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; ISARIC global follow-up working group; ISARIC4C investigators

doi:10.1016/j.lanepe.2021.100186

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'HaraClaire 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, ISARIC global follow-up working group, ISARIC4C investigators

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Article number	100186
Number of pages	13
Journal	The Lancet Regional Health - Europe
Volume	8
Early online date	6 Aug 2021
DOIs	https://doi.org/10.1016/j.lanepe.2021.100186
Publication status	Published - Sept 2021

Keywords

Covid-19
Long-Covid
Long-term outcomes
Post-Covid
Post-acute Covid-19
Quality of life
Sequelae

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Copyright © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license.
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Sigfrid, L., Drake, T. M., Pauley, E., Jesudason, E. C., Olliaro, P., Lim, W. S., Gillesen, A., Berry, C., Lowe, D. J., McPeake, J., Lone, N., Munblit, D., Cevik, M., Casey, A., Bannister, P., Russell, C. D., Goodwin, L., Ho, A., Turtle, L., ... ISARIC4C investigators (2021). Long Covid in adults discharged from UK hospitals after Covid-19: a prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol. The Lancet Regional Health - Europe, 8, Article 100186. https://doi.org/10.1016/j.lanepe.2021.100186

@article{e06c42b0d75146ec8a7d4db64590cc98,

title = "Long Covid in adults discharged from UK hospitals after Covid-19: a prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol",

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.",

keywords = "Covid-19, Long-Covid, Long-term outcomes, Post-Covid, Post-acute Covid-19, Quality of life, Sequelae",

author = "Louise Sigfrid and Drake, {Thomas M} and Ellen Pauley and Jesudason, {Edwin C} and Piero Olliaro and Lim, {Wei Shen} and Annelies Gillesen and Colin Berry and Lowe, {David J} and Joanne McPeake and Nazir Lone and Daniel Munblit and Muge Cevik and Anna Casey and Peter Bannister and Russell, {Clark D} and Lynsey Goodwin and Antonia Ho and Lance Turtle and O'Hara, {Margaret E} and Claire Hastie and Chloe Donohue and Spencer, {Rebecca G} and Cara Donegan and Alison Gummery and Janet Harrison and Hardwick, {Hayley E} and Hastie, {Claire E} and Gail Carson and Laura Merson and Baillie, {J Kenneth} and Peter Openshaw and Harrison, {Ewen M} and Docherty, {Annemarie B} and Semple, {Malcolm G} and Scott, {Janet T} and {ISARIC global follow-up working group} and {ISARIC4C investigators}",

note = "Funding: This work is supported by grants from: the National Institute for Health Research (NIHR) [award CO-CIN-01], the Medical Research Council [grant MC_PC_19059], the Imperial Biomedical Research Centre (NIHR Imperial BRC, grant P45058), the Health Protection Research Unit (HPRU) in Respiratory Infections at Imperial College London and NIHR HPRU in Emerging and Zoonotic Infections at University of Liverpool, both in partnership with Public Health England, [NIHR award 200907], Wellcome Trust and Department for International Development [215091/Z/18/Z], and the Bill and Melinda Gates Foundation [OPP1209135], and Liverpool Experimental Cancer Medicine Centre (Grant Reference: C18616/A25153), NIHR Biomedical Research Centre at Imperial College London [IS-BRC-1215-20013], EU Platform for European Preparedness Against (Re-) emerging Epidemics 1 [FP7 project 602525] and NIHR Clinical Research Network for providing infrastructure support for this research. LT is a Wellcome Trust clinical career development fellow, supported by grant number 205228/Z/16/Z. This research was funded in part, by the Wellcome Trust. PJMO is supported by a NIHR Senior Investigator Award [award 201385]. ",

