Exclusive: study of low-risk individuals finds impairments four months after infection. Young and previously healthy people with ongoing symptoms of Covid-19 are showing signs of damage to multiple organs four months after the initial infection, a study suggests.
Sun 15 Nov 2020 14.14
Source: The Guardian
Reprinted for educational purposes and social benefit, not for profit.
The findings are a step towards unpicking the physical underpinnings and developing treatments for some of the strange and extensive symptoms experienced by people with “long Covid”, which is thought to affect more than 60,000 people in the UK. Fatigue, brain fog, breathlessness and pain are among the most frequently reported effects.
On Sunday, the NHS announced it would launch a network of more than 40 long Covid specialist clinics where doctors, nurses and therapists will assess patients’ physical and psychological symptoms.
The Coverscan study aims to assess the long-term impact of Covid-19 on organ health in around 500 “low-risk” individuals – those who are relatively young and without any major underlying health complaints – with ongoing Covid symptoms, through a combination of MRI scans, blood tests, physical measurements and online questionnaires.
Preliminary data from the first 200 patients to undergo screening suggests that almost 70% have impairments in one or more organs, including the heart, lungs, liver and pancreas, four months after their initial illness.
“The good news is that the impairment is mild, but even with a conservative lens, there is some impairment, and in 25% of people it affects two or more organs,” said Amitava Banerjee, a cardiologist and associate professor of clinical data science at University College London.
“This is of interest because we need to know if [the impairments] continue or improve – or if there is a subgroup of people who could get worse.”
In some, but not all, cases there was a correlation between people’s symptoms and the site of the organ impairment. For instance, heart or lung impairments correlated with breathlessness, while liver or pancreas impairments were associated with gastrointestinal symptoms.
“It supports the idea that there is an insult at organ level, and potentially multi-organ level, which is detectable, and which could help to explain at least some of the symptoms and the trajectory of the disease,” said Banerjee.
However, the study doesn’t prove that organ impairments are the cause of people’s ongoing symptoms, and the data haven’t yet been peer-reviewed.
Banerjee also cautioned that none of the patients were scanned before developing Covid-19, so some of them may have had existing impairments – although this is unlikely given their previous good health and relative youth. The average age of participants was 44.
They will continue to be monitored, and the researchers are also scanning people who haven’t had Covid-19 or have experienced other viral infections such as flu, for comparison.
Preliminary data from a separate study of 58 patients who were hospitalised with Covid-19 similarly found abnormalities in the lungs of 60%; in the kidneys of 29%; in the hearts of 26%; and in the livers of 10% of patients, two to three months after the initial infection, as well as tissue changes in parts of the brain.
“What all the people in the world with long Covid are crying out for is to be taken seriously and to have some idea of what might be going on at the organ level – so to begin to assemble some kind of evidence base is absolutely the way to go,” said Danny Altmann, a professor of immunology at Imperial College London.
“I think this is a first step in a long journey towards providing some kind of mechanism [for their symptoms], and eventually some therapeutics for people with long Covid.”
The new findings could also have implications for the management of people with long Covid, suggesting the need for closer collaboration between medical specialists. “Sending the people you need to the cardiologist, and then to the gastroenterologist, and then to the neurologist would be an inefficient way to deal with things as the pandemic continues,” Banerjee said.