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COVID-19 Post-acute Care Major Organ Damage: A Living Rapid Review

Greer NL, Bart BA, Billington C, Diem SJ, Ensrud KE, Kaka A, Klein M, Melzer AC, Reule S, Shaukat A, Sheets K, Starks J, Ni OV, McKenzie L, Stroebel B, MacDonald R, Sowerby K, Duan-Porter WD, Wilt TJ. COVID-19 Post-acute Care Major Organ Damage: A Living Rapid Review. Health Services Research and Development Service. Washington DC: Evidence Synthesis Program (ESP) Center; 2021 Sep 1. 1-196 p. Report No.: ESP Project #09-009.


Takeaway We included 124 reports (33 US) of post-acute COVID-19 major organ damage and healthcare/service use. Recent evidence included 4 large database studies (1 of US Veterans) with control groups. Evidence from these studies suggests that compared to non-COVID-19 controls, adults hospitalized for COVID-19 had higher post-hospitalization incident respiratory, cardiac, liver, chronic and acute kidney disease, stroke, diabetes, and coagulation disorders. Applicability of findings to sub-groups ( eg, age, gender, COVID severity) and non-hospitalized patients is unknown. Context Coronavirus disease-2019 (COVID-19) is a viral illness caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and was declared a pandemic in March, 2020. As of 8/30/21, there have been over 38 million cases and over 637,000 deaths in the US. This systematic review examined post-acute prevalence of major organ damage and healthcare/service use needs among adults hospitalized with or for COVID-19. Key Findings From 124 reports (33 from the US) of post-acute major organ damage or healthcare/service use outcomes in adults hospitalized with or for COVID-19, pulmonary outcomes were most frequently reported with fewer studies of cardiovascular, neuromuscular, renal, hematologic endocrine, or gastrointestinal outcomes. Among healthcare/service use outcomes, discharge disposition and readmission were most frequently reported with little or no information about post-hospital care, monitoring, or treatments required. Although recent evidence included 4 large database studies with COVID-19 and control groups, available data are largely from studies of convenience samples with poorly described study populations, providing wide ranging prevalence estimates based mainly on physiologic data. Most studies had short follow-up post-discharge; long-term outcomes are unknown. Applicability of findings to subgroups and non-hospitalized patients are also unknown.

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