Not all patients can breathe a sigh of relief after leaving the hospital after treating a moderate to severe case of COVID-19 disease.
More than half of the COVID-19 patients surveyed in a new study at Oxford University had tissue abnormalities in their organs and impaired mental and physical health two to three months after their initial infection.
The researchers looked at 58 patients enrolled at the National Health Service Foundation Trust at Oxford University for COVID-19 treatment between March 14 and May 25. Most of these patients had comorbidities at the time of their hospitalization that may have played a role in their recovery.
At admission, 93% of 58 patients had an abnormal chest x-ray or CT scan; At the time of the study, two to three months later, 60% had “persistent parenchymal abnormalities” on a lung MRI. 64 percent had significant shortness of breath and 55 percent complained of fatigue.
31% of the liver damage had acute liver damage during admission. Two to three months later, blood tests showed that 11% had persistent liver damage, while another 10% showed signs of liver damage.
To determine if symptoms were related to COVID-19, participants were compared to a group of 30 controls that were not infected with the SARS-CoV-2 virus that causes the disease. The control group had the same sex and age, and similar risk factors such as smoking, diabetes, and high blood pressure.
ladyGed tissue remain
While COVID-19 is primarily thought of as a respiratory infection, researchers investigated the possibility that it could damage the tissues of multiple organs. Magnetic resonance imaging (MRI) revealed changes in tissue properties in individual organs. “On MRI, tissue signal abnormalities were seen in the lungs (60%), heart (26%), liver (10%), and kidneys (29%) of the patients,” the researchers said.
The researchers hypothesized that the immune system’s strong inflammatory response to the infection may have contributed to the tissue damage. The extent of tissue change and a person’s ability to exercise was dependent on the level of inflammation, as measured by the presence of antibodies in blood tests, the Oxford study explained.
The fact that none of the controls showed tissue abnormalities in multiple organs, including the brain, added weight to this theory.
“These results underscore the need to further study the physiological processes associated with COVID-19 and develop a holistic, integrated model of clinical care for our patients after they are discharged from hospital,” said study author Betty Raman, MBBS, DPhil. a practicing physician in the Radcliffe Department of Medicine at Oxford, as reported by Reuters.
Mental and physical strength decreased
The infection can also affect the brain. Brain MRIs from former COVID-19 patients showed tissue changes that may have affected their cognitive reasoning skills. Regardless of the severity of the case, 35% reported anxiety and 39% reported depression. “COVID-19 survivors suffer from high levels of depression, anxiety, and decreased quality of life after hospital discharge,” the paper said.
To test physical endurance, both COVID-19 patients and controls rode a stationary bike at a speed that gradually increased over two minutes. Most of the participants were unable to complete this task, which indicates that their lungs and hearts were not functioning well. Participants also found it difficult to walk down a corridor for six minutes without stopping.
This is not the first time the coronavirus has been investigated for spreading to other organs. Researchers at Columbia University’s Irving Medical Center in New York City indicated that while COVID-19 begins as a respiratory infection, it can manifest itself in other organs as well. According to a study published in July by Nature Medicine, SARS-CoV-2 infection can develop in the kidney, gastrointestinal, endocrine, dermatological, and neurological systems.
In another July study based in Rome, almost 13% of 143 recovered patients who were examined 60 days after the onset of the disease experienced “fatigue (53.1%), shortness of breath (43.4%), joint pain (27, 3%) and chest pain (21.7%), ”reads a research letter published on JAMA Network. Italian researchers stressed that further research is needed and “continuous post-discharge monitoring for lasting effects is needed”.
Cons of the study
Several limitations of the Oxford study were identified in a preprint version published on October 18 in medRxiv, an archive of research pending approval from other scientists.
One caveat was the lack of peer review by colleagues, a process that all medical articles go through to determine the accuracy of the results.
Second, the small sample size, all from a single medical center, could have prevented researchers from making accurate estimates. In addition, prior to COVID-19, the researchers had no information about the health status of the participants.
“The lack of pre-COVID imaging also limits our ability to draw causal inferences about the mechanism of multi-organ abnormalities in patients recovering from COVID-19 infection,” the preprint said.
Seema Prasad is a freelance health reporter based in Bengaluru, India. She tweeted @SeemaPrasad_me