Increased Rates Of Organ Damage Among COVID-19 Patients After Hospital Discharge

Patients hospitalized with a SARS-CoV-2 infection appear to have higher rates of organ damage in the months following discharge compared to patients hospitalized for other reasons, a new study finds.

An analysis of data from 47,780 COVID-19 patients and 47,780 matched controls discharged from hospitals in Britain, published in The BMJ, revealed that over an average of 140 days post discharge, those with COVID-19 were 3.0 times more likely to be diagnosed with a major cardiovascular event, 2.8 times more likely to be diagnosed with chronic liver disease, 1.9 times more likely to be diagnosed with chronic kidney disease and 1.5 times more likely to be diagnosed with diabetes.

COVID-19 patients also had a high risk of mortality (one in eight) and hospital readmission (three in 10).

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"These data add to the argument that there are acute and chronic effects of the pandemic which mean that 'living with the virus' has to involve infection suppression strategies and policies if we are to avoid continuing morbidity and mortality at this unprecedented scale around the world," said study coauthor Amitava Banerjee, an associate professor in clinical data science and an honorary consultant cardiologist at the Institute of Health Informatics at University College London and an adjunct associate professor in public health at the Amrita Institute of Medical Sciences in Kochi, India.

"The term 'long COVID' was coined in May 2020 to capture persistent symptoms post-recovery from acute SARS-CoV-2, yet the clinical, research and policy responses have been much slower for the long-term effects which threaten individuals, health systems and economies for months and possibly years to come," Banerjee said in an email. "In the case of the UK, lack of early and stringent lockdown, lack of functioning test and trace infrastructure and lack of border control have had effects far beyond the huge burden of excess deaths."

To explore the long term impact of SARS-CoV-2 patients sick enough to be hospitalized, Banerjee and her colleagues used the Hospital Episode Statistics Admitted Patient Care records for England up to August 31, 2020 and the General Practice Extraction Service Data for Pandemic Planning and Research up to September 30, 2020.

At baseline, individuals with COVID-19 had a mean age of 64.5 and 54.9% were men. Compared with the general population, individuals hospitalized with COVID-19 were more likely to be: male, aged 50 or more, living in a deprived area, a former smoker and overweight or obese. They were also more likely to have comorbidities (such as hypertension, major adverse cardiovascular event, respiratory disease and diabetes) than the general population, with a higher prevalence of previous admission to hospital and of all measured pre-existing conditions.

The new study is "very interesting," said Dr. Alba Azola, an assistant professor in the department of physical medicine and rehabilitation at Johns Hopkins Medicine. "I appreciated the way they found matching controls. It's something we're really in need of. Their findings are putting data to observations we have had in our group."

While the researchers focused on patients with severe COVID-19, there are also patients who had milder cases of the disease who are plagued by lingering symptoms, Dr. Azola said. "That's definitely another subgroup that needs to be studied carefully. They may present a little differently from this group."

—Linda Carroll

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