Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19

Sykes, R. et al. (2023) Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19. Open Heart, 10(1), e002192. (doi: 10.1136/openhrt-2022-002192) (PMID:36822817) (PMCID:PMC9950584)

Abstract

Background: We investigated the associations of healthcare worker status with multisystem illness trajectory in hospitalised post-COVID-19 individuals. Methods and results: One hundred and sixty-eight patients were evaluated 28–60 days after the last episode of hospital care. Thirty-six (21%) were healthcare workers. Compared with non-healthcare workers, healthcare workers were of similar age (51.3 (8.7) years vs 55.0 (12.4) years; p=0.09) more often women (26 (72%) vs 48 (38%); p<0.01) and had lower 10-year cardiovascular risk (%) (8.1 (7.9) vs 15.0 (11.5); p<0.01) and Coronavirus Clinical Characterisation Consortium in-hospital mortality risk (7.3 (10.2) vs 12.7 (9.8); p<0.01). Healthcare worker status associated with less acute inflammation (peak C reactive protein 48 mg/L (IQR: 14–165) vs 112 mg/L (52–181)), milder illness reflected by WHO clinical severity score distribution (p=0.04) and shorter duration of admission (4 days (IQR: 2–6) vs 6 days (3–12)). In adjusted multivariate logistic regression analysis, healthcare worker status associated with a binary classification (probable/very likely vs not present/unlikely) of adjudicated myocarditis (OR: 2.99; 95% CI (1.01 to 8.89) by 28–60 days postdischarge). After a mean (SD, range) duration of follow-up after hospital discharge of 450 (88) days (range 290, 627 days), fewer healthcare workers died or were rehospitalised (1 (3%) vs 22 (17%); p=0.038) and secondary care referrals for post-COVID-19 syndrome were common (42%) and similar to non-healthcare workers (38%; p=0.934). Conclusion: Healthcare worker status was independently associated with the likelihood of adjudicated myocarditis, despite better antecedent health. Two in five healthcare workers had a secondary care referral for post-COVID-19 syndrome. Trial registration number: NCT04403607.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Macfarlane, Professor Peter and Veldtman, Professor Gruschen and Robertson, Dr Keith and McGinley, Dr Christopher and Carrick, Dr David and Church, Dr Colin and Bulluck, Dr Heerajnarain and Corcoran, Dr David and Mangion, Dr Kenneth and Morrow, Dr Andrew and Findlay, Dr Iain and Blyth, Professor Kevin and Roditi, Dr Giles and Weeden, Dr Sarah and Sykes, Dr Robert and Bayes, Dr Hannah and Kamdar, Anna and McConnachie, Professor Alex and Mark, Professor Patrick and Welsh, Professor Paul and McIntosh, Dr Alasdair and Gillespie, Dr Lynsey and Ho, Dr Antonia and Rankin, Dr Alastair and Watkins, Dr Stuart and Lowe, Dr David and Bagot, Dr Catherine and Touyz, Professor Rhian and Berry, Professor Colin and Delles, Professor Christian and Mayne, Dr Kaitlin and Hall Barrientos, Dr Pauline and Allwood-Spiers, Sarah and Lang, Professor Ninian and Wereski, Dr Ryan and Payne, Dr Alexander and Sattar, Professor Naveed
• Authors: Sykes, R., Morrow, A. J., McConnachie, A., Kamdar, A., Bagot, C., Bayes, H., Blyth, K. G., Briscoe, M., Bulluck, H., Carrick, D., Church, C., Corcoran, D., Delles, C., Findlay, I., Gibson, V. B., Gillespie, L., Grieve, D., Hall Barrientos, P., Ho, A., Lang, N. N., Lowe, D. J., Lennie, V., MacFarlane, P., Mayne, K. J., Mark, P., McIntosh, A., McGeoch, R., McGinley, C., Mckee, C., Nordin, S., Payne, A., Rankin, A., Robertson, K. E., Ryan, N., Roditi, G. H., Sattar, N., Stobo, D. B., Allwood-Spiers, S., Touyz, R., Veldtman, G., Weeden, S., Watkins, S., Welsh, P., Wereski, R., Mangion, K., and Berry, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Open Heart
• Publisher: BMJ Publishing Group
• ISSN: 2053-3624
• ISSN (Online): 2053-3624
• Published Online: 23 February 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Open Heart 10(1): e002192
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
311300		CSO covid 19 portfolio	Iain McInnes	Office of the Chief Scientific Adviser (CSO)	COV/GLA/Portfolio	III - Immunology
303944		BHF Centre of Excellence	Colin Berry	British Heart Foundation (BHF)	RE/18/6/34217	CAMS - Cardiovascular Science