It wasn’t long ago that some people speculated that long COVID was on everyone’s minds — a psychosomatic illness.
Thankfully, that period of speculation is now behind. We have strong evidence that Long COVID is very real and can affect major organs in people who were previously hospitalized with the disease.
I am the principal investigator of an ongoing study called C-MORE, which looks at the long-term harm caused by COVID. Our latest findings, published in The Lancet Respiratory Medicine, show that nearly a third of people who were seriously ill with COVID had multiple organ abnormalities on MRI five months after being discharged from hospital.
It is based on a sample of 259 people who were hospitalized with COVID and 52 people in a control group who did not get COVID.
MRI scans revealed that people with long-term COVID were 14 times more likely to have lung abnormalities than people who never had the disease, three times more likely to have brain abnormalities and three times more likely to have kidney abnormalities. were twice as likely to have abnormalities.
The extent of MRI abnormalities was related to the severity of their Covid, their age and whether they had other diseases.
People with long COVID who had abnormalities involving more than two organs were four times more likely to report “severe” or “very severe” mental and physical impairment.
in the beginning
When COVID first emerged, doctors considered it a respiratory disease, with patients reporting severe cough, shortness of breath, and pneumonia-like symptoms.
But as our global understanding of the disease has evolved, so has our understanding of this complex disease.
Reports began to emerge that the virus was capable of affecting not only the lungs but also other organs such as the heart, kidneys, brain and blood vessels, leading to a widespread attack.
Studies also began to emerge identifying viral proteins in various organs, demonstrating the virus’ fondness for certain tissues that were not part of the lungs.
Originally, the main theory was that SARS-CoV-2 (the virus that causes COVID) was directly infecting cells in multiple organs. But, as the data accumulated, a more nuanced understanding emerged.
It was observed that in some patients, the immune system, in its defense against the virus, overreacted, resulting in what was called a “cytokine storm”. This hyperactive immune response was not always discriminatory, leading to unintended damage to organs under direct viral attack.
Further reports highlight the propensity of the virus to induce excessive clotting, mitochondrial disruption (mitochondria are the powerhouse of our cells) and reactivation of other viruses.
More importantly, even after surviving the initial infection, there was a growing number of patients reporting persistent disabling symptoms arising from multiple organs, also known as long COVID , a condition that now affects one in ten people.
So the story changed. COVID was not just a minor respiratory illness, but a multisystemic disease with the potential for long-term complications, challenging our assumptions about treating the disease.
Birth of Sea-Mor
To shed light on these questions, the C-MORE study was launched in the UK, focusing on the late effects of the virus in hospitalized patients.
Some studies conducted on long-term Covid have looked at damage to multiple organs in the same patient. And those that have done so have focused on patients who were not hospitalized with COVID. This makes our study unique. However, like any pioneering study, there are some limitations.
The latest results mentioned above are based on preliminary data (interim analysis from half of the study population). Full analysis is still awaited.
Pre-Covid MRI scans of the patients were not available, making it difficult to draw definitive conclusions about the relationship between Covid and organ changes. The control participants did not exactly match the patient population, but we adjusted our analyzes to account for any differences, ensuring that the findings were as accurate as possible.
MRI scans do not always explain symptoms experienced in individual organs. For example, even if an organ appears normal on an MRI, the patient may still exhibit associated symptoms. The only strong association identified was between lung abnormalities and chest tightness.
Still, the study was an important effort to better understand the long-term effects of COVID on multiple organ health. This reminds us to remain alert to the potential for long-term consequences of the disease and the importance of vaccination – especially in people at risk of severe infection.
Based on the results of our study, doctors and health services around the world can now refine follow-up care, focusing on the lung, brain, kidney and blood vessel health of patients recovering from severe COVID infection.
Betty Raman, Associate Professor of Cardiovascular Medicine, University of Oxford.
This article is republished from The Conversation under a Creative Commons license. Read the original article.