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245 0 0 _aMedium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge /
_cBetty Raman [forty nine others]
520 3 _aBackground: The medium-term effects of Coronavirus disease (COVID-19) on organ health, exercise capacity, cognition, quality of life and mental health are poorly understood. Methods: Fifty-eight COVID-19 patients post-hospital discharge and 30 age, sex, body mass index comorbidity-matched controls were enrolled for multiorgan (brain, lungs, heart, liver and kidneys) magnetic resonance imaging (MRI), spirometry, six-minute walk test, cardiopulmonary exercise test (CPET), quality of life, cognitive and mental health assessments. Findings: At 2-3 months from disease-onset, 64% of patients experienced breathlessness and 55% reported fatigue. On MRI, abnormalities were seen in lungs (60%), heart (26%), liver (10%) and kidneys (29%). Patients exhibited changes in the thalamus, posterior thalamic radiations and sagittal stratum on brain MRI and demonstrated impaired cognitive performance, specifically in the executive and visuospatial domains. Exercise tolerance (maximal oxygen consumption and ventilatory efficiency on CPET) and six-minute walk distance were significantly reduced. The extent of extra-pulmonary MRI abnormalities and exercise intolerance correlated with serum markers of inflammation and acute illness severity. Patients had a higher burden of self-reported symptoms of depression and experienced significant impairment in all domains of quality of life compared to controls (p<0.0001 to 0.044). Interpretation: A significant proportion of patients discharged from hospital reported symptoms of breathlessness, fatigue, depression and had limited exercise capacity. Persistent lung and extra-pulmonary organ MRI findings are common in patients and linked to inflammation and severity of acute illness.
580 _aEClinicalMedicine, 2021 Jan 7;31:100683. doi: 10.1016/j.eclinm.2020.100683
650 2 _aCOVID-19
650 2 _aCoronavirus
650 2 _aMagnetic Resonance Imaging
650 2 _aMental Health
650 2 _aSurvivors
653 _aMultiorgan Effects
700 1 _aRaman, Betty
700 1 _aCassar, Mark Philip
700 1 _aTunnicliffe, Elizabeth M.
700 1 _aFilippini, Nicola
700 1 _aGriffanti, Ludovica
700 1 _aAlfaro-Almagro, Fidel
700 1 _aOkell, Thomas
700 1 _aSheerin, Fintan
700 1 _aXie, Cheng
700 1 _aMahmod, Masliza
700 1 _aMoze, Ferenc E.
700 1 _aLewandowski, Adam J.
700 1 _aOhuma, Eric O.
700 1 _aHoldsworth, David
700 1 _aLamlum, Hanan
700 1 _aWoodman, Myles J.
700 1 _aKrasopoulos, Catherine
700 1 _aMills, Rebecca
700 1 _aMcConnell, Flora A. Kennedy
700 1 _aWang, Chaoyue
700 1 _aArthofer, Christoph
700 1 _aLange, Frederik J.
700 1 _aAndersson, Jesper
700 1 _aJenkinson, Mark
700 1 _aAntoniades, Charalambos
700 1 _aChannon, Keith M.
700 1 _aShanmuganathan, Mayooran
700 1 _aFerreira, Vanessa M.
700 1 _aPiechnik, Stefan K.
700 1 _aKlenerman, Paul
700 1 _aBrightling, Christopher
700 1 _aTalbot, Nick P.
700 1 _aPetousik, Nayia
700 1 _aRahman, Najib M.
700 1 _aHom, Ling-Pei
700 1 _aSaunders, Kate
700 1 _aGeddes, John R.
700 1 _aHarrison, Paul J.
700 1 _aPattinsono, Kyle
700 1 _aRowlando, Matthew J.
700 1 _aAngus, Brian J.
700 1 _aGleeson, Fergus
700 1 _aPavlides, Michael
700 1 _aKoychev, Ivan
700 1 _aMillerd, Karla L.
700 1 _aMackay, Clare
700 1 _aJezzar, Peter
700 1 _aSmith, Stephen M.
700 1 _aNeubauer, Stefan
856 _uhttps://www.thelancet.com/action/showPdf?pii=S2589-5370%2820%2930427-2
942 _cCV
999 _c3787
_d3787