Evidence continues to gather that “prolonged COVID,” that is, persistence of negative health effects months after an apparent recovery from severe COVID-19, presents an important risk for some patients. For example, researchers from the University of Florida Gainesville showed last December that hospitalized patients who had apparently recovered from severe COVID-19 had more than twice the risk of dying over the next year, compared to people who had only mild or moderate symptoms and who had the disease. He was not hospitalized, or who did not become ill.
Now, a team including some of the same authors has shown, for the first time, that among patients hospitalized with COVID-19 who appear to have recovered, severe systemic inflammation while hospitalized is a risk factor for death within one year. This may seem paradoxical, because inflammation is a normal part of the body’s immune response, which has evolved to fight infection. But in some diseases, including COVID-19, this response may bypass, causing more damage.
First author Professor Prof. first author said: “COVID-19 is known to cause inflammation, particularly during the first acute episode. Our study is the first to examine the relationship between inflammation during hospitalization due to COVID-19 and mortality after a patient has recovered.” • Arch G. Mainous III, Vice President for Research in the Division of Community Health and Family Medicine at the University of Florida Gainesville.
“We show here that the stronger the inflammation during initial hospitalization, the more likely the patient is to die within 12 months after apparently ‘recovering’ from COVID-19.”
Mainos and colleagues studied the unidentified electronic health records of 1,207 adults who were hospitalized in 2020 or 2021 after testing positive for COVID-19 within the University of Florida health system, and who were followed for at least a year after hospital discharge. As an indication of the severity of systemic inflammation during hospitalization, they used a popular and reliable measure of the concentration in the blood of the C-reactive protein (CRP) molecule, which is secreted by the liver in response to a signal from active immune cells.
Inflammation in many parts of the body
As expected, serum CRP concentration during hospitalization was strongly correlated with COVID-19 severity: 59.4 mg/L for hospitalized patients not requiring supplemental oxygen, 126.9 mg/L for those requiring supplemental oxygen through non-invasive. , non-mechanical ventilation, and 201.2 mg/L for severe cases requiring ventilation through a ventilator or through extracorporeal membrane oxygenation.
COVID-19 patients with the highest CRP concentration measured during their hospital stay had a 61% greater risk—corrected for other risk factors—of death from any cause within one year of hospital discharge compared to patients with the lowest CRP concentration. . These results have been published in frontiers in medicine.
“Many infectious diseases are accompanied by an increase in inflammation,” Mainos said. “Most of the time the inflammation is localized or localized. COVID-19 is different because it causes inflammation in many places beside the airways, for example in the heart, brain and kidneys. It can High levels of inflammation can lead to tissue damage.
Importantly, the authors showed that the higher risk of death from any cause associated with acute inflammation was again reduced by 51% if anti-inflammatory steroids were prescribed to the patient after hospitalization.
These results imply that the severity of inflammation during hospitalization due to COVID-19 can predict the risk of later serious health problems, including death, from prolonged COVID. They also point out that current best practice recommendations may need to change, to include more widespread prescribing of oral steroids for COVID-19 patients when they are discharged.
COVID-19: a chronic disease?
The authors suggest that COVID-19 should be viewed as a possible chronic disease.
“When someone has a cold or even pneumonia, we usually think of the disease as over once the patient has recovered. This is different from a chronic disease, such as congestive heart failure or diabetes, which continues to affect patients after an acute attack.” Likewise, you should start to think that COVID-19 has persistent effects in many parts of the body after patients recover from the first episode.”
“Once we realize the importance of ‘long COVID’ after apparently ‘recovery’, we need to focus on treatments to prevent later problems, such as strokes, brain dysfunction, and especially early death.”
Neuropsychiatric complications similar to COVID-19, SARI
Impact of primary COVID-19 episode inflammation among adults on mortality within 12 months after hospital discharge: a cohort study, frontiers in medicine (2022). DOI: 10.3389/fmed.2021.778434, www.frontiersin.org/articles/1…med.2021.778434/full
the quote: Steroids common after prolonged recovery from COVID may reduce death risk by up to 51% (2022, May 12) Retrieved May 12, 2022 from https://medicalxpress.com/news/2022-05-common-steroids-covid Death recovery. html
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