Pericardial and myocardial involvement after SARS-CoV-2 infection: a cross-sectional descriptive study in healthcare workers

  1. Rocío Eiros
  2. Manuel Barreiro-Pérez
  3. Ana Martín-García
  4. Julia Almeida
  5. Eduardo Villacorta
  6. Alba Pérez-Pons
  7. Soraya Merchán
  8. Alba Torres-Valle
  9. Clara Sánchez-Pablo
  10. David González-Calle
  11. Oihane Pérez-Escurza
  12. Inés Toranzo
  13. Elena Díaz-Peláez
  14. Blanca Fuentes-Herrero
  15. Laura Macías-Álvarez
  16. Guillermo Oliva-Ariza
  17. Quentin Lecrevisse
  18. Rafael Fluxa
  19. José L. Bravo-Grande
  20. Alberto Orfao
  21. Pedro L. Sánchez

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Abstract

No abstract available

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  1. Version published to 10.1016/j.rec.2021.11.001
  2. ScreenIT

    SciScore for 10.1101/2020.07.12.20151316: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Institutional approval (2020/05/490) for the study was provided by the University Hospital of Salamanca Ethics Committee, and all participants provided written informed consent.
    Consent: After obtaining written informed consent, trained interviewers used a structure questionnaire to collect baseline data in face-to-face interviews.
    RandomizationAs the participants in our study were not randomly selected, all statistics are deemed descriptive only; nonetheless, differences between groups are also provided and were analysed by Fisher’s exact test for categorical variables and by nonparametric Mann-Whitney or Kruskal-Wallis for continuous data.
    BlindingElectrocardiograms were interpreted in consensus by two experienced readers, who were blinded to participant identification, clinical history, symptoms, physical examination and other findings.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Among them, 106 health-care workers tested positive for SARS-CoV-2 by RT-PCR between March 13 and April 25; and 36 health-care workers were diagnosed after testing positive for anti-SARS-CoV-2-IgG antibodies between April 10 and May 22.
    anti-SARS-CoV-2-IgG
    suggested: None
    Reference values were defined based on a cohort of 463 age-matched adults (median age 52 years [IQR 47-61]) from the general population of the province of Salamanca, Spain. Anti-SARS-CoV-2-IgM (AnshLabs, Webster, Texas), IgG and IgA (Mikrogen Diagnostik, Neuried, Germany) antibody levels were measured in parallel in plasma from the same blood samples using commercially available IVD approved (semi-quantitative) ELISA kits, strictly as instructed by the manufacturers.
    Anti-SARS-CoV-2-IgM
    suggested: None
    IgG
    suggested: None
    IgA ( Mikrogen Diagnostik , Neuried , Germany ) antibody levels
    suggested: None
    IgA
    suggested: None
    Software and Algorithms
    SentencesResources
    T2 and T1-based markers of myocardial inflammation were analysed in each of the 16 segments of the 17-segment model of the American Heart Association (the true apex was excluded)14, where only positive segment concordances from the different T2 and T1-based markers were considered.
    American Heart Association
    suggested: (American Heart Association, RRID:SCR_007210)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations of the study: The study analysis was limited to health-care workers in Salamanca and therefore may have limited external generalizability to other non-health-care settings. However, the strength of this study is the addition of non-hospitalized participants and also the inclusion of participants diagnosed of past SARS-CoV-2 infection through serology, who also had a high prevalence of pericarditis and myocarditis. Seropositive participants, although less symptomatic than RT-PCR participants, presented mild symptoms in almost all cases; unfortunately, we cannot draw conclusions regarding the prevalence of pericarditis and myocarditis in the completely asymptomatic general population. Finally, the study relied solely on descriptive observations and cannot provide any conclusion on the benefit of antiviral and anti-inflammatory treatments during the acute phase of infection or whether the prevalence of pericarditis and myocarditis after SARS-CoV-2 infection is higher in women than men.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04413071CompletedCardiac COVID-19 Health Care Workers
    NCT03429452CompletedThe SALMANTICOR Study
    NCT04381936RecruitingRandomised Evaluation of COVID-19 Therapy
    NCT04381936RecruitingRandomised Evaluation of COVID-19 Therapy

