Views: 0 Author: Site Editor Publish Time: 2022-05-22 Origin: Site
There is growing evidence that "long-duration COVID," or negative health effects months after apparent recovery from severe COVID-19, is a significant risk for some patients. For example, researchers at the University of Florida, Gainesville showed in December that people who appear to suffer from severe COVID-19 disease are more likely to suffer from severe COVID-19 than people who have only mild or moderate symptoms, who have not been hospitalized, or who have never contracted the disease. Hospitalized patients who recovered from -19 more than doubled their risk of dying within the next year.
"It was clinically found that the stronger the inflammation at the time of initial hospitalization, the greater the probability that a patient would die within 12 months of seemingly 'recovering' from COVID-19." - Prof. Arch G Mainous III
Now, for the first time, a team of researchers including some of the same authors has shown for the first time that in patients hospitalized with COVID-19 but who appear to have recovered, severe systemic inflammation during hospitalization is a risk factor for death within a year. This seems paradoxical, since inflammation is a natural part of the body's immune response, which has evolved to fight infection. However, in some diseases, including COVID-19, this response can be overdone, causing further harm.
"COVID-19 is known to produce inflammation, especially during the first acute episode," said lead author Arch G Mainous III, Professor, Associate Director of Research in the Department of Community Health and Family Medicine at the University of Florida, Gainesville. "We is the first team to study the relationship between inflammation during a COVID-19 hospital stay and mortality after a patient's 'recovery.' The greater the chance of dying within 12 months of recovery."
Mainous and colleagues studied the de-identified electronic health records of 1,207 adults hospitalized after testing positive for COVID-19 within the University of Florida Health System in 2020 or 2021, who were followed for at least a year after discharge. As a proxy for the severity of systemic inflammation during hospitalization, they used a common, proven measure, the blood concentration of the molecule C-reactive protein (CRP), which is signaled by the liver to active immune cells secreted in response.
inflammation in many parts of the body
As expected, blood concentrations of CRP during hospitalization were closely related to the severity of COVID-19. Inpatients not requiring supplemental oxygen had a CRP of 59.4 mg/L, patients requiring additional oxygen via non-invasive, non-mechanical ventilation had a CRP of 126.9 mg/L, and the most severe cases required either ventilator or Eke membrane oxygen Combined with ventilation, the CRP requirement was 201.2 mg/L.
COVID-19 patients with the highest CRP concentrations measured during hospitalization had a 61% greater risk of dying from any cause within one year after discharge -- adjusted for other risk factors -- than those with the lowest CRP concentrations. These results were published in the journal Frontiers in Medicine on May 12, 2022.
Mainous said. "Many infectious diseases are accompanied by increased inflammation. Most of the time, inflammation is localized or specific to the site of the infection. COVID-19 is different because it produces inflammation in many places other than the respiratory tract, such as in the heart , brain and kidneys. High levels of inflammation can lead to tissue damage". Importantly, the authors showed that if patients were prescribed anti-inflammatory steroids after hospitalization, the risk of death from causes related to severe inflammation was reduced by 51%.
These results imply that inflammation severity during hospitalization for COVID-19 can predict subsequent risk of serious health problems, including death from 'long-duration COVID'. They also suggested that current best practice recommendations may need to change, including more widespread prescribing of oral steroids to COVID-19 patients when they are discharged from the hospital.
COVID-19: A chronic disease?
The authors suggest that COVID-19 should be considered a potentially chronic disease.
"When someone has a cold or even pneumonia, we generally think that the illness is over once the patient recovers. This is different from a range of chronic diseases, such as congestive heart failure or diabetes, which continue to affect the patient after an acute attack," Mainous said: "We may also need to start thinking about the lasting effects of COVID-19 on many parts of the body after a patient recovers from an initial attack. Once we recognize the importance of 'long-duration COVID-19' beyond what appears to be a 'recovery', We need to focus on treatment to prevent later problems like stroke, brain dysfunction, and especially premature death."
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