COVID-19 is a systemic inflammatory disease involving many organs including the lungs,vascular system liver and myocardium that lead to severe pathologies. Patients withsevere cardiopulmonary symptoms usually require weeks to months to fully recover. Studiesof clinical and subclinical impairments of COVID-19 patients are important for medicalpractice and public health as well as providing pathogenic insight to the viral infectionand secondary immune response. Chronic damage of vital organs and systems, and thepotential long-term effects is of serious concern. In this study the investigators planto quantify and characterize chronic consequences of COVID-19 in individuals who receivesimilar medical care related to disease severity and duration in a single health caresystem. Using state-of-the-art Computed Tomography (CT) and Magnetic Resonance Imaging(MRI) technology, we will study the pathology in major organ systems in comparison tomatched controls. The results of this study may facilitate measures to prevent, detect,and manage complications from COVID-19 infections.
As the number of recovered COVID-19 patients increase around the globe, it is important
to understand the longterm impact of the disease so that healthcare systems and providers
can optimize follow-up care of these patients. Identifying long term effects may also
help identify patients with an increased risk of major adverse events following discharge
from the hospital. Currently, the long term effects of COVID-19 in discharged
hospitalized patients remain unknown. Infection with COVID-19 may result in involvement
of many organ systems, including the lung, heart, brain, liver, and kidneys. Patients
with a previous history of cardiovascular disease have been found to be at higher risk
for incident cardiovascular complications. Direct or indirect effects of COVID-19
infection may predispose patients to thrombotic events including acute myocardial injury
or pulmonary defects. Cardio-pulmonary features of COVID-19 include: bilateral multilobar
ground-glass opacifications, septal thickening, bronchiectasis, pleural thickening, and
subpleural involvement. Gradual resolution of consolidative opacities and other imaging
patterns associated with clinical improvement usually occur after the second week of the
disease. Characterization and quantification of organ injury as well associated organ
dysfunction may help facilitating appropriate prevention and management.
Other: Magnetic Resonance Imaging
Completion of Magnetic Resonance Imaging of the brain, heart, lungs, and liver with and
without contrast.
Other: Ultra-High Resolution Computed Tomography (CT) Scan
Completion of a high resolution CT scan of the lungs and high resolution CT of the
coronary arteries.
Inclusion Criteria:
- Age: 18+
- Diagnosed with COVID-19 at any point starting March 2020.
- Subgroup A: hospitalized due to COVID-19 infection
- Subgroup B: non-hospitalized
Exclusion Criteria:
- Known allergy to either gadolinium or iodine based contrast agents
- Glomerular Filtration Rate (GFR) <45 mL/min (using the Cockcroft-Gault formula)
- Pregnancy
- Internal electrical devices, such as cochlear implant, spinal cord stimulator,
pacemaker, or defibrillator
- Atrial fibrillation, uncontrolled tachyarrhythmia or advanced atrioventricular block
(2nd or 3rd degree) at time of imaging
- Evidence of severe symptomatic heart failure (NYHA Class III or IV) at the time of
imaging
- Other acute illness
- Ongoing mechanical ventilation related to hospitalization for COVID-19 related
illness
- Presence of any other history or condition that the investigator feels would be
problematic
- Weight exceeding 300 lbs (MRI table weight restrictions)
- Severe claustrophobia
Johns Hopkins School of Medicine
Baltimore, Maryland, United States
Joao Lima, MD, Principal Investigator
Johns Hopkins School of Medicine