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Semple has studied severe virus disease outbreaks since 1989 in the field of diagnostics, clinical characterization and clinical trials. He was a founder member of ISARIC. He has led studies of COVID-19, MERS, Monkeypox, Ebola (EVD and Survivors), Influenza and Bronchiolitis, at times field-deployed in austere circumstances. He is a Senior Government Clinical Advisor siting on the Scientific Advisory Group for Emergencies (COVID-19 response) and the New Emerging Respiratory Viral Treats Advisory Group (NERVTAG), and former member of the WHO Scientific Technical Advisory Committee for Ebola Emergencies (STAC-EE), Gov.UK Pandemic Flu group. He was appointed Honorary Respiratory Physician at Alder Hey Children’s Hospital Liverpool in 2006. In 2016 he and his team were awarded the Queen’s Ebola Medal for Service in West Africa 2014-16 and in 2019 he received a Commonwealth Association Award for subsequent work with Ebola survivors in Sierra Leone.
Immunoglobulin gene heterogeneity reflects the diversity and focus of the humoral immune response towards different infections, enabling inference of B cell development processes. Detailed compositional and lineage analysis of long read IGH repertoire sequencing, combining examples of pandemic, epidemic and endemic viral infections with control and vaccination samples, demonstrates general responses including increased use of IGHV4-39 in both EBOV and COVID-19 infection cohorts. We also show unique characteristics absent in RSV infection or yellow fever vaccine samples: EBOV survivors show unprecedented high levels of class switching events while COVID-19 repertoires from acute disease appear underdeveloped. Despite the high levels of clonal expansion in COVID-19 IgG1 repertoires there is a striking lack of evidence of germinal centre mutation and selection. Given the differences in COVID-19 morbidity and mortality with age, it is also pertinent that we find significant differences in repertoire characteristics between young and old patients. Our data supports the hypothesis that a primary viral challenge can result in a strong but immature humoral response where failures in selection of the repertoire risks off-target effects.
Alexander Stewart; Emma Sinclair; Joseph Ng; Joselli Silvia O’Hare; Audrey Page; Ilaria Serangeli; Christian Margreitter; Nora Kasar; Katherine Longman; Cecile Frampas; Catia Costa; Holly Lewis; Bryan Wu; David Kipling; Peter Openshaw; Christopher Chu; J Kenneth Baillie; Janet T Scott; Malcolm G Semple; Melanie Bailey; Franca Fraternali; Deborah Dunn-Walters. Pandemic, epidemic, endemic: B cell repertoire analysis reveals unique anti-viral responses to SARS-CoV-2, Ebola and Respiratory Syncytial Virus. 2021, 1 .
AMA StyleAlexander Stewart, Emma Sinclair, Joseph Ng, Joselli Silvia O’Hare, Audrey Page, Ilaria Serangeli, Christian Margreitter, Nora Kasar, Katherine Longman, Cecile Frampas, Catia Costa, Holly Lewis, Bryan Wu, David Kipling, Peter Openshaw, Christopher Chu, J Kenneth Baillie, Janet T Scott, Malcolm G Semple, Melanie Bailey, Franca Fraternali, Deborah Dunn-Walters. Pandemic, epidemic, endemic: B cell repertoire analysis reveals unique anti-viral responses to SARS-CoV-2, Ebola and Respiratory Syncytial Virus. . 2021; ():1.
Chicago/Turabian StyleAlexander Stewart; Emma Sinclair; Joseph Ng; Joselli Silvia O’Hare; Audrey Page; Ilaria Serangeli; Christian Margreitter; Nora Kasar; Katherine Longman; Cecile Frampas; Catia Costa; Holly Lewis; Bryan Wu; David Kipling; Peter Openshaw; Christopher Chu; J Kenneth Baillie; Janet T Scott; Malcolm G Semple; Melanie Bailey; Franca Fraternali; Deborah Dunn-Walters. 2021. "Pandemic, epidemic, endemic: B cell repertoire analysis reveals unique anti-viral responses to SARS-CoV-2, Ebola and Respiratory Syncytial Virus." , no. : 1.
