- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04726150
Effect of CoVid-19 (CoronaVirusDisease-19) and Exercise on Myocardial Fibrosis and Ventricular Arrhythmias (CoViDEx)
Effect of CoVid-19 and Exercise on Myocardial Fibrosis and Ventricular Arrhythmias (CovidEx)
COVID-19 can cause myocarditis, which can cause myocardial fibrosis. This has been shown to increase mortality and morbidity among athletes. Several efforts have been made to guide sports participation after COVID-19, but not much scientific evidence is present to back-up those guidelines. The current initiative aims gain a heightened insight in this matter.To identify the presence of fibrosis athletes who recovered from COVID-19 will undergo CMR (Cardiac MRI). All athletes will also undergo echocardiography, 5-day Holtermonitoring among others. This will allow to determine whether differences between those with and those without fibrosis are present. If fibrosis is present, athletes will be offered an implantation of a very small monitoring device that will be able to detect arrhythmias with a much higher sensitivity. Also an exercise echocardiography will be performed, to determine the safety of continuation of athletic efforts.
Amendment:
Recently myocarditis and pericarditis have also been observed after the administration of mRNA-vaccines, specifically after the second dose. The effect of vaccination on exercise capacity is less clear. To investigate this we propose to amend the inclusion criteria for COVIDEX with "athletes undergoing or having undergone COVID vaccination"
Study Overview
Status
Intervention / Treatment
Detailed Description
Baseline investigations will depend on the clinical presentation of the athlete. Three groups are identified:
- Asymptomatic/mildly symptomatic: anosmia, ageusia, headache, mild fatigue, fever ≤3d, myalgias ≤3d , mild upper respiratory tract illness, and mild gastrointestinal illness
- Moderate to severe symptoms: at least 2 of: persistent fever ≥4d, chills ≥4d, myalgias ≥4d, lethargy impairing activities of daily life (ADL) ≥4d, dyspnea during ADL ≥4d, and chest tightness ≥4d. Or cardiac symptoms: dyspnea, exercise intolerance, chest tightness, dizziness, (pre)syncope, and (new onset) palpitations.
Hospitalized: all athletes admitted for COVID-19, whether or not on the intensive care unit.
- Group 1 will undergo a thorough history, clinical examination, ECG, laboratory tests for hs-Troponin T (TnT) and hsCRP, echocardiography at rest, 5-day-Holter and CMR. These examinations will take place at least 30 days after the first symptoms or positive test. Follow-up will be performed as pointed out with the grey crosses in the table. Depending on the results further investigation may be required (as in group 2 and 3). This part of the study is interventional in nature (not according to standard of care in those individuals).
- Groups 2 and 3 will undergo a more extensive evaluation: a thorough history, clinical examination, ECG, laboratory tests for hs-TnT and hsCRP, echocardiography at rest, CardioPulmonary Exercise Test (CPET), 5-day-Holter, late potentials and CMR.
If in any athlete the CMR shows signs of fibrosis or myocarditis, an exercise echocardiography will be performed additionally. Those subjects will be part of a more extensive follow-up schedule (both white and grey in the table) In the case of the presence of a non-ischemic pattern of Late Gadolinium Enhancement (LGE) or raised myocardial T2 and normal of only mildly contractile reserve, implantation of an Implantable Loop Recorder (ILR) will be performed as a part of the study. This then will be remotely followed-up through telemonitoring. Other athletes (and those who refuse an ILR will receive a 5d-Holter monitoring.
Amendment:
Athletes having undergone complete vaccination will be asked to provide the investigators with their training data prior to and following boostervaccination. Those athletes undergo investigations already included in the COVIDEX study, albeit in a condensed manner (Ergospirometry, Echocardiography and Blood Sample). These tests will take place at the day before the second vaccination and seven days after. Those athletes will also be asked to provide the investigators with their training data prior to and following vaccination.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Antwerp, Belgium, 2650
- University Hospital Antwerp
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
Athletes (professional or recreational but aiming to compete at a national or international level), performing mixed-type or endurance sports as defined by Pelliccia et al. who:
- have recovered from a proven (either by PCR (Polymerase Chain Reaction), serology or chest Computed Tomography) COVID-19 infection
- are more than 1-month post onset of symptoms or the first positive PCR and
- are willing to start (or are) exercising again
Exclusion Criteria:
- known prior cardiac fibrosis
- known or newly diagnosed coronary artery disease
- allergy or contraindications for gadolinium contrast.
