The study will analyze the prevalence of cardiac involvement of health care workers from the University Hospital of Salamanca (HUSA) who have overcome SARS-CoV-2 infection. Participants will undergo a clinical evaluation, electrocardiogram (EKG), cardiac magnetic resonance (CMR) and blood analysis including NT-proBNP, troponin, cellular and humoral immunity and genetics.
Most people infected with SARS-CoV-2 experience mild, self-limiting symptoms that have been
managed in an outpatient setting and therefore have not undergone routine cardiac evaluation
with EKG or cardiac imaging test. Similarly, although the emphasis has been placed on
evaluating patients with severe respiratory symptoms, most of these patients have also not
undergone cardiac imaging tests and; therefore, in both scenarios, possible myocarditis has
not routinely evaluated.
The present study is designed to characterize cardiac involvement in individuals who have
overcome the SARS-CoV-2 infection.
For that aim, the study is designed as an observational cross-sectional study. The target
population are HUSA healthcare workers who have overcome SARS-CoV-2 infection, either
symptomatic or asymptomatic, either having required hospital admission or not. Participants
will undergo a clinical evaluation, electrocardiogram (EKG), cardiac magnetic resonance (CMR)
and blood analysis including NT-proBNP, troponin, cellular and humoral immunity and genetics.
Main objectives of the study are to address the prevalence of myocardial damage suggestive of
myocarditis and to address the prevalence of pericarditis in HUSA health care workers; both
related to the systemic immune response to SARS-CoV-2 infection. As secondary objectives the
study will further address other cardiac affections including: rhythm or conduction
disorders, ischemic heart disease, dilatation of the right chambers, valve disease and will
analyze the relationship between humoral and cellular immunity and the presence of cardiac
involvement, and the genetic susceptibility in the development of cardiac involvement after
SARS-CoV-2 infection.
The study will recruit 141 participants: 47 symptomatic hospitalized health care workers, 47
asymptomatic non-hospitalized health care workers, 47 asymptomatic health care workers
Other: Passed infection of SARS-CoV-2
This is an observational design. Participants have passed infection from SARS-CoV-2 and a cardiac assessment is performed.
Inclusion Criteria:
- Have overcome the SARS-CoV-2 infection meeting any of the following criteria (i)
positive result on a reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of
a specimen collected on a nasopharyngeal swab followed by a second negative RT-PCR and
at least 14 days from this negative RT-PCR; (ii) presence of IgM antibodies and
negative RT-PCR after the antibody assessment; (iii) presence of neutralizing IgG
antibodies and absence of IgM.
- stable clinical situation, which allows performing a CMR.
- signature of informed consent.
Exclusion Criteria:
- Presence of IgM antibodies without negative subsequent RT-PCR.
- Contraindications to perform RMC: (i) gadolinium allergy, (ii) presence of metallic
material in the body, such as plates, screws, incompatible pacemakers, etc. (iii)
claustrophobia, (iv) severe kidney failure, (v) severe liver failure, (vi) sickle cell
anemia
University Hospital of Salamanca
Salamanca, Spain