This study sought to establish the long-term effects of Covid-19 following hospitalisation. 327 hospitalised participants, with SARS-CoV-2 infection were recruited into a prospective multicentre cohort study at least 3 months post-discharge. The primary outcome was self-reported recovery at least ninety days after initial Covid-19 symptom onset. Secondary outcomes included new symptoms, disability (Washington group short scale), breathlessness (MRC Dyspnoea scale) and quality of life (EQ5D-5L). 55% of participants reported not feeling fully recovered. 93% reported persistent symptoms, with fatigue the most common (83%), followed by breathlessness (54%). 47% reported an increase in MRC dyspnoea scale of at least one grade. New or worse disability was reported by 24% of participants. The EQ5D-5L summary index was significantly worse following acute illness (median difference 0.1 points on a scale of 0 to 1, IQR: -0.2 to 0.0). Females under the age of 50 years were five times less likely to report feeling recovered (adjusted OR 5.09, 95% CI 1.64 to 15.74), were more likely to have greater disability (adjusted OR 4.22, 95% CI 1.12 to 15.94), twice as likely to report worse fatigue (adjusted OR 2.06, 95% CI 0.81 to 3.31) and seven times more likely to become more breathless (adjusted OR 7.15, 95% CI 2.24 to 22.83) than men of the same age. Survivors of Covid-19 experienced long-term symptoms, new disability, increased breathlessness, and reduced quality of life. These findings were present in young, previously healthy working age adults, and were most common in younger females. National Institute for Health Research, UK Medical Research Council, Wellcome Trust, Department for International Development and the Bill and Melinda Gates Foundation.
Louise Sigfrid; Thomas M. Drake; Ellen Pauley; Edwin C. Jesudason; Piero Olliaro; Wei Shen Lim; Annelies Gillesen; Colin Berry; David J. Lowe; Joanne McPeake; Nazir Lone; Daniel Munblit; Muge Cevik; Anna Casey; Peter Bannister; Clark D. Russell; Lynsey Goodwin; Antonia Ho; Lance Turtle; Margaret E. O'Hara; Claire Hastie; Chloe Donohue; Rebecca G. Spencer; Cara Donegan; Alison Gummery; Janet Harrison; Hayley E. Hardwick; Gail Carson; Laura Merson; J. Kenneth Baillie; Peter Openshaw; Ewen M. Harrison; Annemarie B. Docherty; Malcolm G. Semple; Janet T. Scott. Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol. The Lancet Regional Health - Europe 2021, 100186 .
AMA StyleLouise Sigfrid, Thomas M. Drake, Ellen Pauley, Edwin C. Jesudason, Piero Olliaro, Wei Shen Lim, Annelies Gillesen, Colin Berry, David J. Lowe, Joanne McPeake, Nazir Lone, Daniel Munblit, Muge Cevik, Anna Casey, Peter Bannister, Clark D. Russell, Lynsey Goodwin, Antonia Ho, Lance Turtle, Margaret E. O'Hara, Claire Hastie, Chloe Donohue, Rebecca G. Spencer, Cara Donegan, Alison Gummery, Janet Harrison, Hayley E. Hardwick, Gail Carson, Laura Merson, J. Kenneth Baillie, Peter Openshaw, Ewen M. Harrison, Annemarie B. Docherty, Malcolm G. Semple, Janet T. Scott. Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol. The Lancet Regional Health - Europe. 2021; ():100186.
Chicago/Turabian StyleLouise Sigfrid; Thomas M. Drake; Ellen Pauley; Edwin C. Jesudason; Piero Olliaro; Wei Shen Lim; Annelies Gillesen; Colin Berry; David J. Lowe; Joanne McPeake; Nazir Lone; Daniel Munblit; Muge Cevik; Anna Casey; Peter Bannister; Clark D. Russell; Lynsey Goodwin; Antonia Ho; Lance Turtle; Margaret E. O'Hara; Claire Hastie; Chloe Donohue; Rebecca G. Spencer; Cara Donegan; Alison Gummery; Janet Harrison; Hayley E. Hardwick; Gail Carson; Laura Merson; J. Kenneth Baillie; Peter Openshaw; Ewen M. Harrison; Annemarie B. Docherty; Malcolm G. Semple; Janet T. Scott. 2021. "Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol." The Lancet Regional Health - Europe , no. : 100186.
