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Studien & Veröffentlichungen

  • Persistent COVID-19 symptoms are highly prevalent 6 months after hospitalization: results from a large prospective cohort
    Mai 2021
    Here we show that 60% of individuals admitted to hospital for COVID-19 still complain of one or more symptom 6 months after admission. A fourth of the participants had three or more persistent symptoms at M6. In addition, our data suggest that symptoms still present at M3 are lingering up to M6, and there is little improvement at M6 when compared with M3. These symptoms had disabling consequences since a third of those who had a professional occupation were not back to work at M6.

  • Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis
    Mai 2021 (vorläufige Studie)
    The literature on longer-term consequences is still maturing, but indicates a particularly high frequency of insomnia, fatigue, cognitive impairment, and anxiety disorders in the first six months after infection. Persistent neuropsychiatric symptoms are common and appear to be limited neither to the post-acute phase, nor to recovery only from severe COVID-19. Our results imply that health services should plan for high rates of requirement for multidisciplinary services (including neurological, neuropsychiatric and psychological management) as populations recover from the COVID-19 pandemic.

  • Systemic and organ-specific immune-related manifestations of COVID-19
    April 2021
    Immune-related manifestations are increasingly recognized in patients with COVID-19, with a protean clinical presentation affecting a wide range of organ systems in both children and adults. The body of evidence consists predominantly of case series and uncontrolled studies that had reported ~3,000 cases worldwide as of August 2020, including more than 70 different systemic and organ-specific disorders.

  • Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study
    April 2021 (vorläufige Studie)
    A quarter of children experienced persistent symptoms months after hospitalization with acute covid-19 infection, with almost one in ten experiencing multi-system involvement. Older age and allergic diseases were associated with higher risk of persistent symptoms at follow-up. Our findings highlight the need for replication and further investigation of potential mechanisms as well as clinical support to improve long term outcomes in children.

  • High-dimensional characterization of post-acute sequalae of COVID-19
    April 2021 (vorläufige Studie)
    We show that beyond the first 30 days of illness, people with COVID-19 exhibit higher risk of death and health resource utilization. Our high dimensional approach identifies incident sequalae in the respiratory system and several others including nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, musculoskeletal pain, and anemia.

  • Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management
    April 2021
    The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric. Patients with long COVID-19 should be managed using structured primary care visits based on the time from diagnosis of SARS-CoV-2 infection. Based on the current limited evidence, disease management of long COVID-19 signs and symptoms will require a holistic, longitudinal follow up in primary care, multidisciplinary rehabilitation services, and the empowerment of affected patient groups.

  • A conceptual framework to accelerate the clinical impact of evolving research into long COVID
    April 2021
    To facilitate an improved understanding and synthesis of research findings across studies and accelerate progress towards clear case definitions, we propose a conceptual framework that delineates the long-term sequelae of COVID-19 into three distinct categories. The categories are: persistent symptoms with causal pathological correlates; persistent symptoms without pathophysiological correlates and the causative pathology is unknown; and organ pathology without associated symptoms or clinical consequence.

  • Long COVID’s long R&D agenda
    April 2021
    Long COVID manifests in various ways, affecting the heart, the lungs, the gastrointestinal system, the brain, mental health and more. The most common reported issues are breathlessness, fatigue, smell and taste disturbance, and anxiety, found a living systematic review of studies of the condition in hospitalized and non-hospitalized patients. For some individuals, these issues can be debilitating. But as yet there is still limited insight into the true scope and scale of this post-viral problem. The underlying biology, too, is unclear.

  • Symptoms and Functional Impairment Assessed 8 Months After Mild COVID-19 Among Health Care Workers
    April 2021
    The results of this study showed that a considerable portion of low-risk individuals with mild COVID-19 reported a diversity of long-term symptoms, and that these symptoms disrupted work, social, and home life. Limitations of the study include the possibility of recall bias and the subjective rating of symptoms. Further research is needed to understand the mechanisms underlying COVID-19–related long-term sequelae.

  • 6-month neurological and psychiatric outcomes in 236  379 survivors of COVID-19: a retrospective cohort study using electronic health records
    April 2021
    Our study provides evidence for substantial neurological and psychiatric morbidity in the 6 months after COVID-19 infection. Risks were greatest in, but not limited to, patients who had severe COVID-19. This information could help in service planning and identification of research priorities. Complementary study designs, including prospective cohorts, are needed to corroborate and explain these findings.

  • Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK
    April 2021
    Self-reported long COVID symptoms were adversely affecting the day-to-day activities of 674,000 people in private households in the UK, with 196,000 of these individuals reporting that their ability to undertake their day-to-day activities had been limited a lot. Of people with self-reported long COVID, 697,000 first had (or suspected they had) COVID-19 at least 12 weeks previously, and 70,000 first had (or suspected they had) COVID-19 at least one year previously. Among a sample of over 20,000 study participants who tested positive for COVID-19 between 26 April 2020 and 6 March 2021, 13.7% continued to experience symptoms for at least 12 weeks.

  • Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses
    April 2021
    Cough is one of the most common presenting symptoms of COVID-19, along with fever and loss of taste and smell. Cough can persist for weeks or months after SARS-CoV-2 infection, often accompanied by chronic fatigue, cognitive impairment, dyspnoea, or pain—a collection of long-term effects referred to as the post-COVID syndrome or long COVID. We hypothesise that the pathways of neurotropism, neuroinflammation, and neuroimmunomodulation through the vagal sensory nerves, which are implicated in SARS-CoV-2 infection, lead to a cough hypersensitivity state. The post-COVID syndrome might also result from neuroinflammatory events in the brain.

  • Alterations in T and B cell function persist in convalescent COVID-19 patients
    März 2021
    Our data detail lymphocyte alterations in previously hospitalized COVID-19 patients up to 6 months following hospital discharge and identify 3 subgroups of convalescent patients based on distinct lymphocyte phenotypes, with one subgroup associated with poorer clinical outcome. We propose that alterations in B and T cell function following hospitalisation with COVID-19 could impact longer term immunity and contribute to some persistent symptoms observed in convalescent COVID-19 patients.

  • Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study 
    März 2021
    In individuals at low risk of COVID-19 mortality with ongoing symptoms, 70% have impairment in one or more organs 4  months after initial COVID-19 symptoms, with implications for healthcare and public health, which have assumed low risk in young people with no comorbidities. Our findings have three research implications. First, as countries face second waves, COVID-19 impact models should include PCS (post-COVID-19 syndrome), whether quality of life, healthcare utilisation or economic effects. Second, there is urgent need for multiorgan assessment, including blood and imaging, as well as primary and secondary care data linkage, to define PCS. Third, longitudinal studies of clustering of symptoms and organ impairment will inform health services research to plan multidisciplinary care pathways.

  • Research priorities for Long Covid: refined through an international multi-stakeholder forum
    März 2021
    Research on Long Covid will require a multi-disciplinary and globally coordinated approach that supports harmonised and large-scale case-control and interventional studies that have the power to provide quality evidence to inform policy and patient care across the full range of populations and countries affected. Governments of the world need to ensure the strengthening of health systems to be able to provide treatment, support and rehabilitation to improve long-term COVID-19 outcomes. To prevent Long Covid becoming the pandemic of 2021, controlling the high rates of infection has to remain a global priority.

  • Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study
    März 2021
    Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Individuals discharged from hospital after covid-19 had increased rates of multiorgan dysfunction compared with the expected risk in the general population. The increase in risk was not confined to the elderly and was not uniform across ethnicities. The diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches, and urgent research is needed to establish the risk factors.

  • Post-acute COVID-19 syndrome
    März 2021
    Given the global scale of this pandemic, it is apparent that the healthcare needs for patients with sequelae of COVID-19 will continue to increase for the foreseeable future. Rising to this challenge will require harnessing of existing outpatient infrastructure, the development of scalable healthcare models and integration across disciplines for improved mental and physical health of survivors of COVID-19 in the long term.

  • Characteristics of Long Covid: findings from a social media survey
    März 2021 (vorläufige Studie)
    We analysed data from 2550 participants with a median duration of illness of 7.7 months. (…) 89.5% described their health as good, very good or excellent before COVID-19. The most common initial symptoms that persisted were exhaustion, chest pressure/tightness, shortness of breath and headache. Cough, fever, and chills were common initial symptoms that became less prevalent later in the illness, whereas cognitive dysfunction and palpitations became more prevalent later in the illness.

