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      Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank


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          Coronavirus disease 2019 (COVID-19) disproportionately affects older people. Observational studies suggest indolent cardiovascular involvement after recovery from acute COVID-19. However, these findings may reflect pre-existing cardiac phenotypes.


          We tested the association of baseline cardiovascular magnetic resonance (CMR) phenotypes with incident COVID-19.


          We studied UK Biobank participants with CMR imaging and COVID-19 testing. We considered left and right ventricular (LV, RV) volumes, ejection fractions, and stroke volumes, LV mass, LV strain, native T1, aortic distensibility, and arterial stiffness index. COVID-19 test results were obtained from Public Health England. Co-morbidities were ascertained from self-report and hospital episode statistics (HES). Critical care admission and death were from HES and death register records. We investigated the association of each cardiovascular measure with COVID-19 test result in multivariable logistic regression models adjusting for age, sex, ethnicity, deprivation, body mass index, smoking, diabetes, hypertension, high cholesterol, and prior myocardial infarction.


          We studied 310 participants ( n = 70 positive). Median age was 63.8 [57.5, 72.1] years; 51.0% ( n = 158) were male. 78.7% ( n = 244) were tested in hospital, 3.5% ( n = 11) required critical care admission, and 6.1% ( n = 19) died. In fully adjusted models, smaller LV/RV end-diastolic volumes, smaller LV stroke volume, and poorer global longitudinal strain were associated with significantly higher odds of COVID-19 positivity.


          We demonstrate association of pre-existing adverse CMR phenotypes with greater odds of COVID-19 positivity independent of classical cardiovascular risk factors.


          Observational reports of cardiovascular involvement after COVID-19 may, at least partly, reflect pre-existing cardiac status rather than COVID-19 induced alterations.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s40520-021-01808-z.

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          Most cited references38

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          Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China

          Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. However, information on cardiac injury in patients affected by COVID-19 is limited.
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            Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19)

            This case series study evaluates the association of underlying cardiovascular disease and myocardial injury on fatal outcomes in patients with coronavirus disease 2019 (COVID-19).
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              Persistent Symptoms in Patients After Acute COVID-19

              This case series describes COVID-19 symptoms persisting a mean of 60 days after onset among Italian patients previously discharged from COVID-19 hospitalization.

                Author and article information

                Aging Clin Exp Res
                Aging Clin Exp Res
                Aging Clinical and Experimental Research
                Springer International Publishing (Cham )
                8 March 2021
                8 March 2021
                : 1-12
                [1 ]GRID grid.4868.2, ISNI 0000 0001 2171 1133, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, , Queen Mary University of London, ; Charterhouse Square, London, EC1M 6BQ UK
                [2 ]GRID grid.416353.6, ISNI 0000 0000 9244 0345, Barts Heart Centre, , St Bartholomew’s Hospital, Barts Health NHS Trust, ; London, EC1A 7BE UK
                [3 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, National Institute for Health Research Oxford Biomedical Research Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, , University of Oxford, ; Oxford, UK
                [4 ]GRID grid.5491.9, ISNI 0000 0004 1936 9297, MRC Lifecourse Epidemiology Unit, , University of Southampton, ; Southampton, UK
                [5 ]GRID grid.430506.4, NIHR Southampton Biomedical Research Centre, , University of Southampton and University Hospital Southampton NHS Foundation Trust, ; Southampton, UK
                Author information
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                : 15 January 2021
                : 2 February 2021
                Funded by: British Heart Foundation (GB)
                Award ID: FS/17/81/33318
                Award ID: PG/14/89/31194
                Award Recipient :
                Funded by: Horizon 2020 ()
                Award ID: 825903
                Award Recipient :
                Funded by: Engineering and Physical Sciences Research Council (GB)
                Award ID: EP/P001009/1
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award ID: 405050259
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100006041, Innovate UK;
                Original Article

                cardiovascular magnetic resonance,coronavirus disease 2019 (covid-19),severe acute respiratory syndrome coronavirus 2 (sars-cov-2)


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