Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study

Hunain Shiwani; Jessica Artico; James C. Moon; Miroslawa Gorecka; Gerry P. McCann; Giles Roditi; Andrew Morrow; Kenneth Mangion; Elena Lukaschuk; Mayooran Shanmuganathan; Christopher A. Miller; Amedeo Chiribiri; Mohammed Alzahir; Sara Ramirez; Andrew Lin; Peter P. Swoboda; Adam K. McDiarmid; Robert Sykes; Trisha Singh; Chiara Bucciarelli-Ducci; Dana Dawson; Marianna Fontana; Charlotte Manisty; Thomas A. Treibel; Eylem Levelt; Ranjit Arnold; Robin Young; Alex McConnachie; Stefan Neubauer; Stefan K. Piechnik; Rhodri H. Davies; Vanessa M. Ferreira; Marc R. Dweck; Colin Berry; John P. Greenwood; J. P. Greenwood; C. Berry; M. Dweck; C. M. Miller; A. Chiribiri; S. Prasad; V. M. Ferreira; C. Bucciarelli-Ducci; D. Dawson; Rhodri Davies; Marc Dweck; Bernard Kelly; Peter W. Macfarlane; Miroslawa Goreka; Kathryn Somers; Roo J. Byrom-Goulthorp; Michelle Anderson; Laura Britton; Fiona Richards; Laura M. Jones; Alastair Moss; Jude Fisher; Joanne Wormleighton; Kelly Parke; Rachel Wright; Jian Yeo; Judith Falconer; Valerie Harries; Paula Henderson; David Newby; Stefan Piechnik; Iulia Popescu; Qiang Zhang; Betty Raman; Keith Channon; Catherine Krasopoulos; Claudia Nunes; Liliana Da Silva Rodrigues; Harriet Nixon; Athanasia Panopoulou; Alison Fletcher; Peter Manley; Kirsty Fallon; Ammani Brown; Laura Kelly; Christopher McGinley; Michael Briscoe; Rosemary Woodward; Tracey Hopkins; Evonne McLennan; Nicola Tynan; Laura Dymock; Peter Swoboda; Judith Wright; Donna Exley; Richard Steeds; Kady Hutton; Sonia MacDonald; Thomas Treibel; Abhishek Shetye; Christopher M. Miller; Christopher Orsborne; William Woodville-Jones; Susan Ferguson; Konstantinos Bratis; Timothy Fairbairn; Michail Sionas; Peris Widdows; Pei Gee Chew; Christian Marsden; Tom Collins; Linsha George; Lisa Kearney; Andrew Flett; Simon Smith; Alice Zhenge; Jake Harvey; Liliana Inacio; Tomas Hanam-Penfold; Lucy Gruner; Yousuf S.K. Razvi; Jacolene Crause; Nina M. Davies; James T. Brown; Liza Chaco; Rishi Patel; Tushar Kotecha; Dan S. Knight; Thomas Green; David Ripley; Maria Thompson; Ugochi Akerele; Elna Cifra; Ebraham Alskaf; Richard Crawley; Adriana Villa; Angus K. Nightingale; Kim Wright; Esther D. Bonnick; Emma Hopkins; Jessy George; Linta Joseph; Graham Cole; Kavitha Vimalesvaran; Nadine Ali; Caitlin R. Carr; Alexandra A.R. Ross; Clara King; Sanjay Prasad; Zohreh Farzad; Sara A. Salmi; Kevin Kirby; Adam McDiarmid; Hannah J. Stevenson; Pamela S. Matsvimbo; Lency Joji; Margaret Fearby; Benjamin Brown; Nicholas Bunce; Robert Jennings; Vennessa Sookhoo; Shatabdi Joshi; Prathap Kanagala; Sandra Fullalove; Catherine Toohey; Kate Fenlon; Nicholas Bellenger; Jingzhou He; Sarah Statton; Nicola Pamphilon; Anna Steele; Claire Ball; Ann McGahey; Silvia Balma; Lynsey Wilkes; Katy Lewis; Michelle Walter; Adrian Ionescu; Tishi Ninan; Suzanne Richards; Marie Williams; Khaled Alfakih; Samia Pilgrim; George Joy; Charlotte H. Manisty; Ifza Hussain

doi:10.1016/j.jcmg.2024.06.008

Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study

Hunain Shiwani
, Jessica Artico
, James C. Moon
, Miroslawa Gorecka
, Gerry P. McCann
, Giles Roditi
, Andrew Morrow
, Kenneth Mangion
, Elena Lukaschuk
, Mayooran Shanmuganathan
, Christopher A. Miller
, Amedeo Chiribiri
, Mohammed Alzahir
, Sara Ramirez
, Andrew Lin
, Peter P. Swoboda
, Adam K. McDiarmid
, Robert Sykes
, Trisha Singh
, Chiara Bucciarelli-Ducci

