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

Autor:	Sykes R; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.; Cardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UK., Morrow AJ; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., McConnachie A; Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK., Kamdar A; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Bagot C; Haematology, Glasgow Royal Infirmary, Glasgow, UK., Bayes H; Respiratory Medicine, Glasgow Royal Infirmary, Glasgow, UK., Blyth KG; School of Cancer Sciences, University of Glasgow, Glasgow, UK.; Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UK., Briscoe M; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., Bulluck H; Cardiology, Leeds General Infirmary, Leeds, West Yorkshire, UK., Carrick D; Cardiology, University Hospital Hairmyres, East Kilbride, South Lanarkshire, UK., Church C; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.; Scottish Pulmonary Vascular Unit, Golden Jubilee Hospital, Clydebank, UK., Corcoran D; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., Delles C; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Findlay I; Cardiology, Royal Alexandra Hospital, Paisley, Renfrewshire, UK., Gibson VB; Haemostasis and Thrombosis, Glasgow Royal Infirmary, Glasgow, UK., Gillespie L; Project Management Unit, Glasgow Clinical Research Facility, Glasgow, UK., Grieve D; Respiratory Medicine, Royal Alexandra Hospital, Paisley, Renfrewshire, UK., Barrientos PH; Medical Physics, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UK., Ho A; MRC-University of Glasgow Centre for Virus Research, School of Infection and Immunity, University of Glasgow, Glasgow, UK., Lang NN; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., Lowe DJ; Emergency Medicine, Queen Elizabeth University Hospital, Glasgow, UK., Lennie V; Cardiology, Aberdeen Royal Infirmary, Aberdeen, Aberdeen, UK., MacFarlane P; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Mayne KJ; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Mark P; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., McIntosh A; Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK., McGeoch R; Cardiology, University Hospital Hairmyres, East Kilbride, South Lanarkshire, UK., McGinley C; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., Mckee C; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., Nordin S; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., Payne A; Cardiology, University Hospital Crosshouse, Kilmarnock, East Ayrshire, UK., Rankin A; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Robertson KE; Cardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UK., Ryan N; Cardiology, Aberdeen Royal Infirmary, Aberdeen, Aberdeen, UK., Roditi GH; Radiology, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UK., Sattar N; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Stobo DB; Radiology, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UK., Allwood-Spiers S; Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UK., Touyz R; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Veldtman G; Cardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UK., Weeden S; Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK., Watkins S; Cardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UK., Welsh P; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Wereski R; Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK., Mangion K; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK., Berry C; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK colin.berry@glasgow.ac.uk.; Cardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UK.; Cardiology, Queen Elizabeth University Hospital, Glasgow, UK.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2023 Feb; Vol. 10 (1).
DOI:	10.1136/openhrt-2022-002192
Abstrakt:	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. Competing Interests: Competing interests: CB is employed by the University of Glasgow, which holds consultancy and research agreements with Abbott Vascular, AstraZeneca, Boehringer Ingelheim, Coroventis, GSK, HeartFlow, Menarini, Novartis, Siemens Healthcare, SomaLogic and Valo Health. These companies had no role in the design or conduct of the study or the data collection, interpretation, or reporting. HeartFlow derived FFRCT. None of the other authors has any relevant disclosures. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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