Background The long-term sequalae of COVID-19 remain poorly characterised. We assessed persistent symptoms in previously hospitalised patients with COVID-19 and assessed potential risk factors. Methods Data were collected from patients discharged from 4 hospitals in Moscow, Russia between April 8 and July 10, 2020. Participants were interviewed via telephone using an ISARIC Long-term Follow-up Study questionnaire. Results 2,649 of 4755 (56%) discharged patients were successfully evaluated, at median 218 (IQR 200, 236) days post-discharge. COVID-19 diagnosis was clinical in 1291 and molecular in 1358. Most cases were mild, but 902 (34%) required supplemental oxygen and 68 (2.6%) needed ventilatory support. Median age was 56 years (IQR 46, 66) and 1,353 (51.1%) were women. Persistent symptoms were reported by 1247 (47.1%) participants, with fatigue (21.2%), shortness of breath (14.5%) and forgetfulness (9.1%) the most common symptoms and chronic fatigue (25%) and respiratory (17.2%) the most common symptom categories. Female sex was associated with any persistent symptom category OR 1.83 (95% CI 1.55 to 2.17) with association being strongest for dermatological (3.26, 2.36 to 4.57) symptoms. Asthma and chronic pulmonary disease were not associated with persistent symptoms overall, but asthma was associated with neurological (1.95, 1.25 to 2.98) and mood and behavioural changes (2.02, 1.24 to 3.18), and chronic pulmonary disease was associated with chronic fatigue (1.68, 1.21 to 2.32). Conclusions Almost half of adults admitted to hospital due to COVID-19 reported persistent symptoms 6 to 8 months after discharge. Fatigue and respiratory symptoms were most common, and female sex was associated with persistent symptoms.
Daniel Munblit; Polina Bobkova; Ekaterina Spiridonova; Anastasia Shikhaleva; Aysylu Gamirova; Oleg Blyuss; Nikita Nekliudov; Polina Bugaeva; Margarita Andreeva; Audrey DunnGalvin; Pasquale Comberiati; Christian Apfelbacher; Jon Genuneit; Sergey Avdeev; Valentina Kapustina; Alla Guekht; Victor Fomin; Andrey A Svistunov; Peter Timashev; Vladislav S Subbot; Valery V Royuk; Thomas M Drake; Sarah Wulf Hanson; Laura Merson; Gail Carson; Peter Horby; Louise Sigfrid; Janet T Scott; Malcolm G Semple; John O Warner; Theo Vos; Piero Olliaro; Petr Glybochko; Denis Butnaru; Elina Abdeeva; Nikol Alekseeva; Elena Antsiferova; Elena Artigas; Anastasiia Bairashevskaia; Anna Belkina; Vadim Bezrukov; Semyon Bordyugov; Maria Bratukhina; Jessica Chen; Salima Deunezhewa; Khalisa Elifkhanova; Anastasia Ezhova; Yulia Filippova; Aleksandra Frolova; Julia Ganieva; Anastasia Gorina; Yulia Kalan; Bogdan Kirillov; Mariia Korgunova; Alexandra Krupina; Anna Kuznetsova; Ekaterina Listovskaia; Margarita Mikheeva; Aigun Mursalova; Marina Ogandzhanova; Callum Parr; Mikhail Rumyantsev; Denis Smirnov; Nataliya Shishkina; Yasmin El‐Taravi; Maria Varaksina; Maria Vodianova; Anna Zezyulina; Sechenov StopCOVID Research Team. Incidence and risk factors for persistent symptoms in adults previously hospitalised for COVID‐19. Clinical & Experimental Allergy 2021, 1 .
