Multi-organ impairment and long COVID: a 1-year prospective longitudinal cohort study

The study titled “Multi-organ impairment and long COVID: a 1-year prospective longitudinal cohort study” conducted by Andrea Dennis et al. provides significant insights into the prevalence and persistence of organ impairment in long COVID patients.

Here’s a detailed summary:

Objectives and Design:

  • The study aimed to determine the prevalence of organ impairment in long COVID patients at 6 and 12 months post-infection and explore its relationship with clinical presentation.
  • This was a prospective cohort study involving individuals who had recovered from acute COVID-19 and were experiencing ongoing symptoms​​.


  • Long COVID, characterized by persistent symptoms following acute COVID-19, has been documented, but its natural history, especially in terms of organ impairment and function, remains poorly understood.
  • Previous findings indicated a need for systematic investigation of long COVID symptoms and associated organ impairments, as well as the development of effective treatments​​.

Study Population and Methods:

  • Participants included individuals with evidence of COVID-19 who had ongoing symptoms beyond 12 weeks post-infection.
  • The study took place before the formal definition of long COVID and included patients recruited from two non-acute healthcare settings in the UK.
  • Diagnostic assessments were conducted using quantitative multi-organ MRI, along with blood tests and online questionnaires​​.

Symptoms and Function Assessment:

  • The assessment focused on common symptoms, health-related quality of life (HRQoL), and breathlessness.
  • At baseline, all participants were symptomatic, with the most common symptoms being fatigue, breathlessness, and cognitive dysfunction.
  • Symptom prevalence reduced over time, but some, like fatigue and cognitive dysfunction, remained high​​.

Health-Related Quality of Life:

  • HRQoL was poor at baseline in the whole cohort, with difficulties in completing usual activities and experiencing pain.
  • Despite some improvement, a significant proportion of participants still reported poor HRQoL and severe breathlessness at the 1-year follow-up​​.

Organ Impairment Findings:

  • At baseline, 59% of participants had impairment in one organ, and 23% had multi-organ impairment.
  • Most standard-of-care biochemical investigations were within normal ranges, except for certain elevated parameters.
  • Single-organ impairment improved slightly but remained high, and multi-organ impairment did not improve significantly over the year.
  • Liver steatosis, kidney fibro-inflammation, and splenomegaly were more frequent among participants with certain symptom groups​​.

Associations between Symptoms and Organ Impairment:

  • Neither abnormal biochemical investigations nor organ impairment were predictive of full symptom resolution at follow-up.
  • Specific liver-related parameters, such as high liver fat and volume, were associated with certain symptom burdens, including severe breathlessness and lower HRQoL​​.


  • Organ impairment persisted in 59% of individuals followed up at 1 year post COVID-19.
  • These findings underscore the need for prevention and integrated care for long COVID, highlighting its implications for symptoms, quality of life, and longer-term health​​.

The study emphasizes the complexity of long COVID, particularly in terms of multi-organ impairment and its impact on health and quality of life, advocating for comprehensive care strategies for affected individuals.

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