ObjectivesThe epidemiology of post-COVID syndrome ( PCS MESHD
) is currently undefined. We quantified rates of organ-specific impairment following recovery from COVID-19 MESHD
hospitalisation compared with those in a matched control group, and how the rate ratio (RR) varies by age, sex, and ethnicity.
DesignObservational, retrospective, matched cohort study.
SettingNHS hospitals in England.
Participants47,780 individuals (mean age 65 years, 55% male) in hospital with COVID-19 MESHD
and discharged alive by 31 August 2020, matched to controls on demographic and clinical characteristics.
Outcome measuresRates of hospital readmission, all-cause mortality, and diagnoses of respiratory, cardiovascular, metabolic, kidney and liver diseases MESHD
until 30 September 2020.
ResultsMean follow-up time was 140 days for COVID-19 MESHD
cases and 153 days for controls. 766 (95% confidence interval: 753 to 779) readmissions and 320 (312 to 328) deaths per 1,000 person-years were observed in COVID-19 MESHD
cases, 3.5 (3.4 to 3.6) and 7.7 (7.2 to 8.3) times greater, respectively, than in controls. Rates of respiratory, diabetes MESHD
and cardiovascular events were also significantly elevated in COVID-19 MESHD
cases, at 770 (758 to 783), 127 (122 to 132) and 126 (121 to 131) events per 1,000 person-years, respectively. RRs were greater for individuals aged <70 than [≥] 70 years, and in ethnic minority groups than the White population, with the biggest differences observed for respiratory disease MESHD
: 10.5 [9.7 to 11.4] for <70 years versus 4.6 [4.3 to 4.8] for [≥] 70 years, and 11.4 (9.8 to 13.3) for Non-White versus 5.2 (5.0 to 5.5) for White.
ConclusionsIndividuals discharged from hospital following COVID-19 MESHD
face elevated rates of multi-organ dysfunction compared with background levels, and the increase in risk is neither confined to the elderly nor uniform across ethnicities. The diagnosis, treatment and prevention of PCS require integrated rather than organ- or disease-specific approaches. Urgent research is required to establish risk factors for PCS.