Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol

Sigfrid, Louise; Drake, Thomas M; Pauley, Ellen; Jesudason, Edwin C.; Olliaro, Piero; Lim, Wei Shen; Gillesen, Annelies; Berry, Colin; Lowe, David J.; McPeake, Joanne; Lone, Nazir; Munblit, Daniel; Çevik, Müge; Casey, A; Bannister, Peter; Russell, Clark D; Goodwin, Lynsey; Ho, Antonia; Turtle, Lance; O’Hara, Margaret; Hastie, Claire; Donohue, Chloe; Spencer, Rebecca G.; Donegan, Cara; Gummery, Alison; Harrison, Janet; Hardwick, Hayley; Hastie, Claire E.; Carson, Gail; Merson, Laura; Baillie, J Kenneth; Openshaw, Peter; Harrison, Ewen M; Docherty, Annemarie B; Semple, Malcolm G; Scott, Janet T.

doi:10.1016/j.lanepe.2021.100186

Cited by 239 publications

(307 citation statements)

References 28 publications

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“…In a cohort of 179 COVID-19 survivors, palpitations and dizziness were reported in 20% of cases after eight-month follow-up, while headache and concentration problems were reported by 40% of participants [23]. Palpitations were reported in 7% of cases two weeks after acute COVID-19 in Nigerian survivors [22], in 9% of cases from a Chinese cohort of 1733 patients followed-up at 6 months from disease onset [53], and in 23% of cases from a multi-center UK cohort [38]. In the latter study, fatigue was reported by 82% of respondents, shortness of breath by 54%, sleep disturbances by 46%, headache by 39%, and dizziness or lightheadedness by 36%.…”

Section: Covid-19 Infection and Dysautonomiamentioning

confidence: 99%

“…At five months from disease onset, among 1077 survivors in the PHOSP-COVID study, middle-aged females were more likely to experience long-haul symptoms [31,80]. In another study from the UK, it was shown that women aged below 50 years were 5 times less likely to be hospitalized for acute COVID-19, but had twice the risk of experiencing long term symptoms after seven months of follow-up [38]. According to a report from Nigeria, male subjects were at a lower risk of persistent symptoms following SARS-CoV-2 infection [22], whereas a study from Saudi Arabia did not confirm these findings [81].…”

Section: Is Pasc Gender-specific?mentioning

confidence: 99%

“…This is currently unknown, although results of ongoing prospective studies should provide some answers. Contemporary reports show the high prevalence of symptoms several months after disease onset [38]. When reviewing the literature that explores the long-term effects of previous coronavirus epidemics, such as SARS, an overall reduction in quality of life was noted up to 1 year after infection, with the most commonly persisting symptoms being fatigue and exercise limitation [14].…”

Section: How Long Will Symptoms Last?mentioning

confidence: 99%

“…The role of hormonal dysregulation has been proposed, but PASC can also be the result of autoimmunity [39], and, although less susceptible to infectious disease compared with men, women are more often prone to autoimmune diseases [39,76]. Male patients showed higher COVID-19-related mortality, while the female sex is overrepresented among symptomatic COVID-19 survivors [38]. Nevertheless, disease severity has not been shown to predict subsequent long COVID syndrome [27].…”

Section: Is Pasc Gender-specific?mentioning

confidence: 99%

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Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Bisaccia

Ricci

Recce

et al. 2021

JCDD

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Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID syndrome, is emerging as a major health issue in patients with previous SARS-CoV-2 infection. Symptoms commonly experienced by patients include fatigue, palpitations, chest pain, dyspnea, reduced exercise tolerance, and “brain fog”. Additionally, symptoms of orthostatic intolerance and syncope suggest the involvement of the autonomic nervous system. Signs of cardiovascular autonomic dysfunction appear to be common in PASC and are similar to those observed in postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. In this review, we report on the epidemiology of PASC, discuss current evidence and possible mechanisms underpinning the dysregulation of the autonomic nervous system, and suggest nonpharmacological and pharmacological interventions to treat and relieve symptoms of PASC-associated dysautonomia.

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Section: Covid-19 Infection and Dysautonomiamentioning

confidence: 99%

Section: Is Pasc Gender-specific?mentioning

confidence: 99%

Section: How Long Will Symptoms Last?mentioning

confidence: 99%

Section: Is Pasc Gender-specific?mentioning

confidence: 99%

See 2 more Smart Citations

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Bisaccia

Ricci

Recce

et al. 2021

JCDD

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“…Since COVID-19 has spread globally, and long COVID became a burgeoning health concern 10 , a growing number of studies has been focused on "long-term effects of COVID-19" [11][12][13][14][15][16][17][18] . However, to date only a few studies [19][20][21][22][23][24] really addressed long term (up to 12 months) sequelae for hospitalized patient populations, as well as temporal trends and longstanding health consequences for "long-haulers" with a whole patient pathway perspective in different populations, timepoints, settings and countries. The full range of long-term health consequences of COVID-19 in patients who were discharged from hospital is largely unclear 25 .…”

Section: Introductionmentioning

confidence: 99%

“Long COVID” follow-up pathway: results of longitudinal cohort study to investigate 6- and 12-month outcomes after hospitalization for SARS-CoV-2 infection

Rigoni¹,

Torri²,

Nollo³

et al. 2021

Preprint

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Long-term sequelae of symptomatic infection caused by SARS-CoV-2 are largely undiscovered. We performed a prospective cohort study on consecutively hospitalized Sars-CoV-2 patients (March-May 2020) for evaluating COVID-19 outcomes at 6 and 12 months. After hospital discharge, patients were addressed to two follow-up pathways based on respiratory support needed during hospitalization. Outcomes were assessed by telephone consultation or ambulatory visit. Among 471 patients, 81.6% received no respiratory support during hospitalization; 8.2% received non-invasive ventilation; 0.2% required invasive mechanical ventilation (IMV). 64 patients died during hospitalization, therefore 407 were enrolled for follow-up. At 6 months, among 355patients, the 27.0% had any symptoms, 19.4% dyspnea, 5.4% neurological symptoms. Fifty-two out of 104 had major damages in interstitial Computed Tomography images. IMV patients had higher probability to suffer of neurological symptoms (OR=4.12, p=0.01). At 12 months, among 344, the 24.4% suffered on any symptoms, 14.0% dyspnea, 10.0% neurological symptoms. Severe interstitial lesions were present in 37 out of 47 investigated patients. IMV patients in respect to no respiratory support, had higher probability of experiencing symptoms (OR=3.51, p<0.01), dyspnea (OR=3.08, p<0.01 ), neurological symptoms (OR= 11.50, p<0.01). COVID-19 patients showed prolonged sequelae up to 12 months, highlighting the need of follow-up pathways for post-COVID-19 syndrome.

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Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021

Hanson

Abbafati

Aerts

et al. 2022

JAMA

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492

324

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ImportanceSome individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).ObjectiveTo estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration.Design, Setting, and ParticipantsBayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022.ExposuresSymptomatic SARS-CoV-2 infection.Main Outcomes and MeasuresProportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age.ResultsA total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months.Conclusions and RelevanceThis study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

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Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol

Cited by 239 publications

References 28 publications

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

“Long COVID” follow-up pathway: results of longitudinal cohort study to investigate 6- and 12-month outcomes after hospitalization for SARS-CoV-2 infection

Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021

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