Determination and Evaluation of the Frequency and Effects of myocardial damage iN patients with a SARS-CoV-2 infEction

How often does COVID-19 lead to myocardial damage? What are the short- and long-term consequences of this damage and what can we do to prevent it from occurring? These are the central questions that will be answered within the DEFENCE consortium.

The consortium brings together a number of large national studies founded at the beginning of the COVID-19 pandemic. All these studies included different patient groups, ranging from elite athletes (COMMIT study), patients that have recovered from COVID-19 at home (COVID@Heart study) to the most ill requiring hospital admission for the management of the disease (CAPACITY-COVID registry and CAPACITY 2 study). Also children that have developed a rare inflammatory syndrome after an corona infection (MIS-C) which may affect the heart are included in DEFENCE (COPP study). By combining and harmonizing these different initiatives an unique cohort is established, covering the whole spectrum of COVID-19 severity (Figure).

The ongoing studies are extended at multiple levels within this project. This includes the implementation and evaluation of a standardized health care pathway to assess the occurrence of cardiac damage in patients hospitalized due to COVID-19 within 6-months and serial Cardiac Magnetic Resonance (CMR) Imaging to determine the prevalence and reversibility of myocardial damage. All CMR scans will be assessed in a core lab. Furthermore, the incidence of complaints suggestive of cardiovascular disease including chest pain and palpitations will be evaluated in the post-acute phase through questionnaires. The relationship between these patient reported outcome measures and cardiovascular complications will be assessed. Lastly, data will be linked to different national datasets at Statistics Netherlands to determine the incidence of cardiovascular morbidity and mortality on the long-term. To evaluate whether cardiovascular disease is a characteristic feature of COVID-19, a comparison with other respiratory tract infections, including seasonal influenza will be made.


Contact persons and information

Prof. Dr. Folkert W. Asselbergs

Drs. Marijke Linschoten -


Netherlands Organisation for Health Research and Development (ZonMw)
Dutch Heart Foundation
EuroQol Research Foundation