AMA StyleDaniel Munblit, Polina Bobkova, Ekaterina Spiridonova, Anastasia Shikhaleva, Aysylu Gamirova, Oleg Blyuss, Nikita Nekliudov, Polina Bugaeva, Margarita Andreeva, Audrey DunnGalvin, Pasquale Comberiati, Christian Apfelbacher, Jon Genuneit, Sergey Avdeev, Valentina Kapustina, Alla Guekht, Victor Fomin, Andrey A Svistunov, Peter Timashev, Vladislav S Subbot, Valery V Royuk, Thomas M Drake, Sarah Wulf Hanson, Laura Merson, Gail Carson, Peter Horby, Louise Sigfrid, Janet T Scott, Malcolm G Semple, John O Warner, Theo Vos, Piero Olliaro, Petr Glybochko, Denis Butnaru, Elina Abdeeva, Nikol Alekseeva, Elena Antsiferova, Elena Artigas, Anastasiia Bairashevskaia, Anna Belkina, Vadim Bezrukov, Semyon Bordyugov, Maria Bratukhina, Jessica Chen, Salima Deunezhewa, Khalisa Elifkhanova, Anastasia Ezhova, Yulia Filippova, Aleksandra Frolova, Julia Ganieva, Anastasia Gorina, Yulia Kalan, Bogdan Kirillov, Mariia Korgunova, Alexandra Krupina, Anna Kuznetsova, Ekaterina Listovskaia, Margarita Mikheeva, Aigun Mursalova, Marina Ogandzhanova, Callum Parr, Mikhail Rumyantsev, Denis Smirnov, Nataliya Shishkina, Yasmin El‐Taravi, Maria Varaksina, Maria Vodianova, Anna Zezyulina, Sechenov StopCOVID Research Team. Incidence and risk factors for persistent symptoms in adults previously hospitalised for COVID‐19. Clinical & Experimental Allergy. 2021; ():1.
Chicago/Turabian StyleDaniel Munblit; Polina Bobkova; Ekaterina Spiridonova; Anastasia Shikhaleva; Aysylu Gamirova; Oleg Blyuss; Nikita Nekliudov; Polina Bugaeva; Margarita Andreeva; Audrey DunnGalvin; Pasquale Comberiati; Christian Apfelbacher; Jon Genuneit; Sergey Avdeev; Valentina Kapustina; Alla Guekht; Victor Fomin; Andrey A Svistunov; Peter Timashev; Vladislav S Subbot; Valery V Royuk; Thomas M Drake; Sarah Wulf Hanson; Laura Merson; Gail Carson; Peter Horby; Louise Sigfrid; Janet T Scott; Malcolm G Semple; John O Warner; Theo Vos; Piero Olliaro; Petr Glybochko; Denis Butnaru; Elina Abdeeva; Nikol Alekseeva; Elena Antsiferova; Elena Artigas; Anastasiia Bairashevskaia; Anna Belkina; Vadim Bezrukov; Semyon Bordyugov; Maria Bratukhina; Jessica Chen; Salima Deunezhewa; Khalisa Elifkhanova; Anastasia Ezhova; Yulia Filippova; Aleksandra Frolova; Julia Ganieva; Anastasia Gorina; Yulia Kalan; Bogdan Kirillov; Mariia Korgunova; Alexandra Krupina; Anna Kuznetsova; Ekaterina Listovskaia; Margarita Mikheeva; Aigun Mursalova; Marina Ogandzhanova; Callum Parr; Mikhail Rumyantsev; Denis Smirnov; Nataliya Shishkina; Yasmin El‐Taravi; Maria Varaksina; Maria Vodianova; Anna Zezyulina; Sechenov StopCOVID Research Team. 2021. "Incidence and risk factors for persistent symptoms in adults previously hospitalised for COVID‐19." Clinical & Experimental Allergy , no. : 1.
