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

• Published in: European heart journal Vol. 43; no. 11; pp. 1124 - 1137
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 14.03.2022
• Subjects: Cohort Studies; COVID-19 - diagnosis; COVID-19 - epidemiology; Editor's Choice; Fast Track Clinical Research; Humans; SARS-CoV-2; Stroke Volume; Ventricular Function, Left; COVID-19; Sequelae; Matched controls; Multi-organ assessment
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehab914

Abstract 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. Graphical Abstract Graphical Abstract The key question is: How does a mild to moderate course of SARS-CoV-2 infection in mainly non-hospitalized individuals impact intermediate-term organ-specific functions in comparison to the general population? The key findings are (i) a mild to moderate course of SARS-CoV-2 infection is associated with subsequent signs of subclinical multi-organ affection; (ii) associations mainly affect the pulmonary, cardiac, coagulation, and renal system; and (iii) no systematic associations with structural brain damage, neurocognition, or quality of life were observed. The take-home message is systematic screening of multi-organ function even after mild to moderate SARS-CoV-2 infection is recommended to identify individuals at risk and initiate appropriate preventive therapies.