A multisystem, cardio-renal investigation of post-COVID-19 illness.
Journal
Nature medicine
ISSN: 1546-170X
Titre abrégé: Nat Med
Pays: United States
ID NLM: 9502015
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
05
11
2021
accepted:
25
04
2022
pubmed:
24
5
2022
medline:
22
6
2022
entrez:
23
5
2022
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 35606551
doi: 10.1038/s41591-022-01837-9
pii: 10.1038/s41591-022-01837-9
pmc: PMC9205780
doi:
Banques de données
ClinicalTrials.gov
['NCT04403607']
Types de publication
Clinical Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1303-1313Subventions
Organisme : Medical Research Council
ID : MC_PC_19026
Pays : United Kingdom
Organisme : Chief Scientist Office
ID : 311300
Pays : United Kingdom
Organisme : British Heart Foundation
ID : RE/18/6134217
Pays : United Kingdom
Investigateurs
Neil Basu
(N)
Ammani Brown
(A)
Elaine Butler
(E)
Stephen J H Dobbin
(SJH)
Andrew Dougherty
(A)
Laura Dymock
(L)
Kirsty Fallon
(K)
Lesley Gilmour
(L)
Tracey Hopkins
(T)
Jennifer S Lees
(JS)
Iain B McInnes
(IB)
Evonne McLennan
(E)
Fiona Savage
(F)
Stefan Siebert
(S)
Nicola Tynan
(N)
Rosemary Woodward
(R)
Informations de copyright
© 2022. The Author(s).
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