4.7 Article

Multi-organ assessment in mainly non-hospitalized individuals after SARS-CoV-2 infection: The Hamburg City Health Study COVID programme

Journal

EUROPEAN HEART JOURNAL
Volume 43, Issue 11, Pages 1124-1137

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehab914

Keywords

COVID-19; Sequelae; Matched controls; Multi-organ assessment

Funding

  1. Senat und Behorde fur Wissenschaft, Forschung, Gleichstellung und Bezirke (BWFGB) [E43026-03.HCHS]
  2. Deutsche Forschungsgemeinschaft [TH1106/5-1, AA93/2-1]
  3. euCanSHare grant agreement [825903-euCanSHare H2020]
  4. Foundation Leducq [16 CVD 03]
  5. Innovative medicine initiative [116074]
  6. Deutsche Gesetzliche Unfallversicherung (DGUV)
  7. Deutsches Krebsforschungszentrum (DKFZ)
  8. Deutsches Zentrum fur Herz-Kreislauf-Forschung (DZHK)
  9. Deutsche Stiftung fur Herzforschung
  10. Seefried Stiftung
  11. Amgen
  12. Bayer
  13. Novartis
  14. Schiller
  15. Siemens
  16. Topcon
  17. Unilever
  18. 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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