  • Living with Covid19 – Second review
    März 2021
    Long Covid is a broad term and can be a multi-system condition. People need investigation and, where indicated, specific clinical interventions. Some will require full rehabilitation programmes, and others may benefit from psychological services. Others will need long-term support in the community, including help with self-management strategies. The impact of Long Covid on vulnerable communities and pre-existing conditions has not been researched, and the long-term needs of these groups is unclear.

  • Physical, cognitive and mental health impacts of COVID-19 following hospitalisation: a multi-centre prospective cohort study
    März 2021 (vorläufige Studie)
    We identified factors related to recovery from a hospital admission with COVID-19 and four different phenotypes relating to the severity of physical, mental, and cognitive health five months later. The implications for clinical care include the potential to stratify care and the need for a pro-active approach with wide-access to COVID-19 holistic clinical services.

  • Persistent neurologic symptoms and cognitive dysfunction in non‐hospitalized Covid‐19 “long haulers”
    März 2021
    Non‐hospitalized Covid‐19 “long haulers” experience prominent and persistent “brain fog” and fatigue that affect their cognition and quality of life. The constellation of “long hauler” symptoms, particularly fatigue and a sense of cognitive dysfunction, present in our “long hauler” patients resemble the prominent fatigue and cognitive complaints seen in those after mild traumatic brain injury, and in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

  • Attributes and predictors of long COVID
    März 2021
    We found that early disease features were predictive of duration. With only three features—the number of symptoms in the first week, age and sex—we built a model designed to separate short (<10 d) and long (≥28 d) duration of COVID-19.

  • COVID Symptoms, Symptom Clusters, and Predictors for Becoming a Long-Hauler: Looking for Clarity in the Haze of the Pandemic
    März 2021 (vorläufige Studie)
    Data are emerging to suggest that infection with SARS-CoV-2 may lead to prolonged and persistent symptoms. These long-term consequences of becoming a long-hauler are unclear, and further research is urgently needed to corroborate our findings. 

  • A pilot study of burnout and long covid in senior specialist doctors
    März 2021
    A total of 114 responses were received. Nearly two-thirds reported that Covid-19 has had an adverse effect on their mental health. One-quarter reported that they or colleagues had experience of ‘long-covid’ secondary to the virus. More comprehensive evaluation of the effect of the pandemic on front-line staff is needed to identify the extent of the problem and the factors which contribute to it. 

  • Recovered not restored: Long-term health consequences after mild COVID-19 in non-hospitalized patients
    März 2021 (vorläufige Studie)
    The on-going presence of either shortness of breath, anosmia, ageusia or fatigue as long-lasting symptoms even in non-hospitalized patients was observed at four and seven months post-infection and summarized as post-COVID syndrome (PCS). The continued assessment of patients with PCS will become a major task to define and mitigate the socioeconomic and medical long-term effects of COVID-19.

  • Are vaccines safe in patients with Long COVID? A prospective observational study
    März 2021 (vorläufige Studie)
    Receipt of vaccination with either an mRNA or adenoviral vector vaccine was not associated with a worsening of Long Covid symptoms, quality of life, or mental wellbeing. Individuals with prolonged COVID-19 symptoms should receive vaccinations as suggested by national guidance.

  • Clinical Characteristics, Activity Levels and Mental Health Problems in Children with Long COVID: A Survey of 510 Children
    März 2021 (vorläufige Studie)
    Our study provides further evidence on Long COVID in children. Symptoms like fatigue, headache, muscle and joint pain, rashes and heart palpitations, and mental health issues like lack of concentration and short memory problems, were particularly frequent and confirm previous observations, suggesting that they may characterize this condition. A better comprehension of Long COVID is urgently needed.

  • Häufigkeit von Long COVID im Kanton Zürich: Implikationen für die Versorgungsplanung
    März 2021
    Unsere Ergebnisse zeigen, dass ein relevanter Anteil von Personen nach einer SARS-CoV-2-Infektion an längerfristigen Folgen leidet. Unsere Ergebnisse deuten darauf hin, dass eine breite Palette von Versorgungsangeboten und integrative Ansätze erforderlich sein wird, um die Genesung dieser Personen zu unterstützen. Neben Maßnahmen zur Eindämmung der Ausbreitung von SARS-CoV-2 wird die frühzeitige Planung von Ressourcen und bedarfsgerechten Angebote für die an Long COVID Erkrankten entscheidend sein für eine Reduktion der Krankheitslast durch Long COVID.

