Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Raman, Betty; Cassar, Mark Philip; Tunnicliffe, Elizabeth M.; Filippini, Nicola; Griffanti, Ludovica; Alfaro-Almagro, Fidel; Okell, Thomas W.; Sheerin, Fintan; Xie, Cheng; Mahmod, Masliza; Mózes, Ferenc; Lewandowski, Adam J.; Ohuma, Eric O; Holdsworth, David; Lamlum, Hanan; Woodman, Myles; Krasopoulos, Catherine; Mills, Rebecca; Fak., McConnell; Wang, Chaoyue; Arthofer, Christoph; Lange, Frederik; Andersson, Jesper; Jenkinson, Mark; Antoniades, Charalambos; Channon, Keith M.; Shanmuganathan, Mayooran; Ferreira, Vanessa M.; Piechnik, Stefan K.; Klenerman, Paul; Brightling, Christopher E.; Talbot, Nick P.; Petousi, Nayia; Rahman, Najib M.; Ho, LP; Saunders, Kate; Geddes, John; Harrison, Paul J.; Pattinson, Kyle T.S.; Rowland, Matthew; Angus, Brian; Gleeson, Fergus; Pavlides, Michael; Koychev, Ivan; Miller, Karla L.; Mackay, Clare E.; Jezzard, Peter; Smith, Stephen M.; Neubauer, Stefan

doi:10.1016/j.eclinm.2020.100683

Cited by 461 publications

(598 citation statements)

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“…reported lower rates, with only 26% with abnormal T1 and 11.5% with an inflammatory LGE pattern. 6 While the proportion is much lower than in the study by Puntmann et al ., 10 it should be kept in mind that an incidence of 11.5% could still have significant consequences on a societal level, given the large number of hospitalized patients with symptomatic COVID-19.…”

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confidence: 54%

“…Myocardial oedema, as defined by increased myocardial T2 signal, has been described in up to 60% of older patients with CMR evidence of myocardial involvement in COVID-19 ( Graphical Abstract ). 6 , 10 The frequency of increased T2 in previously healthy, young competitive athletes with mild or no symptoms was lower at 15% (4/26) in one report. 11 In acutely ill COVID-19 patients, cardiac MRI is not commonly performed because haemodynamic instability and respiratory distress make imaging infeasible.…”

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confidence: 82%

“…In a recent study, 64% of patients 2–3 months after COVID-19 reported dyspnoea and fatigue, an incidence much higher than after other viral diseases. 6 The reasons for ‘long COVID’ are not well understood, but are associated with signs of ongoing inflammation as well as tissue abnormalities of the lungs, heart, and kidneys as identified by magnetic resonance imaging (MRI). 7 …”

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confidence: 99%

“…Their results apparently contrast with the higher rates reported by Puntmann et al ., where the proportion of patients with abnormalities was 73% with increased T1, 60% with increased T2, and 32% with LGE, despite 18% of these patients being initially asymptomatic ( Table 1 ). 6 , 10–13 Raman et al . reported lower rates, with only 26% with abnormal T1 and 11.5% with an inflammatory LGE pattern.…”

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confidence: 99%

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What we (don’t) know about myocardial injury after COVID-19

Friedrich

Cooper

2021

European Heart Journal

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confidence: 54%

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confidence: 82%

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confidence: 99%

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confidence: 99%

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What we (don’t) know about myocardial injury after COVID-19

Friedrich

Cooper

2021

European Heart Journal

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“…Furthermore, included samples were tested three months after hospital discharge, whereas participants in our study had around three weeks of detraining and roughly three weeks of re-training. However, in a study by Raman et al, [20] VO 2max and ventilatory efficiency on CPET and six-minute walk distance (405 ± 118 m vs. 517 ± 106 m in controls, p < 0.0001) were significantly reduced in COVID-19 survivors 2 to 3 months after the infection ended. Moreover, the degree of extra-pulmonary magnetic resonance imaging-detected abnormalities and exercise tolerance correlated with serum markers of ongoing inflammation and severity of acute illness.…”

Section: Discussionmentioning

confidence: 82%

Cardiorespiratory Fitness in Volleyball Athletes Following a COVID-19 Infection: A Cross-Sectional Study

Milovančev

Avakumovic

Lakičević

et al. 2021

IJERPH

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Athletes’ lifestyles have been dramatically affected by the coronavirus disease 2019 (COVID-19) pandemic. Since COVID-19 primarily affects the respiratory system and to a lesser degree the cardiovascular system, the goal of this study was to examine the effects of COVID-19-caused detraining on cardiorespiratory fitness (CRF) of recently recovered volleyball athletes. Sixteen experienced volleyball athletes (age 24 ± 4.5 years) who were recently diagnosed and recovered from a COVID-19 infection volunteered to participate in this study and were tested for CRF and spirometry. Given that participants had only mild symptoms of infection, the primary focus of this study was on the effects of detraining on CRF. On average, the time to exhaustion was 9.4 ± 1.4 min. VE, VCO2, RER and oxygen pulse increased, heart rate exceeded 90% of predicted values, and peak VO2 values were typical for this level of athlete (44.1 ± 3.4 mL/kg). Pulmonary function reflected in FVC, FEV1/FVC and MVV values were well above 80% of predicted values for each of the participants while electrocardiography revealed no ischemia, arrythmias or conduction and repolarization abnormalities were found in the tested subjects. Conclusions: participants experienced typical consequences of detraining. Due to a lack of CRF data prior to COVID-19 infection, we were unable to estimate the magnitude detraining had on CRF. Complete CRF assessment after COVID-19 infection in athletes can be useful for screening of residual myocardial and/or respiratory system damage for safe return-to-play decisions.

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Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19

2021

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Key Points Question What are the frequency and variety of persistent symptoms after COVID-19 infection? Findings In this systematic review of 45 studies including 9751 participants with COVID-19, the median proportion of individuals who experienced at least 1 persistent symptom was 73%; symptoms occurring most frequently included shortness of breath or dyspnea, fatigue or exhaustion, and sleep disorders or insomnia. However, the studies were highly heterogeneous and needed longer follow-up and more standardized designs. Meaning This systematic review found that COVID-19 symptoms commonly persisted beyond the acute phase of infection, with implications for health-associated functioning and quality of life; however, methodological improvements are needed to reliably quantify these risks.

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Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Cited by 461 publications

References 50 publications

What we (don’t) know about myocardial injury after COVID-19

What we (don’t) know about myocardial injury after COVID-19

Cardiorespiratory Fitness in Volleyball Athletes Following a COVID-19 Infection: A Cross-Sectional Study

Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19

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