Perspectum, Oxford, OX4 2LL, UK.
Institute of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, L7 8TX, UK.
J R Soc Med. 2023 Mar;116(3):97-112. doi: 10.1177/01410768231154703. Epub 2023 Feb 14.
To determine the prevalence of organ impairment in long COVID patients at 6 and 12 months after initial symptoms and to explore links to clinical presentation.
Prospective cohort study.
Individuals.
In individuals recovered from acute COVID-19, we assessed symptoms, health status, and multi-organ tissue characterisation and function.
Two non-acute healthcare settings (Oxford and London). Physiological and biochemical investigations were performed at baseline on all individuals, and those with organ impairment were reassessed.
Primary outcome was prevalence of single- and multi-organ impairment at 6 and 12 months post COVID-19.
A total of 536 individuals (mean age 45 years, 73% female, 89% white, 32% healthcare workers, 13% acute COVID-19 hospitalisation) completed 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 number of symptoms 10 and 3, at 6 and 12 months, respectively). Extreme breathlessness (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 at 6 and 12 months, and associated with female gender, younger age and single-organ impairment. Single- and multi-organ impairment were present in 69% and 23% at baseline, persisting in 59% and 27% at follow-up, respectively.
Organ impairment persisted in 59% of 331 individuals followed up at 1 year post COVID-19, with implications for symptoms, quality of life and longer-term health, signalling the need for prevention and integrated care of long COVID.Trial Registration: ClinicalTrials.gov Identifier: NCT04369807.
确定 COVID-19 后 6 个月和 12 个月时长新冠患者的器官损伤发生率，并探讨其与临床表现的关系。
前瞻性队列研究。
个体。
在急性 COVID-19 康复的个体中，我们评估了症状、健康状况以及多器官组织特征和功能。
两个非急性医疗保健机构（牛津和伦敦）。所有个体在基线时进行生理和生化检查，对有器官损伤的个体进行重新评估。
主要结局是 COVID-19 后 6 个月和 12 个月时单器官和多器官损伤的发生率。
共 536 名个体（平均年龄 45 岁，73%为女性，89%为白人，32%为医护人员，13%为急性 COVID-19 住院患者）完成了基线评估（中位数：COVID-19 后 6 个月）；331 名（62%）有器官损伤或偶然发现的个体进行了随访，其症状负担从基线开始减轻（中位数症状数量分别为 10 个和 3 个，分别在 6 个月和 12 个月时）。极度呼吸困难（38%和 30%）、认知功能障碍（48%和 38%）和健康相关生活质量较差（EQ-5D-5L<0.7；57%和 45%）在 6 个月和 12 个月时很常见，且与女性、年龄较小和单器官损伤有关。基线时单器官和多器官损伤分别为 69%和 23%，随访时分别为 59%和 27%。
COVID-19 后 1 年随访时，331 名中有 59%的个体仍存在器官损伤，这对症状、生活质量和长期健康有影响，表明需要预防和综合管理长新冠。
ClinicalTrials.gov 标识符：NCT04369807。
