TY - JOUR
AU - Morrow, Andrew J.
AU - Sykes, Robert
AU - McIntosh, Alastair
AU - Kamdar, Anna
AU - Bagot, Catherine
AU - Bayes, Hannah K.
AU - Blyth, Kevin G.
AU - Briscoe, Michael
AU - Bulluck, Heeraj
AU - Carrick, David
AU - Church, Colin
AU - Corcoran, David
AU - Findlay, Iain
AU - Gibson, Vivienne B.
AU - Gillespie, Lynsey
AU - Grieve, Douglas
AU - Hall Barrientos, Pauline
AU - Ho, Antonia
AU - Lang, Ninian N.
AU - Lennie, Vera
AU - Lowe, David J.
AU - Macfarlane, Peter W.
AU - Mark, Patrick B.
AU - Mayne, Kaitlin J.
AU - McConnachie, Alex
AU - McGeoch, Ross
AU - McGinley, Christopher
AU - McKee, Connor
AU - Nordin, Sabrina
AU - Payne, Alexander
AU - Rankin, Alastair J.
AU - Robertson, Keith E.
AU - Roditi, Giles
AU - Ryan, Nicola
AU - Sattar, Naveed
AU - Allwood-Spiers, Sarah
AU - Stobo, David
AU - Touyz, Rhian M.
AU - Veldtman, Gruschen
AU - Watkins, Stuart
AU - Weeden, Sarah
AU - Weir, Robin A.
AU - Welsh, Paul
AU - Wereski, Ryan
AU - Mangion, Kenneth
AU - Berry, Colin
PY - 2022
DA - May
TI - A multisystem, cardio-renal investigation of post-COVID-19 illness
JO - Nature Medicine
DO - http://dx.doi.org/10.1038/s41591-022-01837-9
AB - The pathophysiology and trajectory of post-Coronavirus Disease 2019 (COVID-19) syndrome is uncertain. To clarify multisystem involvement, we undertook a prospective cohort study including patients who had been hospitalized with COVID-19 (ClinicalTrials.gov ID NCT04403607). Serial blood biomarkers, digital electrocardiography and patient-reported outcome measures were obtained in-hospital and at 28–60 days post-discharge when multisystem imaging using chest computed tomography with pulmonary and coronary angiography and cardio-renal magnetic resonance imaging was also obtained. Longer-term clinical outcomes were assessed using electronic health records. Compared to controls (n = 29), at 28–60 days post-discharge, people with COVID-19 (n = 159; mean age, 55 years; 43% female) had persisting evidence of cardio-renal involvement and hemostasis pathway activation. The adjudicated likelihood of myocarditis was ‘very likely’ in 21 (13%) patients, ‘probable’ in 65 (41%) patients, ‘unlikely’ in 56 (35%) patients and ‘not present’ in 17 (11%) patients. At 28–60 days post-discharge, COVID-19 was associated with worse health-related quality of life (EQ-5D-5L score 0.77 (0.23) versus 0.87 (0.20)), anxiety and depression (PHQ-4 total score 3.59 (3.71) versus 1.28 (2.67)) and aerobic exercise capacity reflected by predicted maximal oxygen utilization (20.0 (7.6) versus 29.5 (8.0) ml/kg/min) (all P &lt; 0.01). During follow-up (mean, 450 days), 24 (15%) patients and two (7%) controls died or were rehospitalized, and 108 (68%) patients and seven (26%) controls received outpatient secondary care (P = 0.017). The illness trajectory of patients after hospitalization with COVID-19 includes persisting multisystem abnormalities and health impairments that could lead to substantial demand on healthcare services in the future.
PB - Springer Nature
UR - http://eprints.gla.ac.uk/270434/
KW - Coronavirus (COVID-19)
ER