Background Although age, obesity and pre-existing chronic diseases are established risk factors for COVID-19 outcomes, their interactions have not been well researched. Methods We used data from the Clinical Characterisation Protocol UK (CCP-UK) for Severe Emerging Infection developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC). Patients admitted to hospital with COVID-19 from 6th February to 12th October 2020 were included where there was a coded outcome following hospital admission. Obesity was determined by an assessment from a clinician and chronic disease by medical records. Chronic diseases included: chronic cardiac disease, hypertension, chronic kidney disease, chronic pulmonary disease, diabetes and cancer. Mutually exclusive categories of obesity, with or without chronic disease, were created. Associations with in-hospital mortality were examined across sex and age categories. Results The analysis included 27,624 women with 6407 (23.2%) in-hospital deaths and 35,065 men with 10,001 (28.5%) in-hospital deaths. The prevalence of chronic disease in women and men was 66.3 and 68.5%, respectively, while that of obesity was 12.9 and 11.1%, respectively. Association of obesity and chronic disease status varied by age (p < 0.001). Under 50 years of age, obesity and chronic disease were associated with in-hospital mortality within 28 days of admission in a dose-response manner, such that patients with both obesity and chronic disease had the highest risk with a hazard ratio (HR) of in-hospital mortality of 2.99 (95% CI: 2.12, 4.21) in men and 2.16 (1.42, 3.26) in women compared to patients without obesity or chronic disease. Between the ages of 50–69 years, obesity and chronic disease remained associated with in-hospital COVID-19 mortality, but survival in those with obesity was similar to those with and without prevalent chronic disease. Beyond the age of 70 years in men and 80 years in women there was no meaningful difference between those with and without obesity and/or chronic disease. Conclusion Obesity and chronic disease are important risk factors for in-hospital mortality in younger age groups, with the combination of chronic disease and obesity being particularly important in those under 50 years of age. These findings have implications for targeted public health interventions, vaccination strategies and in-hospital clinical decision making.
Thomas Yates; Francesco Zaccardi; Nazrul Islam; Cameron Razieh; Clare L. Gillies; Claire A. Lawson; Yogini Chudasama; Alex Rowlands; Melanie J. Davies; Annemarie B. Docherty; Peter J. M. Openshaw; J. Kenneth Baillie; Malcolm G. Semple; Kamlesh Khunti. Obesity, chronic disease, age, and in-hospital mortality in patients with covid-19: analysis of ISARIC clinical characterisation protocol UK cohort. BMC Infectious Diseases 2021, 21, 1 -9.
AMA StyleThomas Yates, Francesco Zaccardi, Nazrul Islam, Cameron Razieh, Clare L. Gillies, Claire A. Lawson, Yogini Chudasama, Alex Rowlands, Melanie J. Davies, Annemarie B. Docherty, Peter J. M. Openshaw, J. Kenneth Baillie, Malcolm G. Semple, Kamlesh Khunti. Obesity, chronic disease, age, and in-hospital mortality in patients with covid-19: analysis of ISARIC clinical characterisation protocol UK cohort. BMC Infectious Diseases. 2021; 21 (1):1-9.
Chicago/Turabian StyleThomas Yates; Francesco Zaccardi; Nazrul Islam; Cameron Razieh; Clare L. Gillies; Claire A. Lawson; Yogini Chudasama; Alex Rowlands; Melanie J. Davies; Annemarie B. Docherty; Peter J. M. Openshaw; J. Kenneth Baillie; Malcolm G. Semple; Kamlesh Khunti. 2021. "Obesity, chronic disease, age, and in-hospital mortality in patients with covid-19: analysis of ISARIC clinical characterisation protocol UK cohort." BMC Infectious Diseases 21, no. 1: 1-9.
Background Continuous positive airways pressure (CPAP) and high-flow nasal oxygen (HFNO) are considered ‘aerosol-generating procedures’ (AGPs) in the treatment of COVID-19. We aimed to measure air and surface environmental contamination of SARS-CoV-2 virus when CPAP and HFNO were used, compared with supplemental oxygen, to investigate the potential risks of viral transmission to healthcare workers and patients. Methods 30 hospitalised patients with COVID-19 requiring supplemental oxygen, with a fraction of inspired oxygen ≥0.4 to maintain oxygen saturations ≥94%, were prospectively enrolled into an observational environmental sampling study. Participants received either supplemental oxygen, CPAP or HFNO (n=10 in each group). A nasopharyngeal swab, three air and three surface samples were collected from each participant and the clinical environment. RT qPCR analyses were performed for viral and human RNA, and positive/suspected-positive samples were cultured for the presence of biologically viable virus. Results Overall 21/30 (70%) of participants tested positive for SARS-CoV-2 RNA in the nasopharynx. In contrast, only 4/90 (4%) and 6/90 (7%) of all air and surface samples tested positive (positive for E and ORF1a) for viral RNA respectively, although there were an additional 10 suspected-positive samples in both air and surfaces samples (positive for E or ORF1a). CPAP/HFNO use or coughing was not associated with significantly more environmental contamination. Only one nasopharyngeal sample was culture positive. Conclusions The use of CPAP and HFNO to treat moderate/severe COVID-19 was not associated with significantly higher levels of air or surface viral contamination in the immediate care environment.
