Hospitalized COVID-19 Patients Face Triple Risk of Multi-Organ Damage, Study Reveals

In a recent study published in Lancet Respiratory MedicineResearchers evaluated the burden and determinants of multiorgan abnormalities after hospitalization due to moderate to severe cases of coronavirus disease 2019 (COVID-19) and their associations with disease outcomes.

Study: Multi-Organ MRI Findings Following Hospitalization with COVID-19 in the UK (C-MORE): A Prospective, Multicentre, Observational Cohort Study. Image Credit: Terelyuk/Shutterstock

Background

A large body of evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections cause long-term multiorgan complications, and possible causes include viral cytotoxicity, ischemic injury, chronic inflammation, metabolic disorders, and the impact of treatment. methods such as invasive ventilation. This multitude of persistent symptoms, such as chronic fatigue, dyspnea, post-exertional malaise, and gastrointestinal and neurological complications, are now called post-acute sequelae of COVID-19 (PASC) or long COVID.

However, while many studies have explored the potential mechanisms of long COVID, the burden of multi-organ impairments that persist after hospitalization due to COVID-19 and its impact on patient outcomes and recovery are not yet known. clear. In this sense, magnetic resonance imaging (MRI) is an excellent tool to evaluate organic manifestations that occur after moderate to severe SARS-CoV-2 infections, and previous studies reported an association between inflammatory markers and abnormal tissue findings, as well as Alterations in the hemostatic pathways.

About the study

In the present study, researchers conducted multicenter, multiorgan MRI follow-up across the United Kingdom of patients who had been hospitalized with COVID-19. This study, called Capturing Multiorgan Effects of COVID-19 or C-MORE, was designed to characterize and evaluate the prevalence of multiorgan deficiencies in patients who had recovered from COVID-19 compared to people who had never been infected with SARS-CoV. . 2.

C-MORE also aimed to decipher potential mechanisms of COVID-19-related multi-organ dysfunction and examine whether these multi-organ abnormalities were associated with patient-reported outcomes. This prospective observational study enrolled hospitalized patients with SARS-CoV-2 infections confirmed by polymerase chain reaction (PCR) or clinically diagnosed between March 2020 and November 2021.

As part of follow-up, clinical evaluations were performed, including pulmonary function tests and blood samples. MRIs were obtained of the heart, lungs, brain, kidneys, and liver. People over 18 years of age, without contraindications on MRI, who had not been hospitalized in the last year and who were asymptomatic due to recent or previous COVID-19 with negative nucleocapsid antibody and PCR tests, were invited to act as checks at the hospital. study.

Clinical and demographic characteristics, comorbidities, clinical progression scale specified by the World Health Organization, and area of ​​residence were recorded for all participants. People with contraindications to MRI, such as metallic or other implants, including pacemakers or defibrillators, and claustrophobia, were excluded from the study.

Blood and lung function tests were also performed on all participants, measuring forced expiratory volume, forced vital capacity, and, in some cases, lung carbon monoxide transfer factor to assess lung function. Outcome measures related to anxiety, cognitive function, dyspnea, and fatigue were assessed using several questionnaires.

Results

The findings suggested that hospitalization for COVID-19 increased the medium-term risk of multi-organ abnormalities. MRI results reported a higher incidence of multi-organ abnormalities in post-hospitalized COVID-19 patients compared to healthy controls, with more frequent findings of lung, brain, and kidney abnormalities among COVID-19 patients. However, the frequencies of liver and heart abnormalities on MRI scans were similar for patients and controls. Hemostatic or vascular and inflammatory injury patterns were also observed in some organs on MRI.

Furthermore, the presence of multi-organ abnormalities was found to be age-related: people who were slightly older, with more than three comorbidities, and who had experienced a more severe form of SARS-CoV-2 infection had a higher incidence of abnormalities. multi-organ. .

Evaluation of patient-reported outcome measures also indicated that abnormal MRI findings in the lungs were associated with double the risk of chest tightness, and multi-organ abnormalities on MRI were associated with deteriorations in severe and persistent physical and mental health after hospitalization with COVID-19. 19.

Conclusions

Overall, the findings reported that multi-organ abnormalities on MRI were three times more prevalent among patients who had been hospitalized with COVID-19 compared to healthy, uninfected people. MRI revealed patterns of hemostatic and inflammatory injury in some organs, and multiorgan abnormalities were associated with persistent and severe mental and physical disabilities. These results highlight the need for multidisciplinary therapeutic and management strategies for post-hospitalized patients with COVID-19.