Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study

ObjectiveTo assess medium-term organ impairment in symptomatic individuals following recovery from acute SARS-CoV-2 infection.DesignBaseline findings from a prospective, observational cohort study.SettingCommunity-based individuals from two UK centres between 1 April and 14 September 2020.Participan...

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Vydáno v:BMJ open Ročník 11; číslo 3; s. e048391
Hlavní autoři: Dennis, Andrea, Wamil, Malgorzata, Alberts, Johann, Oben, Jude, Cuthbertson, Daniel J, Wootton, Dan, Crooks, Michael, Gabbay, Mark, Brady, Michael, Hishmeh, Lyth, Attree, Emily, Heightman, Melissa, Banerjee, Rajarshi, Banerjee, Amitava
Médium: Journal Article
Jazyk:angličtina
Vydáno: England British Medical Journal Publishing Group 30.03.2021
BMJ Publishing Group LTD
BMJ Publishing Group
Edice:Original research
Témata:
Activities of Daily Living
Adult
Aged
Case-Control Studies
Community-Based Participatory Research
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
COVID-19 - physiopathology
Diabetes
Diabetes Mellitus, Type 2 - complications
Epidemiology
Female
health policy
Health Services Research
Hospitalization - statistics & numerical data
Humans
Kidneys
Male
Middle Aged
Mortality
Prospective Studies
Public health
SARS-CoV-2
Severity of Illness Index
United Kingdom > UK
COVID-19
epidemiology
health policy
public health
ISSN:2044-6055, 2044-6055
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Shrnutí:ObjectiveTo assess medium-term organ impairment in symptomatic individuals following recovery from acute SARS-CoV-2 infection.DesignBaseline findings from a prospective, observational cohort study.SettingCommunity-based individuals from two UK centres between 1 April and 14 September 2020.ParticipantsIndividuals ≥18 years with persistent symptoms following recovery from acute SARS-CoV-2 infection and age-matched healthy controls.InterventionAssessment of symptoms by standardised questionnaires (EQ-5D-5L, Dyspnoea-12) and organ-specific metrics by biochemical assessment and quantitative MRI.Main outcome measuresSevere post-COVID-19 syndrome defined as ongoing respiratory symptoms and/or moderate functional impairment in activities of daily living; single-organ and multiorgan impairment (heart, lungs, kidneys, liver, pancreas, spleen) by consensus definitions at baseline investigation.Results201 individuals (mean age 45, range 21–71 years, 71% female, 88% white, 32% healthcare workers) completed the baseline assessment (median of 141 days following SARS-CoV-2 infection, IQR 110–162). The study population was at low risk of COVID-19 mortality (obesity 20%, hypertension 7%, type 2 diabetes 2%, heart disease 5%), with only 19% hospitalised with COVID-19. 42% of individuals had 10 or more symptoms and 60% had severe post-COVID-19 syndrome. Fatigue (98%), muscle aches (87%), breathlessness (88%) and headaches (83%) were most frequently reported. Mild organ impairment was present in the heart (26%), lungs (11%), kidneys (4%), liver (28%), pancreas (40%) and spleen (4%), with single-organ and multiorgan impairment in 70% and 29%, respectively. Hospitalisation was associated with older age (p=0.001), non-white ethnicity (p=0.016), increased liver volume (p<0.0001), pancreatic inflammation (p<0.01), and fat accumulation in the liver (p<0.05) and pancreas (p<0.01). Severe post-COVID-19 syndrome was associated with radiological evidence of cardiac damage (myocarditis) (p<0.05).ConclusionsIn individuals at low risk of COVID-19 mortality with ongoing symptoms, 70% have impairment in one or more organs 4 months after initial COVID-19 symptoms, with implications for healthcare and public health, which have assumed low risk in young people with no comorbidities.Trial registration numberNCT04369807; Pre-results.
Bibliografie:Original research
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RB and AB are joint senior authors.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2020-048391