In:
BMJ Open, BMJ, Vol. 11, No. 3 ( 2021-03), p. e048391-
Kurzfassung:
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 COVI D-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.
Materialart:
Online-Ressource
ISSN:
2044-6055
,
2044-6055
DOI:
10.1136/bmjopen-2020-048391
DOI:
10.1136/bmjopen-2020-048391.supp3
DOI:
10.1136/bmjopen-2020-048391.supp2
DOI:
10.1136/bmjopen-2020-048391.supp1
Sprache:
Englisch
Verlag:
BMJ
Publikationsdatum:
2021
ZDB Id:
2599832-8
