TY - JOUR
AU - Berry, Colin
AU - Morrow, Andrew J.
AU - Sykes, Robert
AU - McIntosh, Alasdair
AU - Kamdar, Anna
AU - Bagot, Catherine
AU - Barrientos, Pauline Hall
AU - Bayes, Hannah K.
AU - Blyth, Kevin G.
AU - Briscoe, Michael
AU - Carrick, David
AU - Church, Colin
AU - Corcoran, David
AU - Findlay, Iain
AU - Gibson, Vivienne B.
AU - Gillespie, Lynsey
AU - Grieve, Douglas
AU - Ho, Antonia
AU - Lang, Ninian N.
AU - Lowe, David
AU - Lennie, Vera
AU - Macfarlane, Peter W.
AU - Mayne, Kaitlin J.
AU - Mark, Patrick B.
AU - McConnachie, Alex
AU - McGeoch, Ross
AU - McGinley, Christopher
AU - McKee, Connor
AU - Nordin, Sabrina
AU - Payne, Alexander
AU - Rankin, Alastair J.
AU - Ryan, Nicola
AU - Roditi, Giles
AU - Stobo, David
AU - Sattar, Naveed
AU - Allwood-Spiers, Sarah
AU - Touyz, Rhian M.
AU - Veldtman, Gruschen
AU - Weeden, Sarah
AU - Watkins, Stuart
AU - Welsh, Paul
AU - Wereski, Ryan
AU - Mangion, Kenneth
PY - 2021
DA - November
TI - Post-COVID-19 illness trajectory: a multisystem investigation [Pre-print]
JO - University of Glasgow
DO - https://doi.org/10.21203/rs.3.rs-1053331/v1
AB - 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.
PB - Springer Nature
UR - https://eprints.gla.ac.uk/320057/
KW - Coronavirus (COVID-19)
ER