tetano
Editor, Senior Moderator
Nat Med
. 2022 May 23.
doi: 10.1038/s41591-022-01837-9. Online ahead of print.
A multisystem, cardio-renal investigation of post-COVID-19 illness
Andrew J Morrow[SUP] #[/SUP][SUP] 1 2 [/SUP], Robert Sykes[SUP] #[/SUP][SUP] 1 2 [/SUP], Alasdair McIntosh[SUP] 3 [/SUP], Anna Kamdar[SUP] 1 [/SUP], Catherine Bagot[SUP] 4 [/SUP], Hannah K Bayes[SUP] 5 [/SUP], Kevin G Blyth[SUP] 6 7 [/SUP], Michael Briscoe[SUP] 2 [/SUP], Heerajnarain Bulluck[SUP] 8 [/SUP], David Carrick[SUP] 9 [/SUP], Colin Church[SUP] 6 10 [/SUP], David Corcoran[SUP] 1 2 [/SUP], Iain Findlay[SUP] 11 [/SUP], Vivienne B Gibson[SUP] 4 [/SUP], Lynsey Gillespie[SUP] 12 [/SUP], Douglas Grieve[SUP] 13 [/SUP], Pauline Hall Barrientos[SUP] 14 [/SUP], Antonia Ho[SUP] 15 [/SUP], Ninian N Lang[SUP] 1 2 [/SUP], Vera Lennie[SUP] 16 [/SUP], David J Lowe[SUP] 17 [/SUP], Peter W Macfarlane[SUP] 18 [/SUP], Patrick B Mark[SUP] 1 19 [/SUP], Kaitlin J Mayne[SUP] 1 19 [/SUP], Alex McConnachie[SUP] 3 [/SUP], Ross McGeoch[SUP] 9 [/SUP], Christopher McGinley[SUP] 2 [/SUP], Connor McKee[SUP] 2 [/SUP], Sabrina Nordin[SUP] 2 [/SUP], Alexander Payne[SUP] 20 [/SUP], Alastair J Rankin[SUP] 1 [/SUP], Keith E Robertson[SUP] 10 [/SUP], Giles Roditi[SUP] 21 [/SUP], Nicola Ryan[SUP] 16 [/SUP], Naveed Sattar[SUP] 1 [/SUP], Sarah Allwood-Spiers[SUP] 5 [/SUP], David Stobo[SUP] 21 [/SUP], Rhian M Touyz[SUP] 1 [/SUP], Gruschen Veldtman[SUP] 22 [/SUP], Stuart Watkins[SUP] 10 [/SUP], Sarah Weeden[SUP] 3 [/SUP], Robin A Weir[SUP] 9 [/SUP], Paul Welsh[SUP] 1 [/SUP], Ryan Wereski[SUP] 17 23 [/SUP], CISCO-19 Consortium; Kenneth Mangion[SUP] 1 2 [/SUP], Colin Berry[SUP] 24 25 26 [/SUP]
Collaborators, Affiliations
Abstract
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 < 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.
. 2022 May 23.
doi: 10.1038/s41591-022-01837-9. Online ahead of print.
A multisystem, cardio-renal investigation of post-COVID-19 illness
Andrew J Morrow[SUP] #[/SUP][SUP] 1 2 [/SUP], Robert Sykes[SUP] #[/SUP][SUP] 1 2 [/SUP], Alasdair McIntosh[SUP] 3 [/SUP], Anna Kamdar[SUP] 1 [/SUP], Catherine Bagot[SUP] 4 [/SUP], Hannah K Bayes[SUP] 5 [/SUP], Kevin G Blyth[SUP] 6 7 [/SUP], Michael Briscoe[SUP] 2 [/SUP], Heerajnarain Bulluck[SUP] 8 [/SUP], David Carrick[SUP] 9 [/SUP], Colin Church[SUP] 6 10 [/SUP], David Corcoran[SUP] 1 2 [/SUP], Iain Findlay[SUP] 11 [/SUP], Vivienne B Gibson[SUP] 4 [/SUP], Lynsey Gillespie[SUP] 12 [/SUP], Douglas Grieve[SUP] 13 [/SUP], Pauline Hall Barrientos[SUP] 14 [/SUP], Antonia Ho[SUP] 15 [/SUP], Ninian N Lang[SUP] 1 2 [/SUP], Vera Lennie[SUP] 16 [/SUP], David J Lowe[SUP] 17 [/SUP], Peter W Macfarlane[SUP] 18 [/SUP], Patrick B Mark[SUP] 1 19 [/SUP], Kaitlin J Mayne[SUP] 1 19 [/SUP], Alex McConnachie[SUP] 3 [/SUP], Ross McGeoch[SUP] 9 [/SUP], Christopher McGinley[SUP] 2 [/SUP], Connor McKee[SUP] 2 [/SUP], Sabrina Nordin[SUP] 2 [/SUP], Alexander Payne[SUP] 20 [/SUP], Alastair J Rankin[SUP] 1 [/SUP], Keith E Robertson[SUP] 10 [/SUP], Giles Roditi[SUP] 21 [/SUP], Nicola Ryan[SUP] 16 [/SUP], Naveed Sattar[SUP] 1 [/SUP], Sarah Allwood-Spiers[SUP] 5 [/SUP], David Stobo[SUP] 21 [/SUP], Rhian M Touyz[SUP] 1 [/SUP], Gruschen Veldtman[SUP] 22 [/SUP], Stuart Watkins[SUP] 10 [/SUP], Sarah Weeden[SUP] 3 [/SUP], Robin A Weir[SUP] 9 [/SUP], Paul Welsh[SUP] 1 [/SUP], Ryan Wereski[SUP] 17 23 [/SUP], CISCO-19 Consortium; Kenneth Mangion[SUP] 1 2 [/SUP], Colin Berry[SUP] 24 25 26 [/SUP]
Collaborators, Affiliations
- PMID: 35606551
- DOI: 10.1038/s41591-022-01837-9
Abstract
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 < 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.
