Multi-organ assessment in mainly non-hospitalized individuals after SARS-CoV-2 infection: The Hamburg City Health Study COVID programme.
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Petersen Elina Larissa, Goßling Alina, Adam Gerhard, Aepfelbacher Martin, Behrendt Christian-Alexander, Cavus Ersin, Cheng Bastian, Fischer Nicole, Gallinat Jürgen, Kühn Simone, Gerloff Christian, Koch-Gromus Uwe, Härter Martin, Hanning Uta, Huber Tobias B, Kluge Stefan, Knobloch Johannes K, Kuta Piotr, Schmidt-Lauber Christian, Lütgehetmann Marc, Magnussen Christina, Mayer Carola, Muellerleile Kai, Münch Julia, Nägele Felix Leonard, Petersen Marvin, Renné Thomas, Riedl Katharina Alina, Rimmele David Leander, Schäfer Ines, Schulz Holger, Tahir Enver, Waschki Benjamin, Wenzel Jan-Per, Zeller Tanja, Ziegler Andreas, Thomalla Götz, Twerenbold Raphael, Blankenberg Stefan
Аннотация
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.