18 Impact of age and sex on myocardial involvement in hospitalized COVID-19 patients. A Pre-specified Subanalysis of COVID-HEART
Bibliographic record
Abstract
Introduction COVID-HEART was a prospective, longitudinal, multicenter, observational cohort study of patients hospitalized with COVID-19 and elevated serum troponin in the United Kingdom. From a pre-specified subanalysis, we evaluated and compared the interaction of age and sex with CMR abnormalities in COVID-19 inpatients and contemporary controls. Materials and Methods Patients recruited to COVID-HEART and contemporary controls were included and divided in three groups (COVID-19 positive, troponin positive inpatients; COVID-19 positive inpatients with non-elevated serum troponin; and non-hospitalized, age and sex-matched controls). The impact of age and sex on cardiac abnormalities (left and right ventricular systolic function, pericardial effusion, and myocardial scarring) and myocardial inflammation on CMR was assessed in linear or logistic regression models, and odds ratios (OR) with 95% confidence intervals along with the corresponding p-values for interaction reported. Results Of 519 individuals in COVID-HEART (n=342 cases and n=177 controls), 163 (31.4%) were females, of which 99 (60.7%) were hospitalized with COVID-19 and elevated serum troponin. Median age (IQR) was 61 (54–69) years. CMR abnormalities were not dependent on patient age (p-interaction = 0.5) and were more frequent in males (72% vs 60%, p-interaction < 0.001. Overall, a higher prevalence of macroscopic infarction was observed in males (16% in males vs 5.3% in females, p-interaction = 0.002). Comparable proportions of males and females had microinfarction (9.2%), non-ischemic scar (12.0%), or dual pathology (2.5%) patterns. The microinfarct pattern was exclusively identified among hospitalized patients irrespective of age and sex. No differences in the proportion of patients with LV systolic impairment or pericardial effusion were identified. Females had significantly higher myocardial inflammation detected by global T2 values (Z-score 0.56 vs -0.07, p < 0.0001), while no age-related differences were detected in global T1 or T2 values. At clinical follow-up, no differences were observed in major adverse cardiovascular event rates between males (15.0%) and females (9.1%, p-interaction = 0.3). Conclusion COVID-19 affected the heart differently in males and females, with no major differences noted attributable to age. A greater proportion of male patients was found to have an ischemic scar during the acute infection, while microinfarction and other scar patterns were similarly prevalent between sexes. Acknowledgements None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".