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

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 heal...

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Main Authors: Kevin G Blyth, Naveed Sattar, Colin Berry, David Corcoran, Kenneth Mangion, Alex McConnachie, David Carrick, Stuart Watkins, Paul Welsh, Sabrina Nordin, Ross McGeoch, Rhian Touyz, David J Lowe, Andrew J Morrow, Antonia Ho, Ryan Wereski, Alasdair McIntosh, Giles H Roditi, Peter MacFarlane, David B Stobo, Robert Sykes, Colin Church, Nicola Ryan, N N Lang, C Delles, Iain Findlay, Michael Briscoe, Gruschen Veldtman, Heeraj Bulluck, Patrick Mark, Vera Lennie, Alexander Payne, Keith E Robertson, Anna Kamdar, C Bagot, Hannah Bayes, Vivienne B Gibson, Lynsey Gillespie, Douglas Grieve, Pauline Hall Barrientos, Kaithlin J Mayne, Christopher McGinley, Connor Mckee, Alastair Rankin, Sarah Allwood-Spiers, Sarah Weeden
Format: Article
Language:English
Published: BMJ Publishing Group 2023-02-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/10/1/e002192.full
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author Kevin G Blyth
Naveed Sattar
Colin Berry
David Corcoran
Kenneth Mangion
Alex McConnachie
David Carrick
Stuart Watkins
Paul Welsh
Sabrina Nordin
Ross McGeoch
Rhian Touyz
David J Lowe
Andrew J Morrow
Antonia Ho
Ryan Wereski
Alasdair McIntosh
Giles H Roditi
Peter MacFarlane
David B Stobo
Robert Sykes
Colin Church
Nicola Ryan
N N Lang
C Delles
Iain Findlay
Michael Briscoe
Gruschen Veldtman
Heeraj Bulluck
Patrick Mark
Vera Lennie
Alexander Payne
Keith E Robertson
Anna Kamdar
C Bagot
Hannah Bayes
Vivienne B Gibson
Lynsey Gillespie
Douglas Grieve
Pauline Hall Barrientos
Kaithlin J Mayne
Christopher McGinley
Connor Mckee
Alastair Rankin
Sarah Allwood-Spiers
Sarah Weeden
author_facet Kevin G Blyth
Naveed Sattar
Colin Berry
David Corcoran
Kenneth Mangion
Alex McConnachie
David Carrick
Stuart Watkins
Paul Welsh
Sabrina Nordin
Ross McGeoch
Rhian Touyz
David J Lowe
Andrew J Morrow
Antonia Ho
Ryan Wereski
Alasdair McIntosh
Giles H Roditi
Peter MacFarlane
David B Stobo
Robert Sykes
Colin Church
Nicola Ryan
N N Lang
C Delles
Iain Findlay
Michael Briscoe
Gruschen Veldtman
Heeraj Bulluck
Patrick Mark
Vera Lennie
Alexander Payne
Keith E Robertson
Anna Kamdar
C Bagot
Hannah Bayes
Vivienne B Gibson
Lynsey Gillespie
Douglas Grieve
Pauline Hall Barrientos
Kaithlin J Mayne
Christopher McGinley
Connor Mckee
Alastair Rankin
Sarah Allwood-Spiers
Sarah Weeden
author_sort Kevin G Blyth
collection DOAJ
description 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.
