Long-term effects of COVID-19 have become increasingly recognized. Acute lung damage may be followed by chronic impairment of lung function. COVID-19 may also be associated with increased risk of chronic cardiac and vascular injury, and persistent shortness of breath may be a symptom of both pulmonary and cardiac injury. SARS-CoV-2 infection may also directly or indirectly cause injury to the central nervous system.
The studies suggesting that COVID-19 is associated with increased risk of chronic pulmonary, cardiac, and neurological injury are so far mainly based on hospitalized patients with limited objective information concerning the health status prior to COVID-19, making interpretation of the contribution of COVID-19 versus pre-existing disease to the observed pathology difficult. Moreover, information derived from the general population is limited.
To overcome these limitations and to accurately assess the long-term cardiac, pulmonary and neurological consequences of COVID-19, not only in hospitalized patient, but also in the general population, the current study will be based on longitudinal follow-up of different groups, such as hospitalized patients with confirmed COVID-19, community-dwelling individuals who tested positive for SARS-CoV-2, and individuals drawn from large population-based studies who have previously undergone extensive pulmonary, cardiovascular, cognitive and neuropsychological testing.
Given that COVID-19 is a new disease, data on how to treat adverse long-term effects associated with COVID-19 are sparse. Accordingly, we will test different potential therapeutic approaches, including biological, psychological and exercise-based interventions.
Long-term effects and sequelae of SARS-CoV-2 infection have become increasingly recognized. Acute lung damage may be followed by pulmonary fibrosis and chronic impairment of lung function. COVID-19 may be associated with increased risk of chronic myocardial and vascular injury, and persistent dyspnea may be a symptom of both pulmonary and cardiovascular injury. SARS-CoV-2 infection may also involve the CNS and directly or indirectly via immunological mechanisms lead to long-term sequelae. The studies suggesting that COVID-19 is associated with increased risk of chronic pulmonary, cardiovascular, and CNS injury are so far mainly based on retrospective analyses of convenience cohorts of hospitalized patients. Information derived from community-based cohorts is limited and based on cross-sectional data collection, making interpretation of the contribution of COVID-19 versus pre-existing disease to the observed pathology difficult. To overcome these limitations and to accurately assess the long-term cardio-pulmonary and CNS consequences of COVID-19, not only in hospitalized patient, but also in the general population, the current proposal will be based on prospective, longitudinal follow-up of complementary cohorts, i.e. hospitalized patients with confirmed COVID-19, community-dwelling individuals who tested positive for SARS-CoV-2, and individuals drawn from large population-based cohort studies who have previously undergone extensive pulmonary, cardiovascular, cognitive and neuropsychological phenotyping. Given that COVID-19 is a new disease, data on how to treat adverse long-term effects associated with COVID-19 are lacking. Accordingly, we will perform two separate randomized controlled trials testing three different interventions. The most critical challenges to be faced relate to the evolvement of the pandemic. Our principal efforts to mitigate this risk are efficient procedures for patient recruitment and collection of baseline data before widespread vaccination.