Dana Dawson, Marianna Fontana, Charlotte Manisty, Thomas A. Treibel, Eylem Levelt, Ranjit Arnold, Robin Young, Alex McConnachie, Stefan Neubauer, Stefan K. Piechnik, Rhodri H. Davies, Vanessa M. Ferreira, Marc R. Dweck, Colin Berry, John P. Greenwood, J. P. Greenwood, C. Berry, M. Dweck, C. M. Miller, A. Chiribiri, S. Prasad, V. M. Ferreira, C. Bucciarelli-Ducci, D. Dawson, Rhodri Davies, Marc Dweck, Bernard Kelly, Peter W. Macfarlane, Miroslawa Goreka, Kathryn Somers, Roo J. Byrom-Goulthorp, Michelle Anderson, Laura Britton, Fiona Richards, Laura M. Jones, Alastair Moss, Jude Fisher, Joanne Wormleighton, Kelly Parke, Rachel Wright, Jian Yeo, Judith Falconer, Valerie Harries, Paula Henderson, David Newby, Stefan Piechnik, Iulia Popescu, Qiang Zhang, Betty Raman, Keith Channon, Catherine Krasopoulos, Claudia Nunes, Liliana Da Silva Rodrigues, Harriet Nixon, Athanasia Panopoulou, Alison Fletcher, Peter Manley, Kirsty Fallon, Ammani Brown, Laura Kelly, Christopher McGinley, Michael Briscoe, Rosemary Woodward, Tracey Hopkins, Evonne McLennan, Nicola Tynan, Laura Dymock, Peter Swoboda, Judith Wright, Donna Exley, Richard Steeds, Kady Hutton, Sonia MacDonald, Thomas Treibel, Abhishek Shetye, Christopher M. Miller, Christopher Orsborne, William Woodville-Jones, Susan Ferguson, Konstantinos Bratis, Timothy Fairbairn, Michail Sionas, Peris Widdows, Pei Gee Chew, Christian Marsden, Tom Collins, Linsha George, Lisa Kearney, Andrew Flett, Simon Smith, Alice Zhenge, Jake Harvey, Liliana Inacio, Tomas Hanam-Penfold, Lucy Gruner, Yousuf S.K. Razvi, Jacolene Crause, Nina M. Davies, James T. Brown, Liza Chaco, Rishi Patel, Tushar Kotecha, Dan S. Knight, Thomas Green, David Ripley, Maria Thompson, Ugochi Akerele, Elna Cifra, Ebraham Alskaf, Richard Crawley, Adriana Villa, Angus K. Nightingale, Kim Wright, Esther D. Bonnick, Emma Hopkins, Jessy George, Linta Joseph, Graham Cole, Kavitha Vimalesvaran, Nadine Ali, Caitlin R. Carr, Alexandra A.R. Ross, Clara King, Sanjay Prasad, Zohreh Farzad, Sara A. Salmi, Kevin Kirby, Adam McDiarmid, Hannah J. Stevenson, Pamela S. Matsvimbo, Lency Joji, Margaret Fearby, Benjamin Brown, Nicholas Bunce, Robert Jennings, Vennessa Sookhoo, Shatabdi Joshi, Prathap Kanagala, Sandra Fullalove, Catherine Toohey, Kate Fenlon, Nicholas Bellenger, Jingzhou He, Sarah Statton, Nicola Pamphilon, Anna Steele, Claire Ball, Ann McGahey, Silvia Balma, Lynsey Wilkes, Katy Lewis, Michelle Walter, Adrian Ionescu, Tishi Ninan, Suzanne Richards, Marie Williams, Khaled Alfakih, Samia Pilgrim, George Joy, Charlotte H. Manisty, Ifza Hussain

Department of Psychiatry & Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear. Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes. Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months. Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001). Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life.

