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COVID-19 postacute care major organ damage: a systematic review.
Greer, Nancy; Bart, Bradley; Billington, Charles J; Diem, Susan J; Ensrud, Kristine E; Kaka, Anjum; Klein, Mark; Melzer, Anne C; Reule, Scott; Shaukat, Aasma; Sheets, Kerry; Starks, Jamie; Vardeny, Orly; McKenzie, Lauren; Stroebel, Benjamin; Macdonald, Roderick; Sowerby, Katie; Duan-Porter, Wei; Wilt, Timothy J.
  • Greer N; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA nancy.greer@va.gov.
  • Bart B; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Billington CJ; Division of Cardiology, Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Diem SJ; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Ensrud KE; Section of Endocrinology and Metabolism, Department of Medicine,Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Kaka A; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Klein M; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Melzer AC; General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Reule S; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
  • Shaukat A; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Sheets K; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Starks J; General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Vardeny O; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
  • McKenzie L; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Stroebel B; Section of Infectious Diseases, Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Macdonald R; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Sowerby K; Hematology/Oncology Section, Minneapolis VA Health Care System, Minneapolis, MN, USA.
  • Duan-Porter W; Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Wilt TJ; Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA.
BMJ Open ; 12(8): e061245, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-2001845
ABSTRACT

BACKGROUND:

Major organ complications have been reported in patients hospitalised for COVID-19; most studies lacked controls.

OBJECTIVE:

Examine major organ damage postdischarge among adults hospitalised for COVID-19 versus non-COVID-19 controls. DATA SOURCES MEDLINE, Embase and Cochrane Library from 1 January 2020 to 19 May 2021. STUDY ELIGIBILITY CRITERIA English language studies of adults discharged from hospital for COVID-19; reporting major organ damage. Single review of abstracts; independent dual review of full text. STUDY APPRAISAL AND SYNTHESIS

METHODS:

Study quality was assessed using the Joanna Briggs Institute Appraisal Checklist for Cohort Studies. Outcome data were not pooled due to heterogeneity in populations, study designs and outcome assessment methods; findings are narratively synthesised.

RESULTS:

Of 124 studies in a full evidence report, 9 included non-COVID controls and are described here. Four of the nine (three USA, one UK) used large administrative databases. Four of the remaining five studies enrolled <600 COVID-19 patients. Mean or median age ranged from 49 to 70 years with 46%-94% male and 48%-78% White race; 10%-40% had been in intensive care units. Follow-up ranged from 4 weeks to 22 weeks postdischarge. Four used hospitalised controls, three non-hospitalised controls and two were unclear. Studies used various definitions of, and methods to assess, major organ damage outcomes. While the magnitude of effect differed across studies, incident cardiac, pulmonary, liver, acute and chronic kidney, stroke, diabetes, and coagulation disorders were consistently greater in adults hospitalised for COVID-19 compared with non-COVID-19 controls.

LIMITATIONS:

Applicability to subgroups (age, gender, COVID-19 severity, treatment, vaccination status) and non-hospitalised patients is unknown. CONCLUSIONS AND IMPLICATIONS OF KEY

FINDINGS:

Postacute COVID-19 major organ damage is common and likely higher than controls. However, there is substantial uncertainty. More consistent reporting of clinical outcomes and pre-COVID health status along with careful selection of control groups are needed to address evidence gaps. PROSPERO REGISTRATION NUMBER CRD42020204788.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-061245

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-061245