- unwillingness or impossibility to give informed consent
- Presence of edema on the CMR
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Mildly of Asymptomatic COVID
Athletes with prior COVID-19 that had a mildly or asymptomatic course
|
If LGE is present on CMR, ILR implantation will be proposed
|
Moderate to Severe Symptoms, Cardiac Symptoms
Athletes with prior COVID-19 that had a moderate to severely symptomatic course, or who experience(d) cardiac symptoms
|
If LGE is present on CMR, ILR implantation will be proposed
|
Hospitalized for
Athletes that were hospitalized for COVID-19
|
If LGE is present on CMR, ILR implantation will be proposed
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Percentage of athletes with LGE on CMR
Time Frame: 6months - 3 years post COVID diagnosis
|
6months - 3 years post COVID diagnosis
|
Arrhythmic Burden on ILR
Time Frame: 6months to 2 to3 years post implantation (depending on device longevity)
|
6months to 2 to3 years post implantation (depending on device longevity)
|
Arrhythmic Burden on 5d Holter
Time Frame: At inclusion
|
At inclusion
|
Arrhythmic Burden on 5d Holter
Time Frame: At 6 months
|
At 6 months
|
Arrhythmic Burden on 5d Holter
Time Frame: At 12 months
|
At 12 months
|
Arrhythmic Burden on 5d Holter
Time Frame: At 3 years
|
At 3 years
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Occurrence of (pre)syncope or SCD
Time Frame: throughout the duration of the study, preamble is 3 years
|
throughout the duration of the study, preamble is 3 years
|
Long-term evolution of cardiac function on echo/CMR: ejection fraction
Time Frame: reevaluation at 3 years
|
reevaluation at 3 years
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Heart Diseases
- Cardiovascular Diseases
- Coronavirus Infections
- Coronaviridae Infections
- Nidovirales Infections
- RNA Virus Infections
- Virus Diseases
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Pneumonia, Viral
- Pneumonia
- Lung Diseases
- Cardiomyopathies
- COVID-19
- Arrhythmias, Cardiac
- Myocarditis
Other Study ID Numbers
- 1499
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Covid19
-
Anavasi DiagnosticsNot yet recruiting
-
Ain Shams UniversityRecruiting
-
Israel Institute for Biological Research (IIBR)Completed
-
Colgate PalmoliveCompleted
-
Christian von BuchwaldCompleted
-
Luye Pharma Group Ltd.Shandong Boan Biotechnology Co., LtdActive, not recruiting
-
University of ZurichLabor Speiz; Swiss Armed Forces; Universitätsspital ZürichEnrolling by invitation
-
Alexandria UniversityCompleted
Clinical Trials on ILR implantation
-
University Medical Center GroningenAbbott Medical DevicesCompletedHeart Failure With Preserved Ejection Fraction (HFpEF)Netherlands
-
Meshalkin Research Institute of Pathology of CirculationMedtronic Bakken Research CenterCompletedMyocardial InfarctionRussian Federation
-
University Hospital, BordeauxCompletedHemodialysis | Cardiac Arrhythmia | Cardiac DeathFrance
-
Meshalkin Research Institute of Pathology of CirculationUnknownAtrial FibrillationRussian Federation
-
4th Military Clinical Hospital with Polyclinic,...Recruiting
-
Hospital San Carlos, MadridFundación Centro Nacional de Investigaciones Cardiovasculares Carlos IIIRecruitingPersistent Atrial FibrillationSpain
-
Flinders UniversityNot yet recruitingDilated Cardiomyopathy | Left Ventricular Systolic Dysfunction | Fibrosis Myocardial
-
Flinders UniversitySouth Australian Health and Medical Research InstituteActive, not recruitingHeart Failure | Left Ventricular Systolic DysfunctionAustralia, Germany, United Kingdom
-
Neil SulkeUnknownParoxysmal Atrial FibrillationUnited Kingdom
-
Texas Cardiac Arrhythmia Research FoundationRecruitingCOVID-19 | Atrial Fibrillation New OnsetItaly, United States, Belgium