Original language	English (US)
Pages (from-to)	1320-1331
Number of pages	12
Journal	JACC: Cardiovascular Imaging
Volume	17
Issue number	11
DOIs	https://doi.org/10.1016/j.jcmg.2024.06.008
State	Published - Nov 2024

Keywords

COVID-19
cardiovascular diseases
coronavirus
magnetic resonance imaging
myocardial infarction
troponin

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

Access to Document

10.1016/j.jcmg.2024.06.008

Cite this

Shiwani, H., Artico, J., Moon, J. C., Gorecka, M., McCann, G. P., Roditi, G., Morrow, A., Mangion, K., Lukaschuk, E., Shanmuganathan, M., Miller, C. A., Chiribiri, A., Alzahir, M., Ramirez, S., Lin, A., Swoboda, P. P., McDiarmid, A. K., Sykes, R., Singh, T., ... Hussain, I. (2024). Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study. JACC: Cardiovascular Imaging, 17(11), 1320-1331. https://doi.org/10.1016/j.jcmg.2024.06.008

Shiwani, H, Artico, J, Moon, JC, Gorecka, M, McCann, GP, Roditi, G, Morrow, A, Mangion, K, Lukaschuk, E, Shanmuganathan, M, Miller, CA, Chiribiri, A, Alzahir, M, Ramirez, S, Lin, A, Swoboda, PP, McDiarmid, AK, Sykes, R, Singh, T, Bucciarelli-Ducci, C, Dawson, D, Fontana, M, Manisty, C, Treibel, TA, Levelt, E, Arnold, R, Young, R, McConnachie, A, Neubauer, S, Piechnik, SK, Davies, RH, Ferreira, VM, Dweck, MR, Berry, C, Greenwood, JP, Greenwood, JP, Berry, C, Dweck, M, Miller, CM, Chiribiri, A, Prasad, S, Ferreira, VM, Bucciarelli-Ducci, C, Dawson, D, Davies, R, Dweck, M, Kelly, B, Macfarlane, PW, Goreka, M, Somers, K, Byrom-Goulthorp, RJ, Anderson, M, Britton, L, Richards, F, Jones, LM, Moss, A, Fisher, J, Wormleighton, J, Parke, K, Wright, R, Yeo, J, Falconer, J, Harries, V, Henderson, P, Newby, D, Piechnik, S, Popescu, I, Zhang, Q, Raman, B, Channon, K, Krasopoulos, C, Nunes, C, Da Silva Rodrigues, L, Nixon, H, Panopoulou, A, Fletcher, A, Manley, P, Fallon, K, Brown, A, Kelly, L, McGinley, C, Briscoe, M, Woodward, R, Hopkins, T, McLennan, E, Tynan, N, Dymock, L, Swoboda, P, Wright, J, Exley, D, Steeds, R, Hutton, K, MacDonald, S, Treibel, T, Shetye, A, Miller, CM, Orsborne, C, Woodville-Jones, W, Ferguson, S, Bratis, K, Fairbairn, T, Sionas, M, Widdows, P, Chew, PG, Marsden, C, Collins, T, George, L, Kearney, L, Flett, A, Smith, S, Zhenge, A, Harvey, J, Inacio, L, Hanam-Penfold, T, Gruner, L, Razvi, YSK, Crause, J, Davies, NM, Brown, JT, Chaco, L, Patel, R, Kotecha, T, Knight, DS, Green, T, Ripley, D, Thompson, M, Akerele, U, Cifra, E, Alskaf, E, Crawley, R, Villa, A, Nightingale, AK, Wright, K, Bonnick, ED, Hopkins, E, George, J, Joseph, L, Cole, G, Vimalesvaran, K, Ali, N, Carr, CR, Ross, AAR, King, C, Prasad, S, Farzad, Z, Salmi, SA, Kirby, K, McDiarmid, A, Stevenson, HJ, Matsvimbo, PS, Joji, L, Fearby, M, Brown, B, Bunce, N, Jennings, R, Sookhoo, V, Joshi, S, Kanagala, P, Fullalove, S, Toohey, C, Fenlon, K, Bellenger, N, He, J, Statton, S, Pamphilon, N, Steele, A, Ball, C, McGahey, A, Balma, S, Wilkes, L, Lewis, K, Walter, M, Ionescu, A, Ninan, T, Richards, S, Williams, M, Alfakih, K, Pilgrim, S, Joy, G, Manisty, CH & Hussain, I 2024, 'Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study', JACC: Cardiovascular Imaging, vol. 17, no. 11, pp. 1320-1331. https://doi.org/10.1016/j.jcmg.2024.06.008