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spelling doaj.art-2803299856a24ddab07adfd0640b2cc82023-07-26T02:25:06ZengBMJ Publishing GroupOpen Heart2053-36242023-02-0110110.1136/openhrt-2022-002192Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19Kevin G Blyth0Naveed Sattar1Colin Berry2David Corcoran3Kenneth Mangion4Alex McConnachie5David Carrick6Stuart Watkins7Paul Welsh8Sabrina Nordin9Ross McGeoch10Rhian Touyz11David J Lowe12Andrew J Morrow13Antonia Ho14Ryan Wereski15Alasdair McIntosh16Giles H Roditi17Peter MacFarlane18David B Stobo19Robert Sykes20Colin Church21Nicola Ryan22N N Lang23C Delles24Iain Findlay25Michael Briscoe26Gruschen Veldtman27Heeraj Bulluck28Patrick Mark29Vera Lennie30Alexander Payne31Keith E Robertson32Anna Kamdar33C Bagot34Hannah Bayes35Vivienne B Gibson36Lynsey Gillespie37Douglas Grieve38Pauline Hall Barrientos39Kaithlin J Mayne40Christopher McGinley41Connor Mckee42Alastair Rankin43Sarah Allwood-Spiers44Sarah Weeden45Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKCardiology, Queen Elizabeth University Hospital, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UKCardiology, University Hospital Hairmyres, East Kilbride, South Lanarkshire, UKCardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKCardiology, Queen Elizabeth University Hospital, Glasgow, UKCardiology, University Hospital Hairmyres, East Kilbride, South Lanarkshire, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKEmergency Medicine, Queen Elizabeth University Hospital, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKMRC-University of Glasgow Centre for Virus Research, School of Infection and Immunity, University of Glasgow, Glasgow, UKCentre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UKRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UKRadiology, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKRadiology, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UKCardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKCardiology, Aberdeen Royal Infirmary, Aberdeen, Aberdeen, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKCardiology, Royal Alexandra Hospital, Paisley, Renfrewshire, UKCardiology, Queen Elizabeth University Hospital, Glasgow, UKCardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UKCardiology, Leeds General Infirmary, Leeds, West Yorkshire, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKCardiology, Aberdeen Royal Infirmary, Aberdeen, Aberdeen, UKCardiology, University Hospital Crosshouse, Kilmarnock, East Ayrshire, UKCardiology, Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKHaematology, Glasgow Royal Infirmary, Glasgow, UKRespiratory Medicine, Glasgow Royal Infirmary, Glasgow, UKHaemostasis and Thrombosis, Glasgow Royal Infirmary, Glasgow, UKProject Management Unit, Glasgow Clinical Research Facility, Glasgow, UKRespiratory Medicine, Royal Alexandra Hospital, Paisley, Renfrewshire, UKMedical Physics, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKCardiology, Queen Elizabeth University Hospital, Glasgow, UKCardiology, Queen Elizabeth University Hospital, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKRespiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UKRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UKBackground 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.https://openheart.bmj.com/content/10/1/e002192.full
spellingShingle Kevin G Blyth
Naveed Sattar
Colin Berry
David Corcoran
Kenneth Mangion
Alex McConnachie
David Carrick
Stuart Watkins
Paul Welsh
Sabrina Nordin
Ross McGeoch
Rhian Touyz
David J Lowe
Andrew J Morrow
Antonia Ho
Ryan Wereski
Alasdair McIntosh
Giles H Roditi
Peter MacFarlane
David B Stobo
Robert Sykes
Colin Church
Nicola Ryan
N N Lang
C Delles
Iain Findlay
Michael Briscoe
Gruschen Veldtman
Heeraj Bulluck
Patrick Mark
Vera Lennie
Alexander Payne
Keith E Robertson
Anna Kamdar
C Bagot
Hannah Bayes
Vivienne B Gibson
Lynsey Gillespie
Douglas Grieve
Pauline Hall Barrientos
Kaithlin J Mayne
Christopher McGinley
Connor Mckee
Alastair Rankin
Sarah Allwood-Spiers
Sarah Weeden
Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19
Open Heart
title Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19
title_full Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19
title_fullStr Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19
title_full_unstemmed Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19
title_short Adjudicated myocarditis and multisystem illness trajectory in healthcare workers post-COVID-19
title_sort adjudicated myocarditis and multisystem illness trajectory in healthcare workers post covid 19
url https://openheart.bmj.com/content/10/1/e002192.full
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