European Primary Care Cardiovascular Society

Signs of affection of multi-organ systems after recovery from mild to moderate COVID-19

Multi-organ assessment in mainly non-hospitalized individuals after SARS-CoV-2 infection: The Hamburg City Health Study COVID programme

Literature - Petersen EL, Grossling A, Adam G et al., - Eur Heart J 2021;

Introduction and methods


In severely ill and deceased COVID-19 patients, impairment of pulmonary, cardiac and renal function have been reported, as well as thromboembolism and serious neurological complications [1-4]. Most reports on long term symptoms are from hospitalized cohorts [5] and data on subclinical changes of multi-organ structure and function are lacking.

In this cross-sectional study, the intermediate-term impact of mild to moderate COVID-19 (defined as not requiring intensive care unit treatment) on organ-specific function was determined.


Study design

Multi-organ function was assessed by deep phenotyping patients ~9 months after mild to moderate COVID-19 recovery and comparing data with those of age-, sex-, and education-matched subjects from a population-based cohort study.

The cohort of 443 recovered COVID-19 patients consisted of individuals from Hamburg, Germany, with a positive PCR test for SARS-CoV-2 at least 4 months prior to enrollment (median enrollment was 9.6 months after the positive test). 92.8% Of these subjects were managed as outpatients. The population-based Hamburg City Health Study (HCHS) served a as the control cohort. Controls were eligible for this study if they had been enrolled prior to being at risk of SARS-CoV-2 infection; 1328 controls were enrolled.

Both patients recovered from COVID-19 and matched controls underwent the same standardized 7h assessment at the same center [6].


Main outcomes

Surrogates of biological parameters in the respiratory, cardiac, vascular, renal, metabolic and inflammatory, and neurological systems, and of neurocognition and psychosocial outcomes were assessed.

Main results

Respiratory system

Cardiac system

Vascular system

Renal system

Neurological system


Subclinical multi-organ involvement related to thrombotic function and pulmonary, cardiac and renal systems was observed in mainly non-hospitalized patients who recovered ~9 months ago from mild to moderate COVID-19. There were no signs of structural brain damage, impairment in cognitive function or quality of life.

The take-home message of the authors is that a standardized exam of these conditions after recovery from COVID-19 is recommended to identify individuals at risk and initiate preventive strategies.

Find this article online at Eur Heart J

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