  • Sequelae in Adults at 6 Months After COVID-19 Infection
    Februar 2021
    In this cohort of individuals with COVID-19 who were followed up for as long as 9 months after illness, approximately 30% reported persistent symptoms. A unique aspect of our cohort is the high proportion of outpatients with mild disease. Persistent symptoms were reported by one-third of outpatients in our study, consistent with a previously reported study, in which 36% of outpatients had not returned to baseline health by 14 to 21 days following infection. However, this has not been previously described 9 months after infection.

  • COVID-19-related symptoms 6 months after the infection – Update on a prospective cohort study in Germany
    Februar 2021 (vorläufige Studie)
    Based on this study, the prevalence of COVID-19-related symptoms 6 months after the infection is high. Some bias for overestimation may have affected this result. Nevertheless, ‘long COVID’ requires attention in medical care and a better scientific understanding.

  • Chronic COVID-19 Syndrome and Chronic Fatigue Syndrome (ME/CFS) following the first pandemic wave in Germany – a first analysis of a prospective observational study
    Februar 2021 (vorläufige Studie)
    Chronic COVID-19 Syndrome at months 6 is a multisymptomatic frequently debilitating disease fulfilling diagnostic criteria of ME/CFS in about half of the patients in our study. Research in mechanisms and clinical trials are urgently needed.

  • Long COVID guidelines need to reflect lived experience
    Februar 2021
    Guidelines must represent the complexity of long COVID, including the areas where evidence is still emerging. Hasty attempts to rename the condition or compare it to other conditions is a disservice to thousands of people, and could result in missed pathology to the detriment of the patient. Comprehensive long COVID guidelines are essential to prevent an epidemic of long-term, chronic disease as a result of early mismanagement of pathology, and the potential implications of such an epidemic for health systems and economies.

  • Risk factors for long-term consequences of COVID-19 in hospitalised adults in Moscow using the ISARIC Global follow-up protocol: StopCOVID cohort study
    Februar 2021
    6 to 8 months after acute infection episode almost a half of patients experience symptoms lasting since hospital discharge. One in ten individuals experiences MSI. Female sex is the main risk factor for majority of the LS categories. chronic pulmonary disease is associated with a higher risk of chronic fatigue development, and asthma with neurological and mood and behaviour changes. Individuals with LS and MSI should be the main target for future research and intervention strategies.

  • Children with long covid
    Februar 2021
    Almost half of children who contract covid-19 may have lasting symptoms, which should factor into decisions on reopening schools.

  • 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study
    Januar 2021
    At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery.

  • More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis
    Januar 2021 (vorläufige Studie)
    The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included. The follow-up time ranged from 14 to 110 days post-viral infection. The age of the study participants ranged between 17 and 87 years. It was estimated that 80% (95% CI 65-92) of the patients that were infected with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%).

  • Preliminary Evidence on Long COVID in children
    Januar 2021 (vorläufige Studie)
    The evidence that COVID-19 can have long-term impacts on children as well, including those with asymptomatic/ paucisymptomatic COVID-19, highlights the need for pediatricians, mental health experts and policy makers of implementing measures to reduce impact of the pandemic on child’s health.

  • Will COVID-19 Lead to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?
    Januar 2021
    We should not forget the importance of studying all people who become infected with SARS-CoV-2, even those with only mild initial illnesses, and to study the recovery period and the long-term health consequences of COVID-19. We need to know how to prevent and treat “long COVID.” What we learn may apply to the prevention and treatment of ME/CFS, as well.

  • The prevalence of long COVID symptoms and COVID-19 complications
    Dezember 2020
    Using these estimates (along with the equivalent proportions for durations of 6 to 11 weeks) and the published weekly incidence rates from the COVID-19 Infection Survey, we estimate that during the week commencing 22 November 2020, around 186,000 people in private households in England were living with symptoms that had persisted for between 5 and 12 weeks, with a 95% confidence interval of 153,000 to 221,000.

