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Morrow, Andrew J.; Sykes, Robert; McIntosh, Alasdair; Kamdar, Anna; Bagot, Catherine; Bayes, Hannah K.; Blyth, Kevin G.; Briscoe, Michael; Bulluck, Heerajnarain; Carrick, David; Church, Colin; Corcoran, David; Findlay, Iain; Gibson, Vivienne B.; Gillespie, Lynsey; Grieve, Douglas; Hall Barrientos, Pauline; Ho, Antonia; Lang, Ninian N.; Lennie, Vera; Lowe, David J.; Macfarlane, Peter W.; Mark, Patrick B.; Mayne, Kaitlin J.; [...]

A multisystem, cardio-renal investigation of post-COVID-19 illness

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  • Medientyp: E-Artikel
  • Titel: A multisystem, cardio-renal investigation of post-COVID-19 illness
  • Beteiligte: Morrow, Andrew J.; Sykes, Robert; McIntosh, Alasdair; Kamdar, Anna; Bagot, Catherine; Bayes, Hannah K.; Blyth, Kevin G.; Briscoe, Michael; Bulluck, Heerajnarain; Carrick, David; Church, Colin; Corcoran, David; Findlay, Iain; Gibson, Vivienne B.; Gillespie, Lynsey; Grieve, Douglas; Hall Barrientos, Pauline; Ho, Antonia; Lang, Ninian N.; Lennie, Vera; Lowe, David J.; Macfarlane, Peter W.; Mark, Patrick B.; Mayne, Kaitlin J.; [...]
  • Erschienen: Springer Science and Business Media LLC, 2022
  • Erschienen in: Nature Medicine
  • Sprache: Englisch
  • DOI: 10.1038/s41591-022-01837-9
  • ISSN: 1078-8956; 1546-170X
  • Entstehung:
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  • Beschreibung: <jats:sec><jats:title>Abstract</jats:title><jats:p>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<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT04403607">NCT04403607</jats:ext-link>). 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 (<jats:italic>n</jats:italic> = 29), at 28–60 days post-discharge, people with COVID-19 (<jats:italic>n</jats:italic> = 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<jats:italic>P</jats:italic> &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 (<jats:italic>P</jats:italic> = 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.</jats:p></jats:sec>