@article{91b1c509997c4e03b5a6f4382ea62cc7,

title = "Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study",

abstract = "Background: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear. Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes. Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months. Results: Of 342 participants (median age: 61.3 years; 71.1\% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2\% died; 1.8\% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8\% had new myopericarditis; and 3.3\% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8\% ± 1.0\%; P < 0.001), stable right ventricular ejection fraction (0.4\% ± 0.8\%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001). Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life.",

keywords = "COVID-19, cardiovascular diseases, coronavirus, magnetic resonance imaging, myocardial infarction, troponin",

author = "Hunain Shiwani and Jessica Artico and Moon, \{James C.\} and Miroslawa Gorecka and McCann, \{Gerry P.\} and Giles Roditi and Andrew Morrow and Kenneth Mangion and Elena Lukaschuk and Mayooran Shanmuganathan and Miller, \{Christopher A.\} and Amedeo Chiribiri and Mohammed Alzahir and Sara Ramirez and Andrew Lin and Swoboda, \{Peter P.\} and McDiarmid, \{Adam K.\} and Robert Sykes and Trisha Singh and Chiara Bucciarelli-Ducci and Dana Dawson and Marianna Fontana and Charlotte Manisty and Treibel, \{Thomas A.\} and Eylem Levelt and Ranjit Arnold and Robin Young and Alex McConnachie and Stefan Neubauer and Piechnik, \{Stefan K.\} and Davies, \{Rhodri H.\} and Ferreira, \{Vanessa M.\} and Dweck, \{Marc R.\} and Colin Berry and Greenwood, \{John P.\} and Greenwood, \{J. P.\} and C. Berry and M. Dweck and Miller, \{C. M.\} and A. Chiribiri and S. Prasad and Ferreira, \{V. M.\} and C. Bucciarelli-Ducci and D. Dawson and Rhodri Davies and Marc Dweck and Bernard Kelly and Macfarlane, \{Peter W.\} and Miroslawa Goreka and Kathryn Somers and Byrom-Goulthorp, \{Roo J.\} and Michelle Anderson and Laura Britton and Fiona Richards and Jones, \{Laura M.\} and Alastair Moss and Jude Fisher and Joanne Wormleighton and Kelly Parke and Rachel Wright and Jian Yeo and Judith Falconer and Valerie Harries and Paula Henderson and David Newby and Stefan Piechnik and Iulia Popescu and Qiang Zhang and Betty Raman and Keith Channon and Catherine Krasopoulos and Claudia Nunes and \{Da Silva Rodrigues\}, Liliana and Harriet Nixon and Athanasia Panopoulou and Alison Fletcher and Peter Manley and Kirsty Fallon and Ammani Brown and Laura Kelly and Christopher McGinley and Michael Briscoe and Rosemary Woodward and Tracey Hopkins and Evonne McLennan and Nicola Tynan and Laura Dymock and Peter Swoboda and Judith Wright and Donna Exley and Richard Steeds and Kady Hutton and Sonia MacDonald and Thomas Treibel and Abhishek Shetye and Miller, \{Christopher M.\} and Christopher Orsborne and William Woodville-Jones and Susan Ferguson and Konstantinos Bratis and Timothy Fairbairn and Michail Sionas and Peris Widdows and Chew, \{Pei Gee\} and Christian Marsden and Tom Collins and Linsha George and Lisa Kearney and Andrew Flett and Simon Smith and Alice Zhenge and Jake Harvey and Liliana Inacio and Tomas Hanam-Penfold and Lucy Gruner and Razvi, \{Yousuf S.K.\} and Jacolene Crause and Davies, \{Nina M.\} and Brown, \{James T.\} and Liza Chaco and Rishi Patel and Tushar Kotecha and Knight, \{Dan S.\} and Thomas Green and David Ripley and Maria Thompson and Ugochi Akerele and Elna Cifra and Ebraham Alskaf and Richard Crawley and Adriana Villa and Nightingale, \{Angus K.\} and Kim Wright and Bonnick, \{Esther D.\} and Emma Hopkins and Jessy George and Linta Joseph and Graham Cole and Kavitha Vimalesvaran and Nadine Ali and Carr, \{Caitlin R.\} and Ross, \{Alexandra A.R.\} and Clara King and Sanjay Prasad and Zohreh Farzad and Salmi, \{Sara A.\} and Kevin Kirby and Adam McDiarmid and Stevenson, \{Hannah J.\} and Matsvimbo, \{Pamela S.\} and Lency Joji and Margaret Fearby and Benjamin Brown and Nicholas Bunce and Robert Jennings and Vennessa Sookhoo and Shatabdi Joshi and Prathap Kanagala and Sandra Fullalove and Catherine Toohey and Kate Fenlon and Nicholas Bellenger and Jingzhou He and Sarah Statton and Nicola Pamphilon and Anna Steele and Claire Ball and Ann McGahey and Silvia Balma and Lynsey Wilkes and Katy Lewis and Michelle Walter and Adrian Ionescu and Tishi Ninan and Suzanne Richards and Marie Williams and Khaled Alfakih and Samia Pilgrim and George Joy and Manisty, \{Charlotte H.\} and Ifza Hussain",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

