Portal de Periódicos da CAPES

A multisystem, cardio-renal investigation of post-COVID-19 illness

2022; Nature Portfolio; Volume: 28; Issue: 6 Linguagem: Inglês

10.1038/s41591-022-01837-9

1546-170X

Andrew Morrow, Robert Sykes, Alasdair McIntosh, Anna Kamdar, Catherine Bagot, Hannah Bayes, Kevin G. Blyth, Michael Briscoe, Heerajnarain Bulluck, David Carrick, Colin Church, David Corcoran, Iain Findlay, Vivienne B. Gibson, Lynsey Gillespie, Douglas Grieve, Pauline Hall Barrientos, Antonia Ho, Ninian N. Lang, Vera Lennie, David J. Lowe, Peter W. Macfarlane, Patrick B. Mark, Kaitlin J. Mayne, Alex McConnachie, Ross McGeoch, Christopher McGinley, Connor McKee, Sabrina Nordin, Alexander R. Payne, Alastair J. Rankin, Keith Robertson, Giles Roditi, Nicola Ryan, Naveed Sattar, Sarah Allwood‐Spiers, David Stobo, Rhian M. Touyz, Gruschen Veldtman, Stuart Watkins, Sarah Weeden, Robin A.P. Weir, Paul Welsh, Ryan Wereski, Neil Basu, Ammani Brown, Elaine Butler, Stephen J. H. Dobbin, Andrew Dougherty, Laura Dymock, Kirsty Fallon, L Gilmour, Tracey Hopkins, Jennifer S. Lees, Iain B. McInnes, Evonne McLennan, Fiona Savage, Stefan Siebert, Nicola Tynan, Rosemary Woodward, Kenneth Mangion, Colin Berry,

Dialysis and Renal Disease Management

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.