  • Persistent symptoms after Covid-19: qualitative study of 114 “long Covid” patients and draft quality principles for services
    Dezember 2020
    Suggested quality principles for a long Covid service include ensuring access to care, reducing burden of illness, taking clinical responsibility and providing continuity of care, multi-disciplinary rehabilitation, evidence-based investigation and management, and further development of the knowledge base and clinical services.

  • Long COVID: where do we start with the case definitions?
    Dezember 2020 (vorläufige Studie)
    Long COVID is the condition whereby individuals do not recover for several weeks or months following the onset of COVID19 symptoms. The range of reported symptoms is very wide. There are no agreed case definitions for Long COVID leading to variation in clinical diagnosis, especially if individuals were not tested when initially infected. We propose criteria to establish a retrospective diagnosis of ‘Past Acute COVID’.

  • Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact
    Dezember 2020 (vorläufige Studie)
    Patients with Long COVID report prolonged multisystem involvement and significant disability. Most had not returned to previous levels of work by 6 months. Many patients are not recovered by 7 months, and continue to experience significant symptom burden.

  • Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection
    November 2020
    In a similar fashion to previous coronavirus pandemics, COVID-19 appears to result in symptoms of severe fatigue that outlast the initial acute illness. Over half of individuals in the current study demonstrated symptoms consistent with severe fatigue a median of 10 weeks after their initial illness, while almost one-third of those previously employed had not returned to work. Most interestingly, fatigue was not associated with initial disease severity, and there were no detectable differences in pro-inflammatory cytokines or immune cell populations.

  • Case report and systematic review suggest that children may experience similar long‐term effects to adults after clinical COVID‐19
    November 2020
    The five children with potential long COVID had a median age of 12 years (range 9–15) and four were girls. They had symptoms for 6–8 months after their clinical diagnoses of COVID‐19. None were hospitalised at diagnosis, but one was later admitted for peri‐myocarditis. All five children had fatigue, dyspnoea, heart palpitations or chest pain, and four had headaches, difficulties concentrating, muscle weakness, dizziness and sore throats. Some had improved after 6–8 months, but they all suffered from fatigue and none had fully returned to school.

  • Long COVID in the Faroe Islands: A Longitudinal Study Among Nonhospitalized Patients
    November 2020
    Of the 180 participants (96.3% of the 187 eligible COVID-19 patients), 53.1% reported persistence of at least 1 symptom after a mean of 125 days after symptoms onset, 33.0% reported 1 or 2 symptoms, and 20.1% reported 3 or more symptoms. At the last follow-up, 46.9% were asymptomatic compared with 4.4% during the acute phase. The most prevalent persistent symptoms were fatigue, loss of smell and taste, and arthralgias.

  • Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome
    November 2020
    Hyperinflammatory cytokine storms in many severely symptomatic Covid-19 patients may be rooted in an atypical response to SARS-CoV-2 by the dysfunctional MCs of MCAS rather than a normal response by normal MCs. If proven, this theory has significant therapeutic and prognostic implications.

  • Post-acute COVID-19 syndrome negatively impacts health and wellbeing despite less severe acute infection
    November 2020 (vorläufige Studie)
    Persistent symptoms following COVID-19 infection are prevalent, debilitating and appear to affect individuals regardless of acute infection severity or prior health status. More detailed research is required in order to identify specific symptom clusters associated with PACS, and to devise effective interventional strategies.

  • Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App
    Oktober 2020 (vorläufige Studie)
    A simple model to distinguish between short and long-COVID at 7 days, which gained a ROC-AUC of 76%, was replicated in an independent sample of 2472 antibody positive individuals. This model could be used to identify individuals for clinical trials to reduce long-term symptoms and target education and rehabilitation services.

  • Living with Covid19
    Oktober 2020
    People experience a wide range of fluctuating and multisystem symptoms that need to be acknowledged. A common theme is that symptoms arise in one physiological system then abate only for symptoms to arise in a different system. The varying degrees of dependency mean support in the community should be considered alongside hospital one stop clinics. There are significant psychological and social impacts that will have long-term consequences for individuals and for society if not well managed. Health and social care services are not equipped to support people living with Covid19. Staff need better information and education on the ongoing effects.