month = nov,

doi = "10.1016/j.jcmg.2024.06.008",

language = "English (US)",

volume = "17",

pages = "1320--1331",

journal = "JACC: Cardiovascular Imaging",

issn = "1936-878X",

publisher = "Elsevier Inc.",

number = "11",

}

TY - JOUR

T1 - Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19

T2 - A Prospective, Multicenter, Cohort Study

AU - Shiwani, Hunain

AU - Artico, Jessica

AU - Moon, James C.

AU - Gorecka, Miroslawa

AU - McCann, Gerry P.

AU - Roditi, Giles

AU - Morrow, Andrew

AU - Mangion, Kenneth

AU - Lukaschuk, Elena

AU - Shanmuganathan, Mayooran

AU - Miller, Christopher A.

AU - Chiribiri, Amedeo

AU - Alzahir, Mohammed

AU - Ramirez, Sara

AU - Lin, Andrew

AU - Swoboda, Peter P.

AU - McDiarmid, Adam K.

AU - Sykes, Robert

AU - Singh, Trisha

AU - Bucciarelli-Ducci, Chiara

AU - Dawson, Dana

AU - Fontana, Marianna

AU - Manisty, Charlotte

AU - Treibel, Thomas A.

AU - Levelt, Eylem

AU - Arnold, Ranjit

AU - Young, Robin

AU - McConnachie, Alex

AU - Neubauer, Stefan

AU - Piechnik, Stefan K.

AU - Davies, Rhodri H.

AU - Ferreira, Vanessa M.

AU - Dweck, Marc R.

AU - Berry, Colin

AU - Greenwood, John P.

AU - Greenwood, J. P.

AU - Berry, C.

AU - Dweck, M.

AU - Miller, C. M.

AU - Chiribiri, A.

AU - Prasad, S.

AU - Ferreira, V. M.

AU - Bucciarelli-Ducci, C.

AU - Dawson, D.

AU - Davies, Rhodri

AU - Dweck, Marc

AU - Kelly, Bernard

AU - Macfarlane, Peter W.

AU - Goreka, Miroslawa

AU - Somers, Kathryn

AU - Byrom-Goulthorp, Roo J.

AU - Anderson, Michelle

AU - Britton, Laura

AU - Richards, Fiona

AU - Jones, Laura M.

