Organ Damage Persists in Long COVID Patients

Multi-Organ Impairment and Long COVID: A 1-Year Prospective Longitudinal Cohort Study

Goals

To determine the prevalence of organ impairment in long COVID patients at 6 and 12 months after initial symptoms and explore links with clinical presentation.

Design

Prospective cohort study.

Methods

In individuals recovered from acute COVID-19, we evaluated symptoms, health status, and multi-organ tissue characterization and function.

Setting

Two non-acute healthcare settings (Oxford and London). Physiological and biochemical investigations were performed at baseline in all individuals, and those with organ damage were reevaluated.

The main measures

The primary outcome was the prevalence of single-organ and multi-organ impairment at 6 and 12 months post-COVID-19.

Results

A total of 536 people (median age 45 years, 73% women, 89% white, 32% healthcare workers, 13% acute hospitalization for COVID-19) completed the 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 symptoms 10 and 3, at 6 and 12 months, respectively).

Extreme dyspnea (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 to the 6 and 12 months, and associated with female sex, younger age, and single organ impairment.

Single-organ and multi-organ impairment was present in 69% and 23% at baseline, and persisted in 59% and 27% at follow-up, respectively.

Conclusions

Organ impairment persisted in 59% of 331 people followed 1 year after COVID-19, with implications for symptoms, quality of life, and longer-term health, indicating the need for prevention and integrated long COVID care.

Trial registration: ClinicalTrials.gov Identifier: NCT04369807

Comments

Comprehensive new study of organ deterioration in patients with long COVID over 12 months shows that organ damage persisted in 59% of patients a year after initial symptoms, even in those who were not severely affected when diagnosed the virus for the first time.

Comprehensive new study of organ deterioration in patients with long COVID over 12 months shows that organ damage persisted in 59% of patients a year after initial symptoms, even in those who were not severely affected when diagnosed the virus for the first time.

The study, published in the Journal of the Royal Society of Medicine , focused on patients who reported extreme dyspnea, cognitive dysfunction, and poor health-related quality of life. 536 patients with long COVID were included in the study. 13% were hospitalized when first diagnosed with COVID-19. 32% of the people who participated in the study were health workers.

Of the 536 patients, 331 (62%) were identified with organ impairment six months after their initial diagnosis. These patients were followed six months later with a 40-minute multi-organ MRI ( Perspectum’s CoverScan ), analyzed in Oxford.

The findings confirmed that 29% of long COVID patients had multiorgan impairment, with persistent symptoms and reduced function at six and twelve months. 59% of long COVID patients had single organ impairment 12 months after initial diagnosis.

A member of the research group, Professor Amitava Banerjee, professor of clinical data science at the UCL Institute of Health Informatics, said: "Symptoms were common at six and twelve months and were associated with female sex. , younger age, and single-organ deterioration."

The study reported a reduction in symptoms over six to 12 months (extreme dyspnea in 38% to 30% of patients, cognitive dysfunction in 48% to 38% of patients, and poor health-related quality of life in 57% to 45% of patients).

Professor Banerjee added: “Several studies confirm the persistence of symptoms in people with long COVID of up to a year. Now we add that three in five people with long COVID have deficiency in at least one organ, and one in four has deficiency in two or more organs, in some cases without symptoms.”

He said: “The impact on quality of life and time away from work, particularly on healthcare workers, is a major concern for individuals, healthcare systems and economies. "Many healthcare workers in our study had no prior illnesses, but of 172 of those participants, 19 remained symptomatic at follow-up and not working for a median of 180 days."

The underlying mechanisms of long COVID remain elusive, say researchers, who found no evidence from symptoms, blood tests or MRI to clearly define long COVID subtypes. They say future research should consider associations between symptoms, multiple organ impairment, and function in larger cohorts.

Professor Banerjee concluded: "Organ deterioration in long COVID has implications for symptoms, quality of life and longer-term health, indicating the need for prevention and integrated care for patients with long COVID." .