The Lancet Regional Health. Europe (Sep 2021)
Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol
- Louise Sigfrid,
- Thomas M. Drake,
- Ellen Pauley,
- Edwin C. Jesudason,
- Piero Olliaro,
- Wei Shen Lim,
- Annelies Gillesen,
- Colin Berry,
- David J. Lowe,
- Joanne McPeake,
- Nazir Lone,
- Daniel Munblit,
- Muge Cevik,
- Anna Casey,
- Peter Bannister,
- Clark D. Russell,
- Lynsey Goodwin,
- Antonia Ho,
- Lance Turtle,
- Margaret E. O'Hara,
- Claire Hastie,
- Chloe Donohue,
- Rebecca G. Spencer,
- Cara Donegan,
- Alison Gummery,
- Janet Harrison,
- Hayley E. Hardwick,
- Claire E. Hastie,
- Gail Carson,
- Laura Merson,
- J. Kenneth Baillie,
- Peter Openshaw,
- Ewen M. Harrison,
- Annemarie B. Docherty,
- Malcolm G. Semple,
- Janet T. Scott
Affiliations
- Louise Sigfrid
- Clinical Research Fellow, Public Health Specialist, ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Thomas M. Drake
- Clinical Research Fellow, Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
- Ellen Pauley
- Medical Student, University of Edinburgh Medical School, Edinburgh, UK
- Edwin C. Jesudason
- Consultant in Rehabilitation Medicine, NHS Lothian, Edinburgh, UK
- Piero Olliaro
- Professor of Poverty Related Infectious Diseases, ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Wei Shen Lim
- Honorary Professor of Respiratory Medicine, Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust and University of Nottingham, UK
- Annelies Gillesen
- Senior Clinical Trial Nurse, ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Colin Berry
- Professor of Cardiology and Imaging, Institute of Cardiovascular and Medical Sciences, University of Glasgow
- David J. Lowe
- Consultant in Emergency Medicine, NHS Greater Glasgow and Clyde, Emergency Department, Glasgow, UK
- Joanne McPeake
- Nurse Consultant in Clinical Research, School of Medicine, Dentistry and Nursing, University of Glasgow, UK
- Nazir Lone
- Senior Clinical Lecturer in Critical Care, Usher Institute, University of Edinburgh, Edinburgh, UK
- Daniel Munblit
- Professor of Paediatrics, Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Clinical Senior Lecturer, Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
- Muge Cevik
- Clinical Lecturer, Division of Infection and Global Health Research, University of St Andrews
- Anna Casey
- Medical Student, Brighton and Sussex Medical School, Brighton, UK
- Peter Bannister
- Medical Student, Brighton and Sussex Medical School, Brighton, UK
- Clark D. Russell
- Clinical Lecturer in Infectious Diseases, Centre for Inflammation Research, University of Edinburgh, UK
- Lynsey Goodwin
- Specialist Registrar in Infectious Diseases and General Internal Medicine, Tropical and Infectious Diseases Unit, North Manchester General Hospital, Delaunays Rd, Manchester, UK
- Antonia Ho
- Clinical Senior Lecturer/Consultant in Infectious Diseases, MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
- Lance Turtle
- Senior Clinical Lecturer, NIHR Health Protection Research Unit in emerging and zoonotic infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Consultant in Infectious Disease, Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
- Margaret E. O'Hara
- Patient-advocate, Long COVID Support, Birmingham, UK
- Claire Hastie
- Patient-advocate, Long COVID Support, Birmingham, UK
- Chloe Donohue
- Trials Coordinator, Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
- Rebecca G. Spencer
- Project Administrator, Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, UK
- Cara Donegan
- Project Administrator, Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, UK
- Alison Gummery
- Project Administrator, Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, UK
- Janet Harrison
- Data Base Developer, National Institute of Health Research (NIHR) Health Protection research Unit in Emerging and Zoonotic Infections, Liverpool, UK; Institute of Infection and Global Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Hayley E. Hardwick
- Institute of Infection and Global Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK; Project Manager, National Institute of Health Research (NIHR) Health Protection research Unit in Emerging and Zoonotic Infections, Liverpool, UK
- Claire E. Hastie
- Lecturer in Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Gail Carson
- Head, ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Laura Merson
- Head of Data, ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- J. Kenneth Baillie
- Senior Clinical Research Fellow, Roslin Institute, University of Edinburgh, Edinburgh, UK
- Peter Openshaw
- Prof. of Experimental Medicine, National Heart and Lung Institute, Imperial College, London UK
- Ewen M. Harrison
- Director Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
- Annemarie B. Docherty
- Wellcome Clinical Research Career Development Fellow, Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK; Consultant in Intesnive Care Medicine, Intensive Care Unit, Royal Infirmary Edinburgh, Edinburgh, UK
- Malcolm G. Semple
- Professor of Child Health and Outbreak Medicine, Health Protection Research Unit In Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, UK; Consultant in Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, UK
- Janet T. Scott
- Clinical Lecturer in Infectious Disease, MRC-University of Glasgow Centre for Virus Research, Glasgow, UK; Correspondence to: Dr Janet T Scott, MRC-University of Glasgow Centre for Virus Research, Garscube Estate, Glasgow, G61 1QH, Phone: +44 (0)141 339 4017
- Journal volume & issue
-
Vol. 8
p. 100186
Abstract
Background: This study sought to establish the long-term effects of Covid-19 following hospitalisation. Methods: 327 hospitalised participants, with SARS-CoV-2 infection were recruited into a prospective multicentre cohort study at least 3 months post-discharge. The primary outcome was self-reported recovery at least ninety days after initial Covid-19 symptom onset. Secondary outcomes included new symptoms, disability (Washington group short scale), breathlessness (MRC Dyspnoea scale) and quality of life (EQ5D-5L). Findings: 55% of participants reported not feeling fully recovered. 93% reported persistent symptoms, with fatigue the most common (83%), followed by breathlessness (54%). 47% reported an increase in MRC dyspnoea scale of at least one grade. New or worse disability was reported by 24% of participants. The EQ5D-5L summary index was significantly worse following acute illness (median difference 0.1 points on a scale of 0 to 1, IQR: -0.2 to 0.0). Females under the age of 50 years were five times less likely to report feeling recovered (adjusted OR 5.09, 95% CI 1.64 to 15.74), were more likely to have greater disability (adjusted OR 4.22, 95% CI 1.12 to 15.94), twice as likely to report worse fatigue (adjusted OR 2.06, 95% CI 0.81 to 3.31) and seven times more likely to become more breathless (adjusted OR 7.15, 95% CI 2.24 to 22.83) than men of the same age. Interpretation: Survivors of Covid-19 experienced long-term symptoms, new disability, increased breathlessness, and reduced quality of life. These findings were present in young, previously healthy working age adults, and were most common in younger females. Funding: National Institute for Health Research, UK Medical Research Council, Wellcome Trust, Department for International Development and the Bill and Melinda Gates Foundation.
