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


Dennis, Andrea, Wamil, Malgorzata, Alberts, Johann, Oben, Jude, Cuthbertson, Daniel J ORCID: 0000-0002-6128-0822, Wootton, Dan ORCID: 0000-0002-5903-3881, Crooks, Michael, Gabbay, Mark ORCID: 0000-0002-0126-8485, Brady, Michael, Hishmeh, Lyth et al (show 5 more authors) (2021) Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study BMJ Open, 11 (3). e048391-. ISSN 2044-6055, 2044-6055

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Abstract

Objective To assess medium-term organ impairment in symptomatic individuals following recovery from acute SARS-CoV-2 infection. Design Baseline findings from a prospective, observational cohort study. Setting Community-based individuals from two UK centres between 1 April and 14 September 2020. Participants Individuals ≥18 years with persistent symptoms following recovery from acute SARS-CoV-2 infection and age-matched healthy controls. Intervention Assessment of symptoms by standardised questionnaires (EQ-5D-5L, Dyspnoea-12) and organ-specific metrics by biochemical assessment and quantitative MRI. Main outcome measures Severe 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. Results 201 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). Conclusions In 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 number NCT04369807; Pre-results.

Item Type: Article
Uncontrolled Keywords: COVID-19, epidemiology, health policy, public health
Divisions: Faculty of Health & Life Sciences
Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences
Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences
Faculty of Health & Life Sciences > Inst. Population Health
Depositing User: Symplectic Admin
Date Deposited: 07 Jun 2021 09:12
Last Modified: 23 Jan 2026 14:05
DOI: 10.1136/bmjopen-2020-048391
Open Access URL: https://bmjopen.bmj.com/content/11/3/e048391
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3125413
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