The Chief Scientist Office Cardiovascular and Pulmonary Imaging in SARS Coronavirus disease-19 (CISCO-19) study

Kenneth Mangion, Andrew Morrow, Catherine Bagot, Hannah Bayes, Kevin G Blyth, Colin Church, David Corcoran, Christian Delles, Lynsey Gillespie, Douglas Grieve, Antonia Ho, Sharon Kean, Ninian N Lang, Vera Lennie, David J Lowe, Peter Kellman, Peter W Macfarlane, Alex McConnachie, Giles Roditi, Robert Sykes, Rhian M Touyz, Naveed Sattar, Ryan Wereski, Sylvia Wright, Colin Berry, Kenneth Mangion, Andrew Morrow, Catherine Bagot, Hannah Bayes, Kevin G Blyth, Colin Church, David Corcoran, Christian Delles, Lynsey Gillespie, Douglas Grieve, Antonia Ho, Sharon Kean, Ninian N Lang, Vera Lennie, David J Lowe, Peter Kellman, Peter W Macfarlane, Alex McConnachie, Giles Roditi, Robert Sykes, Rhian M Touyz, Naveed Sattar, Ryan Wereski, Sylvia Wright, Colin Berry

Abstract

Background: COVID-19 is typically a primary respiratory illness with multisystem involvement. The prevalence and clinical significance of cardiovascular and multisystem involvement in COVID-19 remain unclear.

Methods: This is a prospective, observational, multicentre, longitudinal, cohort study with minimal selection criteria and a near-consecutive approach to screening. Patients who have received hospital care for COVID-19 will be enrolled within 28 days of discharge. Myocardial injury will be diagnosed according to the peak troponin I in relation to the upper reference limit (URL, 99th centile) (Abbott Architect troponin I assay; sex-specific URL, male: >34 ng/L; female: >16 ng/L). Multisystem, multimodality imaging will be undertaken during the convalescent phase at 28 days post-discharge (Visit 2). Imaging of the heart, lung, and kidneys will include multiparametric, stress perfusion, cardiovascular magnetic resonance imaging, and computed tomography coronary angiography. Health and well-being will be assessed in the longer term. The primary outcome is the proportion of patients with a diagnosis of myocardial inflammation.

Conclusion: CISCO-19 will provide detailed insights into cardiovascular and multisystem involvement of COVID-19. Our study will inform the rationale and design of novel therapeutic and management strategies for affected patients.

Clinical trial registration: ClinicalTrials.gov identifier NCT04403607.

Keywords: Biomarkers; Imaging; Myocardial infarction; Myocardial inflammation; Myocardial injury; SARS-CoV-2.

© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.

Figures

Figure 1
Figure 1
Cardiovascular pathophysiology of COVID-19. With permission of T. Guzik et al. Cardiovascular Research 2020.
Figure 2
Figure 2
Schematic study design: flow diagram. The time periods are from hospital discharge. Abbreviations: CTCA, omputed tomography coronary angiography; ECG, electrocardiogram; Q, questionnaires; MRI, stress perfusion cardiac magnetic resonance imaging.
Figure 3
Figure 3
Primary outcome evaluation.

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