In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 6 ( 2022-6-10), p. e0267392-
Abstract:
There have been more than 425 million COVID-19 infections worldwide. Post-COVID illness has become a common, disabling complication of this infection. Therefore, it presents a significant challenge to global public health and economic activity. Methods Comprehensive clinical assessment (symptoms, WHO performance status, cognitive testing, CPET, lung function, high-resolution CT chest, CT pulmonary angiogram and cardiac MRI) of previously well, working-age adults in full-time employment was conducted to identify physical and neurocognitive deficits in those with severe or prolonged COVID-19 illness. Results 205 consecutive patients, age 39 (IQR30.0–46.7) years, 84% male, were assessed 24 (IQR17.1–34.0) weeks after acute illness. 69% reported ≥3 ongoing symptoms. Shortness of breath (61%), fatigue (54%) and cognitive problems (47%) were the most frequent symptoms, 17% met criteria for anxiety and 24% depression. 67% remained below pre-COVID performance status at 24 weeks. One third of lung function tests were abnormal, (reduced lung volume and transfer factor, and obstructive spirometry). HRCT lung was clinically indicated in 〈 50% of patients, with COVID-associated pathology found in 25% of these. In all but three HRCTs, changes were graded ‘mild’. There was an extremely low incidence of pulmonary thromboembolic disease or significant cardiac pathology. A specific, focal cognitive deficit was identified in those with ongoing symptoms of fatigue, poor concentration, poor memory, low mood, and anxiety. This was notably more common in patients managed in the community during their acute illness. Conclusion Despite low rates of residual cardiopulmonary pathology, in this cohort, with low rates of premorbid illness, there is a high burden of symptoms and failure to regain pre-COVID performance 6-months after acute illness. Cognitive assessment identified a specific deficit of the same magnitude as intoxication at the UK drink driving limit or the deterioration expected with 10 years ageing, which appears to contribute significantly to the symptomatology of long-COVID.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0267392
DOI:
10.1371/journal.pone.0267392.g001
DOI:
10.1371/journal.pone.0267392.g002
DOI:
10.1371/journal.pone.0267392.g003
DOI:
10.1371/journal.pone.0267392.t001
DOI:
10.1371/journal.pone.0267392.t002
DOI:
10.1371/journal.pone.0267392.t003
DOI:
10.1371/journal.pone.0267392.t004
DOI:
10.1371/journal.pone.0267392.t005
DOI:
10.1371/journal.pone.0267392.t006
DOI:
10.1371/journal.pone.0267392.s001
DOI:
10.1371/journal.pone.0267392.s002
DOI:
10.1371/journal.pone.0267392.s003
DOI:
10.1371/journal.pone.0267392.s004
DOI:
10.1371/journal.pone.0267392.s005
DOI:
10.1371/journal.pone.0267392.s006
DOI:
10.1371/journal.pone.0267392.s007
DOI:
10.1371/journal.pone.0267392.r001
DOI:
10.1371/journal.pone.0267392.r002
DOI:
10.1371/journal.pone.0267392.r003
DOI:
10.1371/journal.pone.0267392.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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