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-.
Abstract
<h4>Objective</h4>To assess medium-term organ impairment in symptomatic individuals following recovery from acute SARS-CoV-2 infection.<h4>Design</h4>Baseline findings from a prospective, observational cohort study.<h4>Setting</h4>Community-based individuals from two UK centres between 1 April and 14 September 2020.<h4>Participants</h4>Individuals ≥18 years with persistent symptoms following recovery from acute SARS-CoV-2 infection and age-matched healthy controls.<h4>Intervention</h4>Assessment of symptoms by standardised questionnaires (EQ-5D-5L, Dyspnoea-12) and organ-specific metrics by biochemical assessment and quantitative MRI.<h4>Main outcome measures</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.<h4>Trial registration number</h4>NCT04369807; Pre-results.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COVID-19, epidemiology, health policy, public health |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 07 Jun 2021 09:12 |
| Last Modified: | 18 Jan 2023 22:36 |
| DOI: | 10.1136/bmjopen-2020-048391 |
| Open Access URL: | https://bmjopen.bmj.com/content/11/3/e048391 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3125413 |
Dimensions
Dimensions
