SARS-CoV2 infection and COVID-19 is frequently associated with cardiac complications. The pathogenesis likely involves a microvascular angiopathy related to endothelial dysfunction and systemic coagulopathy. More severe forms of disease lead to acute respiratory distress syndrome (ARDS) which often results in admission to intensive care units (ICU) with a requirement for invasive ventilation. However, even in non-ICU patients or those who recover at home, there are significant abnormalities in serum levels of biomarkers in the weeks or months while recovering, which may point to ongoing endotheliopathy or inflammation. In the cardiac context, a number of cardiac magnetic resonance imaging (CMR) studies have suggested ongoing inflammation in a significant cohort of patients who recover from SARS-CoV2 at home, several months post initial infection.
The Study of HEarT DiseAse and ImmuNiTy After COVID-19 in Ireland (SETANTA) is a prospective, community-based, single-arm observational cross-sectional population study. The aim of the study is to investigate the incidence of cardiac abnormalities as assessed by cardiac magnetic resonance imaging in unselected patients after acute SARS-CoV-2 infection and the correlation with immunological response and biomarkers of coagulation. Consecutive patients (n=100) with recent COVID-19 infection (≥ 6 weeks and ≤ 12 months before enrolment), as evidenced by positive reverse-transcriptase polymerase chain reaction (RT-PCR) SARS-CoV-2 nasopharyngeal swab will be enrolled if they meet all inclusion criteria and no exclusion criterion. All patients will undergo cardiac magnetic resonance imaging, anti-SARS-CoV-2 total antibody testing and analysis of markers of coagulation and endothelial cell activation. The primary outcome of interest is evidence of cardiac injury as detected by cardiac magnetic resonance imaging.