Many Recovering COVID Patients Show Signs of Long-Term Organ Damage
Long-term organ damage appears to be common in hospitalized COVID-19 patients after they've recovered and been discharged, British researchers report.
One U.S. expert who read over the report said she's seen the same in her practice.
"This study proves that the damage done is not just to the lungs, but can affect the heart, the brain and the kidneys, as well," said Dr. Mangala Narasimhan, who directs critical care services at Northwell Health in New Hyde Park, N.Y.
She said that "care should be taken to counsel patients as they are discharged to be aware of these other possible abnormalities that can occur."
The U.K. research team noted that -- along with causing serious respiratory problems -- COVID-19 appears to be able to affect other organs, including the heart, kidneys and liver. But the overall long-term pattern of organ damage in COVID-19 patients was still unclear, so researchers led by Amitava Banerjee of University College London decided to investigate.
The team assessed organ damage in more than 47,700 COVID-19 patients (average age 65) who were hospitalized in England and discharged before September of last year. Those clinical findings were compared to those from a matched "control group" taken from the general population.
The researchers tracked rates of hospital readmission among the COVID-19 patients and the control group, as well as death from any cause. They also tracked any new diagnoses of respiratory, cardiovascular, metabolic, kidney and liver diseases in both groups until the end of September 2020.
Over an average follow-up of 140 days, nearly one-third of COVID-19 patients were readmitted to the hospital, and more than one in 10 died after discharge, Banerjee's group found.
Overall, COVID-19 patients' rates of 766 readmissions and 320 deaths per 1,000 person-years were four and eight times greater, respectively, than those observed in the control group.
The researchers also found that COVID-19 patients' rates of new diagnoses of respiratory disease, cardiovascular disease and diabetes were 27, 3 and 1.5 times greater, respectively, than those observed in the control group.
Age seemed to matter: Differences in rates of organ damage between COVID-19 patients and the control group were greater among people younger than 70 versus for those aged 70 or older, the study found.
As to race, patients from ethnic minority groups were more at risk than white people, with the largest differences seen in respiratory disease.
Men and women seemed roughly similar in terms of rates of long-term organ damage after COVID-19, according to the report published March 31 in the BMJ.
All of the study findings suggest that hospitals and health care systems could have to cope with a substantial long-term burden of COVID-19-related illnesses, the researchers said in a journal news release.
The study authors believe research is urgently needed "to understand the risk factors for post-COVID syndrome, so that treatment can be targeted better to demographically and clinically at-risk populations."
For her part, Narasimhan said that "increased rates of organ damage is something we see commonly in hospitalized COVID patients. This most commonly includes kidney damage, cardiac and neurological issues."
She added that "there are many factors that contribute to these other organs being affected. Some of these factors are the increased rates of clots we see in COVID patients -- this then creates a lot of downstream issues. We also know that the heart is directly infiltrated by virus and this can cause a decrease in heart function. The same for the kidneys, which can cause kidney failure. All these complications can cause a patient to return to the hospital post-discharge."
The bottom line, according to Narasimhan: "COVID infections affect the entire body in many different ways."
The U.S. Centers for Disease Control and Prevention has more on the long-term effects of COVID-19.
SOURCES: Mangala Narasimhan, DO, director, critical care services, Northwell Health, New Hyde Park, N.Y.; BMJ, news release, March 31, 2021