@article{Berry_C-2021_202875,
title = {Post-COVID-19 illness trajectory: a multisystem investigation [Pre-print]},
author = {Berry, C. and Morrow, A. and Sykes, R. and McIntosh, A. and Kamdar, A. and Bagot, C. and Barrientos, P. and Bayes, H. and Blyth, K. and Briscoe, M. and Carrick, D. and Church, C. and Corcoran, D. and Findlay, I. and Gibson, V. and Gillespie, L. and Grieve, D. and Ho, A. and Lang, N. and Lowe, D. and Lennie, V. and Macfarlane, P. and Mayne, K. and Mark, P. and McConnachie, A. and McGeoch, R. and McGinley, C. and McKee, C. and Nordin, S. and Payne, A. and Rankin, A. and Ryan, N. and Roditi, G. and Stobo, D. and Sattar, N. and Allwood-Spiers, S. and Touyz, R. and Veldtman, G. and Weeden, S. and Watkins, S. and Welsh, P. and Wereski, R. and Mangion, K.},
month = {nov},
year = {2021},
abstract = {Background: The pathophysiology and trajectory of multiorgan involvement in post-COVID-19 syndrome is uncertain. Methods: A prospective, multicenter, longitudinal, cohort study involving post-COVID-19 patients enrolled in-hospital or early post-discharge (visit 1) and reevaluated 28-60 days post-discharge (visit 2). Multisystem investigations included chest computed tomography with pulmonary and coronary  angiography, cardiovascular and renal magnetic resonance imaging, digital electrocardiography, and multisystem biomarkers. The primary outcome was the adjudicated likelihood of myocarditis. Results: 161 patients (mean age 55 years, 43% female) and 27 controls with similar age, sex, ethnicity, and vascular risk factors were enrolled from 22 May 2020 to 2 July 2021 and had a primary outcome evaluation. Compared to controls, at 28-60 days post-discharge, patients with COVID-19 had persisting evidence of cardio-renal involvement, systemic inflammation, and hemostasis pathway activation. Myocarditis was adjudicated as being not likely (n=17; 10%), unlikely (n=56; 35%), probable (n=67; 42%) or very likely (n=21; 13%). Acute kidney injury (odds ratio, 95% confidence interval: 3.40 (1.13, 11.84); p=0.038) and low hemoglobin A1c (0.26 (0.07, 0.87); p=0.035) were multivariable associates of adjudicated myocarditis. During convalescence, compared to controls, COVID-19 was associated with worse health-related quality of life (EQ5D-5L) (p&lt;0.001), illness perception (p&lt;0.001), anxiety and depression (p&lt;0.001), physical activity (p&lt;0.001) and predicted maximal oxygen utilization (ml/kg/min) (p&lt;0.001). These measures were associated with adjudicated myocarditis. Conclusions: The illness trajectory of COVID-19 includes persisting cardio-renal inflammation, lung damage and hemostasis activation. Adjudicated myocarditis occurred in one in eight hospitalized patients and was associated with impairments in health status, physical and psychological wellbeing during community convalescence.},
journal = {University of Glasgow},
publisher = {Springer Nature},
url = {https://doi.org/10.21203/rs.3.rs-1053331/v1},
}
