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.