COCARDE Study-Cardiac Imaging Phenotype in Patients With COVID-19: Protocol for a Prospective Observational Study.

Olivier Lairez,Fanny Vardon-Bounes,Samia Collot,Valérie Houard,Yves Rolland,Vincent Minville,Stéphanie Cazalbou,Stéphanie Ruiz,Virginie Blanchard,Jean-Marie Conil,Laurent Balardy

doi:10.2196/24931

Abstract

BackgroundThe effects of SARS-CoV-2 (COVID-19) on the myocardium and their role in the clinical course of infected patients are still unknown. The severity of SARS-CoV-2 is driven by hyperinflammation, and the effects of SARS-CoV-2 on the myocardium may be significant. This study proposes to use bedside observations and biomarkers to characterize the association of COVID-19 with myocardial injury.ObjectiveThe aim of the study is to describe the myocardial function and its evolution over time in patients infected with SARS-CoV-2 and to investigate the link between inflammation and cardiac injury.MethodsThis prospective, monocentric, observational study enrolled 150 patients with suspected or confirmed SARS-CoV-2 infection at Toulouse University Hospital, Toulouse, France. Patients admitted to the intensive care unit (ICU), regular cardiologic ward, and geriatric ward of our tertiary university hospital were included during the pandemic period. Blood sampling, electrocardiography, echocardiography, and morphometric and demographic data were prospectively collected.ResultsA total of 100 patients were included. The final enrolment day was March 31, 2020, with first report of results at the end of the first quarter of 2021. The first echocardiographic results at admission of 31 patients of the COCARDE-ICU substudy population show that biological myocardial injury in COVID-19 has low functional impact on left ventricular systolic function.ConclusionsA better understanding of the effects of COVID-19 on myocardial function and its link with inflammation would improve patient follow-up and care.Trial RegistrationClinicaltrials.gov NCT04358952; https://clinicaltrials.gov/ct2/show/NCT04358952International Registered Report Identifier (IRRID)DERR1-10.2196/24931

Highlights

SARS-CoV-2 infection, the pathogen which is responsible for COVID-19 and which can lead to acute respiratory distress syndrome, is not limited to the pulmonary sphere and has systemic effects that contribute to its significant mortality
The COCARDE study is the first study to date to propose a cardiac imaging phenotyping of patients infected with SARS-CoV-2
Troponin is a marker of myocardial injury, including, but not limited to, myocardial infarction or myocarditis, and the clinical relevance of this distinction has never been clear and is even less clear in the context of the SARS-COV-2 infection, which causes a plethora of ischemic and nonischemic origins of myocardial lesions [30]

Summary

Introduction

BackgroundSARS-CoV-2 infection, the pathogen which is responsible for COVID-19 and which can lead to acute respiratory distress syndrome, is not limited to the pulmonary sphere and has systemic effects that contribute to its significant mortality. The effects of SARS-COV-2 on the myocardium and their role in the clinical course of infected patients are still unknown. Cardiovascular risk factors such as diabetes and hypertension, as well as coronary or cerebral cardiovascular history, have been associated with severe forms of infection [1,2,3]. The effects of SARS-CoV-2 (COVID-19) on the myocardium and their role in the clinical course of infected patients are still unknown. Objective: The aim of the study is to describe the myocardial function and its evolution over time in patients infected with SARS-CoV-2 and to investigate the link between inflammation and cardiac injury. Trial Registration: Clinicaltrials.gov NCT04358952; https://clinicaltrials.gov/ct2/show/NCT04358952 International Registered Report Identifier (IRRID): DERR1-10.2196/24931

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