance Vol. 23; no. 1; pp. 77 - 13
• Main Authors: Gorecka, Miroslawa, McCann, Gerry P., Berry, Colin, Ferreira, Vanessa M., Moon, James C., Miller, Christopher A., Chiribiri, Amedeo, Prasad, Sanjay, Dweck, Marc R., Bucciarelli-Ducci, Chiara, Dawson, Dana, Fontana, Marianna, Macfarlane, Peter W., McConnachie, Alex, Neubauer, Stefan, Greenwood, John P.
• Format: Journal Article
• Language: English
• Published: London BioMed Central 10.06.2021; BioMed Central Ltd; Elsevier
• Subjects: Adenosine; Angiology; Aorta; Biomarkers; Biomarkers - blood; Calcium-binding protein; Cardiology; Cardiovascular magnetic resonance; Comorbidity; Contrast Media; Coronavirus; Coronaviruses; COVID-19; COVID-19 - complications; Demographics; Demography; EKG; Electrocardiogram; Electrocardiography; Female; Gadolinium; Gene mapping; Genetic factors; Genetic research; Genetics; Health aspects; Heart attack; Heart Diseases - physiopathology; Heart Diseases - virology; Humans; Imaging; Longitudinal Studies; Magnetic resonance; Magnetic resonance imaging; Magnetic Resonance Imaging, Cine; Male; Medical care; Medical imaging; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Morbidity; Mortality; Multicenter Studies as Topic; Myocardial infarction; Myocardial Perfusion Imaging; Myocarditis; Myopericarditis; Observational studies; Observational Studies as Topic; Patients; Perfusion; Pneumonia, Viral - virology; Prospective Studies; Quality assessment; Quality management; Quality of Life; Radiology; Recovery; Research Design; Risk analysis; Risk Factors; SARS-CoV-2; Sex; Study Protocol; Troponin; Troponin - blood; United Kingdom; Viral diseases; Walk Test; United Kingdom; United Kingdom > UK; COVID-19; Myocarditis; Myocardial infarction; Myocardial inflammation; Coronavirus; Myopericarditis; myocardial injury; Cardiovascular magnetic resonance; Myocardial repair; Cardiovascular disease
• ISSN: 1097-6647; 1532-429X; 1532-429X
• DOI: 10.1186/s12968-021-00752-1

Background Although coronavirus disease 2019 (COVID-19) is primarily a respiratory illness, myocardial injury is increasingly reported and associated with adverse outcomes. However, the pathophysiology, extent of myocardial injury and clinical significance remains unclear. Methods COVID-HEART is a UK, multicentre, prospective, observational, longitudinal cohort study of patients with confirmed COVID-19 and elevated troponin (sex-specific > 99th centile). Baseline assessment will be whilst recovering in-hospital or recently discharged, and include cardiovascular magnetic resonance (CMR) imaging, quality of life (QoL) assessments, electrocardiogram (ECG), serum biomarkers and genetics. Assessment at 6-months includes repeat CMR, QoL assessments and 6-min walk test (6MWT). The CMR protocol includes cine imaging, T1/T2 mapping, aortic distensibility, late gadolinium enhancement (LGE), and adenosine stress myocardial perfusion imaging in selected patients. The main objectives of the study are to: (1) characterise the extent and nature of myocardial involvement in COVID-19 patients with an elevated troponin, (2) assess how cardiac involvement and clinical outcome associate with recognised risk factors for mortality (age, sex, ethnicity and comorbidities) and genetic factors, (3) evaluate if differences in myocardial recovery at 6 months are dependent on demographics, genetics and comorbidities, (4) understand the impact of recovery status at 6 months on patient-reported QoL and functional capacity. Discussion COVID-HEART will provide detailed characterisation of cardiac involvement, and its repair and recovery in relation to comorbidity, genetics, patient-reported QoL measures and functional capacity. Clinical Trial registration: ISRCTN 58667920. Registered 04 August 2020.