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Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank

Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank
Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank
Background: coronavirus disease 2019 (COVID-19) disproportionately affects older people. Observational studies suggest indolent cardiovascular involvement after recovery from acute COVID-19. However, these findings may reflect pre-existing cardiac phenotypes.

Aims: we tested the association of baseline cardiovascular magnetic resonance (CMR) phenotypes with incident COVID-19.

Methods: we studied UK Biobank participants with CMR imaging and COVID-19 testing. We considered left and right ventricular (LV, RV) volumes, ejection fractions, and stroke volumes, LV mass, LV strain, native T1, aortic distensibility, and arterial stiffness index. COVID-19 test results were obtained from Public Health England. Co-morbidities were ascertained from self-report and Hospital Episode Statistics (HES). Critical care admission and death were from HES and death register records. We tested the association of each cardiovascular measure with COVID-19 test result in multivariable logistic regression models adjusting for age, sex, ethnicity, deprivation, body mass index, smoking, diabetes, hypertension, high cholesterol, and prior myocardial infarction.

Results: we studied 310 participants (n=70 positive). Median age was 63·8 [57·5, 72·1] years; 51·0% (n=158) were male. 78·7% (n=244) were tested in hospital, 3·5% (n=11) required critical care admission, and 6·1% (n=19) died. In fully adjusted models, smaller LV/RV end-diastolic volumes, smaller LV stroke volume, and poorer global longitudinal strain were associated with significantly higher odds of COVID-19 positivity.

Discussion: we demonstrate association of pre-existing adverse CMR phenotypes with greater odds of COVID-19 positivity independent of classical cardiovascular risk factors.

Conclusions: observational reports of cardiovascular involvement after COVID-19 may, at least partly, reflect pre-existing cardiac status rather than COVID-19 induced alterations.

1594-0667
Raisi-Estabragh, Zahra
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McCracken, Celeste
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Cooper, Jackie
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Fung, Kenneth
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Paiva, José M.
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Khanji, Mohammed Y.
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Rauseo, Elisa
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Biasiolli, Luca
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Raman, Betty
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Piechnik, Stefan K.
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Neubauer, Stefan
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Munroe, Patricia B.
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
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Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Cooper, Jackie
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Fung, Kenneth
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Paiva, José M.
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Khanji, Mohammed Y.
fcc9f8c6-b352-4870-8fe0-9ab6676cff86
Rauseo, Elisa
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Biasiolli, Luca
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Raman, Betty
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Piechnik, Stefan K.
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Neubauer, Stefan
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Munroe, Patricia B.
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Harvey, Nicholas
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Petersen, Steffen E.
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Raisi-Estabragh, Zahra, McCracken, Celeste, Cooper, Jackie, Fung, Kenneth, Paiva, José M., Khanji, Mohammed Y., Rauseo, Elisa, Biasiolli, Luca, Raman, Betty, Piechnik, Stefan K., Neubauer, Stefan, Munroe, Patricia B., Harvey, Nicholas and Petersen, Steffen E. (2021) Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank. Aging Clinical and Experimental Research. (In Press)

Record type: Article

Abstract

Background: coronavirus disease 2019 (COVID-19) disproportionately affects older people. Observational studies suggest indolent cardiovascular involvement after recovery from acute COVID-19. However, these findings may reflect pre-existing cardiac phenotypes.

Aims: we tested the association of baseline cardiovascular magnetic resonance (CMR) phenotypes with incident COVID-19.

Methods: we studied UK Biobank participants with CMR imaging and COVID-19 testing. We considered left and right ventricular (LV, RV) volumes, ejection fractions, and stroke volumes, LV mass, LV strain, native T1, aortic distensibility, and arterial stiffness index. COVID-19 test results were obtained from Public Health England. Co-morbidities were ascertained from self-report and Hospital Episode Statistics (HES). Critical care admission and death were from HES and death register records. We tested the association of each cardiovascular measure with COVID-19 test result in multivariable logistic regression models adjusting for age, sex, ethnicity, deprivation, body mass index, smoking, diabetes, hypertension, high cholesterol, and prior myocardial infarction.

Results: we studied 310 participants (n=70 positive). Median age was 63·8 [57·5, 72·1] years; 51·0% (n=158) were male. 78·7% (n=244) were tested in hospital, 3·5% (n=11) required critical care admission, and 6·1% (n=19) died. In fully adjusted models, smaller LV/RV end-diastolic volumes, smaller LV stroke volume, and poorer global longitudinal strain were associated with significantly higher odds of COVID-19 positivity.

Discussion: we demonstrate association of pre-existing adverse CMR phenotypes with greater odds of COVID-19 positivity independent of classical cardiovascular risk factors.

Conclusions: observational reports of cardiovascular involvement after COVID-19 may, at least partly, reflect pre-existing cardiac status rather than COVID-19 induced alterations.

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Accepted/In Press date: 2 February 2021

Identifiers

Local EPrints ID: 446921
URI: http://eprints.soton.ac.uk/id/eprint/446921
ISSN: 1594-0667
PURE UUID: f48a3e0a-123f-44bb-b901-72321818bdda
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 26 Feb 2021 17:32
Last modified: 27 Feb 2021 02:38

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Contributors

Author: Zahra Raisi-Estabragh
Author: Celeste McCracken
Author: Jackie Cooper
Author: Kenneth Fung
Author: José M. Paiva
Author: Mohammed Y. Khanji
Author: Elisa Rauseo
Author: Luca Biasiolli
Author: Betty Raman
Author: Stefan K. Piechnik
Author: Stefan Neubauer
Author: Patricia B. Munroe
Author: Nicholas Harvey ORCID iD
Author: Steffen E. Petersen

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