DYNamic Assessment of Multi-Organ level dysfunction in patients recovering from COVID-19: DYNAMO COVID-19.

Autor: Gupta A; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.; Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.; Nottingham University Hospitals NHS Trust, Nottingham, UK., Nicholas R; Sir Peter Mansfield Imaging Centre, School of Physics & Astronomy, University of Nottingham, Nottingham, UK., McGing JJ; David Greenfield Human Physiology Unit, School of Life Sciences, University of Nottingham, Nottingham, UK., Nixon AV; David Greenfield Human Physiology Unit, School of Life Sciences, University of Nottingham, Nottingham, UK., Mallinson JE; David Greenfield Human Physiology Unit, School of Life Sciences, University of Nottingham, Nottingham, UK., McKeever TM; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.; Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK., Bradley CR; Sir Peter Mansfield Imaging Centre, School of Physics & Astronomy, University of Nottingham, Nottingham, UK., Piasecki M; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.; MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK., Cox EF; Sir Peter Mansfield Imaging Centre, School of Physics & Astronomy, University of Nottingham, Nottingham, UK., Bonnington J; Nottingham University Hospitals NHS Trust, Nottingham, UK., Lord JM; MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK.; NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK., Brightling CE; NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK., Evans RA; NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK., Hall IP; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.; Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.; Nottingham University Hospitals NHS Trust, Nottingham, UK., Francis ST; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.; Sir Peter Mansfield Imaging Centre, School of Physics & Astronomy, University of Nottingham, Nottingham, UK., Greenhaff PL; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.; David Greenfield Human Physiology Unit, School of Life Sciences, University of Nottingham, Nottingham, UK.; MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, UK., Bolton CE; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.; Centre for Respiratory Research, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.; Nottingham University Hospitals NHS Trust, Nottingham, UK.
Jazyk: angličtina
Zdroj: Experimental physiology [Exp Physiol] 2024 Aug; Vol. 109 (8), pp. 1274-1291. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1113/EP091590
Abstrakt: We evaluated the impacts of COVID-19 on multi-organ and metabolic function in patients following severe hospitalised infection compared to controls. Patients (n = 21) without previous diabetes, cardiovascular or cerebrovascular disease were recruited 5-7 months post-discharge alongside controls (n = 10) with similar age, sex and body mass. Perceived fatigue was estimated (Fatigue Severity Scale) and the following were conducted: oral glucose tolerance (OGTT) alongside whole-body fuel oxidation, validated magnetic resonance imaging and spectroscopy during resting and supine controlled exercise, dual-energy X-ray absorptiometry, short physical performance battery (SPPB), intra-muscular electromyography, quadriceps strength and fatigability, and daily step-count. There was a greater insulin response (incremental area under the curve, median (inter-quartile range)) during the OGTT in patients [18,289 (12,497-27,448) mIU/min/L] versus controls [8655 (7948-11,040) mIU/min/L], P < 0.001. Blood glucose response and fasting and post-prandial fuel oxidation rates were not different. This greater insulin resistance was not explained by differences in systemic inflammation or whole-body/regional adiposity, but step-count (P = 0.07) and SPPB scores (P = 0.004) were lower in patients. Liver volume was 28% greater in patients than controls, and fat fraction adjusted liver T 1 , a measure of inflammation, was raised in patients. Patients displayed greater perceived fatigue scores, though leg muscle volume, strength, force-loss, motor unit properties and post-exercise muscle phosphocreatine resynthesis were comparable. Further, cardiac and cerebral architecture and function (at rest and on exercise) were not different. In this cross-sectional study, individuals without known previous morbidity who survived severe COVID-19 exhibited greater insulin resistance, pointing to a need for physical function intervention in recovery.
(© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)
Databáze: MEDLINE
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