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

Andrew J Morrow1,2, Robert Sykes1,2, Alasdair McIntosh3

  • 1British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.

Nature Medicine
|May 23, 2022
PubMed

Insights

Post-COVID-19 syndrome involves persistent multisystem issues, including cardio-renal problems and impaired quality of life, impacting long-term health and healthcare demand. This study clarifies the trajectory of these long-term effects.

Area of Science:

  • Cardiology
  • Nephrology
  • Pulmonology
  • Infectious Diseases
  • Immunology

Background:

  • The long-term effects and multisystem involvement of post-Coronavirus Disease 2019 (COVID-19) syndrome remain incompletely understood.
  • Hospitalization for COVID-19 can lead to persistent health impairments, necessitating further investigation into its trajectory.

Purpose of the Study:

  • To investigate the multisystem involvement and clinical trajectory of patients following hospitalization for COVID-19.
  • To assess cardio-renal involvement, hemostasis activation, and health-related quality of life in the subacute phase post-COVID-19.

Main Methods:

  • A prospective cohort study (NCT04403607) involving patients hospitalized with COVID-19 and controls.
  • Serial data collection included blood biomarkers, digital ECG, patient-reported outcomes, and multisystem imaging (CT, MRI) at 28-60 days post-discharge.
  • Longer-term outcomes were tracked via electronic health records.

Main Results:

  • Patients (n=159) showed persisting cardio-renal involvement and hemostasis activation compared to controls (n=29) at 28-60 days post-discharge.
  • Myocarditis likelihood was 'very likely' or 'probable' in 54% of patients.
  • COVID-19 patients reported worse quality of life, higher anxiety/depression, and reduced aerobic capacity (P < 0.01).

Conclusions:

  • Hospitalization for COVID-19 is associated with persistent multisystem abnormalities and significant health impairments.
  • These findings suggest a substantial future demand on healthcare services due to the long-term consequences of COVID-19.
  • The study highlights the complex and prolonged nature of post-COVID-19 syndrome.

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