year = "2021",

month = sep,

doi = "10.1016/j.lanepe.2021.100186",

language = "English",

volume = "8",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier",

}

Sigfrid, L, Drake, TM, Pauley, E, Jesudason, EC, Olliaro, P, Lim, WS, Gillesen, A, Berry, C, Lowe, DJ, McPeake, J, Lone, N, Munblit, D, Cevik, M, Casey, A, Bannister, P, Russell, CD, Goodwin, L, Ho, A, Turtle, L, O'Hara, ME, Hastie, C, Donohue, C, Spencer, RG, Donegan, C, Gummery, A, Harrison, J, Hardwick, HE, Hastie, CE, Carson, G, Merson, L, Baillie, JK, Openshaw, P, Harrison, EM, Docherty, AB, Semple, MG, Scott, JT, ISARIC global follow-up working group & ISARIC4C investigators 2021, 'Long Covid in adults discharged from UK hospitals after Covid-19: a prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol', The Lancet Regional Health - Europe, vol. 8, 100186. https://doi.org/10.1016/j.lanepe.2021.100186

TY - JOUR

T1 - Long Covid in adults discharged from UK hospitals after Covid-19

T2 - a prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol

AU - Sigfrid, Louise

AU - Drake, Thomas M

AU - Pauley, Ellen

AU - Jesudason, Edwin C

AU - Olliaro, Piero

AU - Lim, Wei Shen

AU - Gillesen, Annelies

AU - Berry, Colin

AU - Lowe, David J

AU - McPeake, Joanne

AU - Lone, Nazir

AU - Munblit, Daniel

AU - Cevik, Muge

AU - Casey, Anna

AU - Bannister, Peter

AU - Russell, Clark D

AU - Goodwin, Lynsey

AU - Ho, Antonia

AU - Turtle, Lance

AU - O'Hara, Margaret E

AU - Hastie, Claire

AU - Donohue, Chloe

AU - Spencer, Rebecca G

AU - Donegan, Cara

AU - Gummery, Alison

AU - Harrison, Janet

AU - Hardwick, Hayley E

AU - Hastie, Claire E

AU - Carson, Gail

AU - Merson, Laura

AU - Baillie, J Kenneth

AU - Openshaw, Peter

AU - Harrison, Ewen M

AU - Docherty, Annemarie B

AU - Semple, Malcolm G

AU - Scott, Janet T

AU - ISARIC global follow-up working group

AU - ISARIC4C investigators

N1 - Funding: This work is supported by grants from: the National Institute for Health Research (NIHR) [award CO-CIN-01], the Medical Research Council [grant MC_PC_19059], the Imperial Biomedical Research Centre (NIHR Imperial BRC, grant P45058), the Health Protection Research Unit (HPRU) in Respiratory Infections at Imperial College London and NIHR HPRU in Emerging and Zoonotic Infections at University of Liverpool, both in partnership with Public Health England, [NIHR award 200907], Wellcome Trust and Department for International Development [215091/Z/18/Z], and the Bill and Melinda Gates Foundation [OPP1209135], and Liverpool Experimental Cancer Medicine Centre (Grant Reference: C18616/A25153), NIHR Biomedical Research Centre at Imperial College London [IS-BRC-1215-20013], EU Platform for European Preparedness Against (Re-) emerging Epidemics 1 [FP7 project 602525] and NIHR Clinical Research Network for providing infrastructure support for this research. LT is a Wellcome Trust clinical career development fellow, supported by grant number 205228/Z/16/Z. This research was funded in part, by the Wellcome Trust. PJMO is supported by a NIHR Senior Investigator Award [award 201385].

PY - 2021/9

Y1 - 2021/9

N2 - 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.

AB - 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.

KW - Covid-19

KW - Long-Covid

KW - Long-term outcomes

KW - Post-Covid

KW - Post-acute Covid-19

KW - Quality of life

KW - Sequelae

U2 - 10.1016/j.lanepe.2021.100186

DO - 10.1016/j.lanepe.2021.100186

M3 - Article

SN - 2666-7762

VL - 8

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

M1 - 100186

ER -

Long Covid in adults discharged from UK hospitals after Covid-19: a prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol

Abstract

Keywords

UN SDGs

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