Multi-organ impairment and long COVID: a 1-year prospective, longitudinal cohort study. (March 2023)

• Record Type: Journal Article
• Authors: Dennis, Andrea; Cuthbertson, Daniel J; Wootton, Dan; Crooks, Michael; Gabbay, Mark; Eichert, Nicole; Mouchti, Sofia; Pansini, Michele; Roca-Fernandez, Adriana; Thomaides-Brears, Helena; Kelly, Matt; Robson, Matthew; Hishmeh, Lyth; Attree, Emily; Heightman, Melissa; Banerjee, Rajarshi; Banerjee, Amitava
• Is Part Of: Journal of the Royal Society of Medicine. Volume 116:Number 3(2023)
• Page Start: 97
• Page End: 112
• Publication Date: 2023-03
• Subjects: COVID-19 -- long COVID -- organ impairment -- quality of life -- prevention -- integrated care; Medicine -- Periodicals; Medicine -- Great Britain -- Periodicals; Periodicals; 610.5
• DOI: 10.1177/01410768231154703
• Languages: English
• ISSNs: 0410-0768

Abstract

Objectives: To determine the prevalence of organ impairment in long COVID patients at 6 and 12 months after initial symptoms and to explore links to clinical presentation. Design: Prospective cohort study. Participants: Individuals. Methods: In individuals recovered from acute COVID-19, we assessed symptoms, health status, and multi-organ tissue characterisation and function. Setting: Two non-acute healthcare settings (Oxford and London). Physiological and biochemical investigations were performed at baseline on all individuals, and those with organ impairment were reassessed. Main outcome measures: Primary outcome was prevalence of single- and multi-organ impairment at 6 and 12 months post COVID-19. Results: A total of 536 individuals (mean age 45 years, 73% female, 89% white, 32% healthcare workers, 13% acute COVID-19 hospitalisation) completed baseline assessment (median: 6 months post COVID-19); 331 (62%) with organ impairment or incidental findings had follow-up, with reduced symptom burden from baseline (median number of symptoms 10 and 3, at 6 and 12 months, respectively). Extreme breathlessness (38% and 30%), cognitive dysfunction (48% and 38%) and poor health-related quality of life (EQ-5D-5L < 0.7; 57% and 45%) were common at 6 and 12 months, and associated with female gender, younger age and single-organ impairment. Single- and multi-organ impairment were present in 69% and 23% at baseline, persisting in 59% and 27% at follow-up, respectively. Conclusions: Organ impairment persisted in 59% of 331 individuals followed up at 1 year post COVID-19, with implications for symptoms, quality of life and longer-term health, signalling the need for prevention and integrated care of long COVID. Trial Registration: ClinicalTrials.gov Identifier: NCT04369807