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Impression COVID-19 Study

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Overview

The coronavirus disease (COVID-19) outbreak brings about a number of significant challenges for health care. In addition to chest infection and breathing problems, COVID-19 also affects the heart; inflammatory heart involvement may be associated with poor outcomes.
Heart injury due to COVID-19 is not well understood. Inflammatory involvement of the heart muscle is the likely mechanism of injury, possibly heralding an increased burden of heart failure among COVID-19 survivors. To guide cardioprotection, heart muscle damage needs to be recognised early and prior to the development of irreversible damage. The aim of this study is to determine the burden of heart damage post-COVID using advanced cardiac imaging and blood markers. We will look at how the disease mechanisms evolve over time. Based on these findings, we expect to gain insights to anticipate COVID-19 related heart complications and allow to establish specific heart protective therapies.

Übersicht

Der Ausbruch der Coronavirus-Krankheit (COVID-19) führt zu erheblichen Herausforderungen für die Krankenversorgung. Neben Atemproblemen wirkt sich COVID-19 auch auf das Herz aus. Eine frühe Herzbeteiligung ist mit einer schlechten Prognose verbunden. Die genaue Entstehung der Herzverletzung aufgrund von COVID-19 ist noch nicht gut verstanden. Aus Erfahrung mit früheren Grippeepidemien vermuten wir am ehesten die Entzündung des Herzmuskels als den wahrscheinlichsten Verletzungsmechanismus. Dies könnte zu einem deutlichen Anstieg von Herzinsuffizienz bei COVID-19-Genesenen führen. Um die das Herz frühzeitig schützen zu können, müssen Herzmuskelschäden früh erkannt, charakterisiert und klassifiziert werden, insbesondere bevor irreversible Schäden auftreten. In dieser Studie werden wir den frühen Herzschaden bei COVID-19-Genesenen durch fortgeschrittene Herzbildgebung mit Magnetresonanztomographie, Echokardiographie und Blutmarkern bestimmen. Wir werden untersuchen, wie sich die Krankheitsmechanismen im Laufe der Zeit verändern. Basierend auf den Ergebnissen erwarten wir die Entwicklung eines klinischen Bewertungsinstruments, das die Vorhersage der COVID-19-bedingten kardiovaskulären Komplikationen und Etablierung einer frühen spezifischen Therapie erleichtert.

Registration

NCT04444128

Principal Investigator(s)

Priv. Doz. Dr. Valentina Puntmann, Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Germany
Prof Dr Eike Nagel, Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Germany

Collaborators

Participating sites: Institut for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany

Funding

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With support from

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Study design

An observational longitudinal outcome study of patients with recent COVID-19 infection and no previously known heart disease or comorbidities.

Inclusion criteria

Exclusion criteria

  1. Adults >18 years of age
  2. Able to provide informed consent
  3. recent COVID-19 infection (proven infection within the last 4 weeks)
  4. no longer infectious (at least one negative nasal swab)
  5. No known heart disease or commorbidities
  1. Presence of absolute contraindication for MRI studies (MR unsafe or incompatible devices, aneurysm clips, incompatible cochlear implants, loose metal foreign objects)
  2. Absolute contraindications to gadolinium contrast agent (previous allergic reaction or pregnancy)
  3. Not willing to participate in the follow up studies (second cardiac MRI, telephone interviews).

Recruitment

The recruitment into this substudy is now completed.

Study Protocol

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Publications

 1. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, Shchendrygina A, Escher F, Vasa-Nicotera M, Zeiher AM, Vehreschild M, Nagel E. 
Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19).
JAMA Cardiol. 2020 Nov 1;5(11):1265-1273. doi: 10.1001/jamacardio.2020.3557.PMID: 32730619

2. Puntmann V, Nagel E. Cardiac Involvement After Recovering From COVID-19-Reply. JAMA Cardiol. 2021 Feb 1;6(2):244-245. doi: 10.1001/jamacardio.2020.5285.PMID: 33112394 No abstract available.

3.  
Shchendrygina A, Nagel E, Puntmann VO, Valbuena-Lopez S. COVID-19 myocarditis and prospective heart failure burden.
Expert Rev Cardiovasc Ther. 2021 Jan;19(1):5-14. doi: 10.1080/14779072.2021.1844005. Epub 2020 Nov 27.PMID: 33119418 Review.
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