/
COVID-19: Recovery and Outcomes COVID-19: Recovery and Outcomes

COVID-19: Recovery and Outcomes - PowerPoint Presentation

CherryBlossom
CherryBlossom . @CherryBlossom
Follow
342 views
Uploaded On 2022-08-01

COVID-19: Recovery and Outcomes - PPT Presentation

Justin Rosenheck DO 102320 Global Cases https coronavirusjhuedumaphtml accessed 102220 Short Term Recovery General Symptoms Tenforde Kim et al 2020 1421 days post dx ID: 931564

recovery term long 2020 term recovery 2020 long sars patients follow pts short cases pulmonary months month persistent post

Share:

Link:

Embed:

Download Presentation from below link

Download Presentation The PPT/PDF document "COVID-19: Recovery and Outcomes" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

COVID-19: Recovery and Outcomes

Justin Rosenheck, DO

10/23/20

Slide2

Global Cases

https://

coronavirus.jhu.edu/map.html

; accessed 10/22/20

Slide3

Short Term Recovery – General Symptoms

|

Tenforde

, Kim, et al., 2020

*14-21 days post dx

Slide4

Short Term Recovery – Pulmonary

1 month follow up – 51 patients with “common COVID”

Persistent lung lesions in 35.3%

|

Liu, Ye, et al., 2020

Slide5

Short Term Recovery – Pulmonary

1 month follow up, 57 pts

Persistent lung lesions in 54.3%: 94% of severe cases, 37.5% of non-severe

Abnormal PFTs in 75%

6MWD shorter in severe patients (517m v. 573.5m)Sx: 10.5% cough, 7% SOB

|

Huang, Tan, et al., 2020

Slide6

Short Term Recovery – Pulmonary

3

month follow up, 55 patients

47 moderate, 4 mild, 4 severe

Residual CT findings in 71%Abnormal PFTs in 25.5%GI sx in 31%, HA 18%, Fatigue 16%, Dyspnea 14.5%

|

Zhao, Shang, et al., 2020

Slide7

Short Term Recovery – Cardiac

CMR in Competitive Athletes

26 athletes with no or mild symptoms, Median 23 days post dx

No hospitalizations, no specific therapy

All with normal ECGsCMR findings4 with active myocarditis8 with evidence of prior myocardial injury

|

Rajpal

, Tong, et al., 2020

Late Gadolinium Enhancement

Slide8

Short Term Recovery – Cardiac

CMR in Patients Recovered from COVID

Prospective, observational cohort (n=100)

Median 71 days post dx

33 req’d hospitalization78 pts: evidence of cardiac involvement60 pts: ongoing myocardial inflammationSymptoms: 36 pts:ongoing fatigue and dyspnea17 pts: atypical chest pain20 pts: palpitations

|

Puntmann

,

Carerj

, et al., 2020

Slide9

Short Term Outcomes – Renal

9657 patients – 13 metro NY hospitals

AKI incidence 38.4/1000 patient days

684 patients required renal replacement

tx33 pts req’d HD on dcNo outpatient follow up

|

Ng, Hirsch, et al., 2020

Slide10

Long Term Recovery

|

Slide11

SARS - MERS - COVID-19

|

SARS-CoV-1:

11/2003

07/2004

8098 confirmed cases. 774 deaths, 9.6% case fatality

MERS:

09/2012

2562 confirmed cases. 881 deaths, 34.4% case fatality

SARS-CoV-2:

12/2019

>41 million cases. 1.12 million deaths, 2.8% fatality

Slide12

Long Term Sx

and HR-QOL

Ahmed

, Patel, et al.,

2020Carfi, Bernabei, et al., 2020

Slide13

Long Term Recovery - Pulmonary

Lessons from SARS-1:

At 7 years, 11 SARS survivors

Impaired DLCO in 24%

Dyspnea (5), Cough (4), Sputum (2)At 15 years, 71 SARS survivorsImpaired DLCO in 35%Abnormal CT in 38%Femoral head osteonecrosis in 21%

|

Wu, Dong, et al., 2016

Zhang, Li, et al., 2019

Slide14

Long Term Recovery - Pulmonary

MERS, SARS: Meta-Analysis 28 studies

At 6 months, decreased 6MWD

At 12 months, 24% with impaired DLCO

Impaired HRQOL at 6 months and beyond Anxiety, Depression, PTSD commonH7N9: 56 survivorsAt 12 months: 14.6% with normal CTsAt 24 months: Persistent impaired DLCOARDS patients: consistently lower PFTs

|

Chen, Wu,

et al., 2017

Ahmed, Patel, et al., 2020

Slide15

Long Term Recovery – Cardiac

SARS-1:

At 12 years post recovery, 8 of 25 patients with persistent cardiovascular abnormalities

Viral Myocarditis:

502 bx proven patients: 6.6% rate of aborted or actual SCDArrhythmia burden similar between active or previous myocarditis1142 patients with prior myocarditis: 6-8% with HF hospitalization over 14 years of observation

|

Yancy

,

Fonarow

(2020)

Mitrani

,

Dabas

, et al. (2020)

Slide16

Long Term Recovery – Hepatic, Renal

Hepatic

No long term follow up data from SARS-1 or MERS

Renal

No long term follow up data from SARS-1 or MERSNCT04353583: Enrolling to evaluate 3 month COVID outcomes

|

Leung,

et al., 2020

Slide17

Assessing Long Term Outcomes

Dozens of planned long term follow up registries and studies

|

Ross, Seiler,

et al., 2020

Slide18

wexnermedical.osu.edu