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. ScreenIT

    SciScore for 10.1101/2020.07.12.20151316: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementInstitutional approval (2020/05/490) for the study was provided by the University Hospital of Salamanca Ethics Committee, and all participants provided written informed consent.RandomizationAs the participants in our study were not randomly selected, all statistics are deemed descriptive only; nonetheless, differences between groups are also provided and were analysed by Fisher´s exact test for categorical variables and by nonparametric Mann-Whitney or KruskalWallis for continuous data.BlindingElectrocardiograms were interpreted in consensus by two experienced readers, who were blinded to participant identification, clinical history, symptoms, physical examination and other findings.Power Analysisnot detected.Sex as a biological variableResults Median age was 52 years (IQR 41–57), 100 (72%) were women, and 23 (16%) were previously hospitalized for Covid-19 pneumonia.

    Table 2: Resources

    Antibodies
    SentencesResources
    Pericarditis was associated with elevated CD4-CD8/lo Tαβ-cell numbers (p=0.011), while participants diagnosed with myopericarditis or myocarditis had lower (p<0.05) plasmacytoid dendritic cell, NK-cell and plasma cell counts and lower anti-SARS-CoV-2-IgG antibody levels (p=0.027).
    anti-SARS-CoV-2-IgG
    suggested: None
    Reference values were defined based on a cohort of 463 age-matched adults (median age 52 years [IQR 47-61]) from the general population of the province of Salamanca, Spain. Anti-SARS-CoV-2-IgM (AnshLabs, Webster, Texas), IgG and IgA (Mikrogen Diagnostik, Neuried, Germany) antibody levels were measured in parallel in plasma from the same blood samples using commercially available IVD approved (semi-quantitative) ELISA kits, strictly as instructed by the manufacturers.
    Anti-SARS-CoV-2-IgM
    suggested: None
          <div style="margin-bottom:8px">
        <div><b>IgG</b></div>
        <div>suggested: None</div>
      </div>
    
      <div style="margin-bottom:8px">
        <div><b>IgA ( Mikrogen Diagnostik , Neuried , Germany ) antibody levels</b></div>
        <div>suggested: None</div>
      </div>
    
      <div style="margin-bottom:8px">
        <div><b>IgA</b></div>
        <div>suggested: None</div>
      </div>
    </td></tr><tr><td style="min-width:100px;text-align:center; padding-top:4px;" colspan="2"><b>Software and Algorithms</b></td></tr><tr><td style="min-width:100px;text=align:center"><i>Sentences</i></td><td style="min-width:100px;text-align:center"><i>Resources</i></td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">The trial is registered with ClinicalTrials.</td><td style="min-width:100px;border-bottom:1px solid lightgray">
      <div style="margin-bottom:8px">
        <div><b>ClinicalTrials</b></div>
        <div>suggested: (ClinicalTrials.gov, <a href="https://scicrunch.org/resources/Any/search?q=SCR_002309">SCR_002309</a>)</div>
      </div>
    </td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">gov, number NCT04413071 Keywords (MeSH terms) SARS-CoV-2; COVID-19; health-care worker; pericarditis; myocarditis; cardiac magnetic resonance; electrocardiogram; immune response; immune cells; serology Research in context Evidence before this study Very little evidence exists describing long cardiac sequelae after SARS-CoV-2 infection.</td><td style="min-width:100px;border-bottom:1px solid lightgray">
      <div style="margin-bottom:8px">
        <div><b>MeSH</b></div>
        <div>suggested: (MeSH, <a href="https://scicrunch.org/resources/Any/search?q=SCR_004750">SCR_004750</a>)</div>
      </div>
    </td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">T2 and T1-based markers of myocardial inflammation were analysed in each of the 16 segments of the 17segment model of the American Heart Association (the true apex was excluded)14, where only positive segment concordances from the different T2 and T1-based markers were considered.</td><td style="min-width:100px;border-bottom:1px solid lightgray">
      <div style="margin-bottom:8px">
        <div><b>American Heart Association</b></div>
        <div>suggested: (American Heart Association, <a href="https://scicrunch.org/resources/Any/search?q=SCR_007210">SCR_007210</a>)</div>
      </div>
    </td></tr></table>

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.07.12.20151316v1 on medRxiv