Journal
EUROPEAN HEART JOURNAL
Volume 43, Issue 11, Pages 1124-1137Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehab914
Keywords
COVID-19; Sequelae; Matched controls; Multi-organ assessment
Categories
Funding
- Senat und Behorde fur Wissenschaft, Forschung, Gleichstellung und Bezirke (BWFGB) [E43026-03.HCHS]
- Deutsche Forschungsgemeinschaft [TH1106/5-1, AA93/2-1]
- euCanSHare grant agreement [825903-euCanSHare H2020]
- Foundation Leducq [16 CVD 03]
- Innovative medicine initiative [116074]
- Deutsche Gesetzliche Unfallversicherung (DGUV)
- Deutsches Krebsforschungszentrum (DKFZ)
- Deutsches Zentrum fur Herz-Kreislauf-Forschung (DZHK)
- Deutsche Stiftung fur Herzforschung
- Seefried Stiftung
- Amgen
- Bayer
- Novartis
- Schiller
- Siemens
- Topcon
- Unilever
- Forderverein zur Forderung der HCHS e.V.
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This study comprehensively assessed organ-specific functions in individuals after mild to moderate SARS-CoV-2 infection and found subclinical multi-organ affection related to pulmonary, cardiac, thrombotic, and renal function. However, there were no signs of structural brain damage, neurocognitive impairment, or quality-of-life impairment.
Aims Long-term sequelae may occur after SARS-CoV-2 infection. We comprehensively assessed organ-specific functions in individuals after mild to moderate SARS-CoV-2 infection compared with controls from the general population. Methods and results Four hundred and forty-three mainly non-hospitalized individuals were examined in median 9.6 months after the first positive SARS-CoV-2 test and matched for age, sex, and education with 1328 controls from a population-based German cohort. We assessed pulmonary, cardiac, vascular, renal, and neurological status, as well as patient-related outcomes. Bodyplethysmography documented mildly lower total lung volume (regression coefficient -3.24, adjusted P = 0.014) and higher specific airway resistance (regression coefficient 8.11, adjusted P = 0.001) after SARS-CoV-2 infection. Cardiac assessment revealed slightly lower measures of left (regression coefficient for left ventricular ejection fraction on transthoracic echocardiography -0.93, adjusted P= 0.015) and right ventricular function and higher concentrations of cardiac biomarkers (factor 1.14 for high-sensitivity troponin, 1.41 for N-terminal pro-B-type natriuretic peptide, adjusted P <= 0.01) in post-SARS-CoV-2 patients compared with matched controls, but no significant differences in cardiac magnetic resonance imaging findings. Sonographically non-compressible femoral veins, suggesting deep vein thrombosis, were substantially more frequent after SARS-CoV-2 infection (odds ratio 2.68, adjusted P <0.001). Glomerular filtration rate (regression coefficient -2.35, adjusted P = 0.019) was lower in post-SARS-CoV-2 cases. Relative brain volume, prevalence of cerebral microbleeds, and infarct residuals were similar, while the mean cortical thickness was higher in post-SARS-CoV-2 cases. Cognitive function was not impaired. Similarly, patient-related outcomes did not differ. Conclusion Subjects who apparently recovered from mild to moderate SARS-CoV-2 infection show signs of subclinical multi- organ affection related to pulmonary, cardiac, thrombotic, and renal function without signs of structural brain damage, neurocognitive, or quality-of-life impairment. Respective screening may guide further patient management. [GRAPHICS] .
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