AU - Moss, Alastair

AU - Fisher, Jude

AU - Wormleighton, Joanne

AU - Parke, Kelly

AU - Wright, Rachel

AU - Yeo, Jian

AU - Falconer, Judith

AU - Harries, Valerie

AU - Henderson, Paula

AU - Newby, David

AU - Piechnik, Stefan

AU - Popescu, Iulia

AU - Zhang, Qiang

AU - Raman, Betty

AU - Channon, Keith

AU - Krasopoulos, Catherine

AU - Nunes, Claudia

AU - Da Silva Rodrigues, Liliana

AU - Nixon, Harriet

AU - Panopoulou, Athanasia

AU - Fletcher, Alison

AU - Manley, Peter

AU - Fallon, Kirsty

AU - Brown, Ammani

AU - Kelly, Laura

AU - McGinley, Christopher

AU - Briscoe, Michael

AU - Woodward, Rosemary

AU - Hopkins, Tracey

AU - McLennan, Evonne

AU - Tynan, Nicola

AU - Dymock, Laura

AU - Swoboda, Peter

AU - Wright, Judith

AU - Exley, Donna

AU - Steeds, Richard

AU - Hutton, Kady

AU - MacDonald, Sonia

AU - Treibel, Thomas

AU - Shetye, Abhishek

AU - Miller, Christopher M.

AU - Orsborne, Christopher

AU - Woodville-Jones, William

AU - Ferguson, Susan

AU - Bratis, Konstantinos

AU - Fairbairn, Timothy

AU - Sionas, Michail

AU - Widdows, Peris

AU - Chew, Pei Gee

AU - Marsden, Christian

AU - Collins, Tom

AU - George, Linsha

AU - Kearney, Lisa

AU - Flett, Andrew

AU - Smith, Simon

AU - Zhenge, Alice

AU - Harvey, Jake

AU - Inacio, Liliana

AU - Hanam-Penfold, Tomas

AU - Gruner, Lucy

AU - Razvi, Yousuf S.K.

AU - Crause, Jacolene

AU - Davies, Nina M.

AU - Brown, James T.

AU - Chaco, Liza

AU - Patel, Rishi

AU - Kotecha, Tushar

AU - Knight, Dan S.

AU - Green, Thomas

AU - Ripley, David

AU - Thompson, Maria

AU - Akerele, Ugochi

AU - Cifra, Elna

AU - Alskaf, Ebraham

AU - Crawley, Richard

AU - Villa, Adriana

AU - Nightingale, Angus K.

AU - Wright, Kim

AU - Bonnick, Esther D.

AU - Hopkins, Emma

AU - George, Jessy

AU - Joseph, Linta

AU - Cole, Graham

AU - Vimalesvaran, Kavitha

AU - Ali, Nadine

AU - Carr, Caitlin R.

AU - Ross, Alexandra A.R.

AU - King, Clara

AU - Prasad, Sanjay

AU - Farzad, Zohreh

AU - Salmi, Sara A.

AU - Kirby, Kevin

AU - McDiarmid, Adam

AU - Stevenson, Hannah J.

AU - Matsvimbo, Pamela S.

AU - Joji, Lency

AU - Fearby, Margaret

AU - Brown, Benjamin

AU - Bunce, Nicholas

AU - Jennings, Robert

AU - Sookhoo, Vennessa

AU - Joshi, Shatabdi

AU - Kanagala, Prathap

AU - Fullalove, Sandra

AU - Toohey, Catherine

AU - Fenlon, Kate

AU - Bellenger, Nicholas

AU - He, Jingzhou

AU - Statton, Sarah

AU - Pamphilon, Nicola

AU - Steele, Anna

AU - Ball, Claire

AU - McGahey, Ann

AU - Balma, Silvia

AU - Wilkes, Lynsey

AU - Lewis, Katy

AU - Walter, Michelle

AU - Ionescu, Adrian

AU - Ninan, Tishi

AU - Richards, Suzanne

AU - Williams, Marie

AU - Alfakih, Khaled

AU - Pilgrim, Samia

AU - Joy, George

AU - Manisty, Charlotte H.

AU - Hussain, Ifza

PY - 2024/11

Y1 - 2024/11

N2 - Background: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear. Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes. Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months. Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001). Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life.

AB - Background: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear. Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes. Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months. Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001). Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life.

KW - COVID-19

KW - cardiovascular diseases

KW - coronavirus

KW - magnetic resonance imaging

KW - myocardial infarction

KW - troponin

UR - https://www.scopus.com/pages/publications/85203787148

UR - https://www.scopus.com/pages/publications/85203787148#tab=citedBy

U2 - 10.1016/j.jcmg.2024.06.008

DO - 10.1016/j.jcmg.2024.06.008

M3 - Article

C2 - 39207330

AN - SCOPUS:85203787148

SN - 1936-878X

VL - 17

SP - 1320

EP - 1331

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

IS - 11

ER -

Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study

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