Rl Winslow; J Zhou; Ef Windle; I Nur; R Lall; C Ji; Je Millar; P Dark; J Naisbitt; A Simonds; J Dunning; W Barclay; K Baillie; Gd Perkins; Mg Semple; Df McAuley; Ca Green. SARS-CoV-2 environmental contamination from hospitalised COVID-19 patients receiving aerosol generating procedures. 2021, 1 .
AMA StyleRl Winslow, J Zhou, Ef Windle, I Nur, R Lall, C Ji, Je Millar, P Dark, J Naisbitt, A Simonds, J Dunning, W Barclay, K Baillie, Gd Perkins, Mg Semple, Df McAuley, Ca Green. SARS-CoV-2 environmental contamination from hospitalised COVID-19 patients receiving aerosol generating procedures. . 2021; ():1.
Chicago/Turabian StyleRl Winslow; J Zhou; Ef Windle; I Nur; R Lall; C Ji; Je Millar; P Dark; J Naisbitt; A Simonds; J Dunning; W Barclay; K Baillie; Gd Perkins; Mg Semple; Df McAuley; Ca Green. 2021. "SARS-CoV-2 environmental contamination from hospitalised COVID-19 patients receiving aerosol generating procedures." , no. : 1.
Background The COVID-19 pandemic created the need for very large scale, rapid testing to prevent and contain transmission of the SARS-CoV-2 virus. Lateral flow device (LFD) immunoassays meet this need by indicating the presence of SARS-CoV-2 antigen from nose/throat swab washings in 30 minutes without laboratory processing, and can be manufactured quickly at low cost. Since March 2021, UK schools have asked pupils without symptoms to test twice weekly. Pupils have posted on social media about using soft drinks to create positive results. The aim of this study was to systematically test a variety soft drinks to determine whether they can cause false false positive LFD results. Methods This study used 14 soft drinks and 4 artificial sweeteners to determine the outcome of misusing them as analyte for the Innova SARS-CoV-2 antigen rapid qualitative LFD. The pH value, sugar content and ingredients of each sample are described. The LFD results were double read and a subset was repeated using the same devices and fake analytes but differently sourced. Findings One sample (1/14; 7%), spring water, produced a negative result. Ten drinks (10/14; 71%) produced a positive or weakly positive result. Three samples (3/14; 21%) produced void results, mostly the fruit concentrate drinks. There was no apparent correlation between the pH value (pH 5.0 in 13/14, 93%; pH 6.5 in 1/14; 7%) or the sugar content (range 0-10.7 grams per 100mls) of the drinks and their LFD result. The 4 artificial sweeteners all produced negative results. A subset of the results was fully replicated with differently sourced materials. Interpretation Several soft drinks can be misused to give false positive SARS-CoV-2 LFD results. Daily LFD testing should be performed first thing in the morning, prior to the consumption of any food or drinks, and supervised where feasible. Funding This work was self-funded by author LO and the LFD were gifted for use in this study.
Louise Oni; Daniel Hawcutt; Iain Buchan; Malcom G Semple. Soft drinks can be misused to give false false positive SARS-CoV-2 lateral flow device results. 2021, 1 .
AMA StyleLouise Oni, Daniel Hawcutt, Iain Buchan, Malcom G Semple. Soft drinks can be misused to give false false positive SARS-CoV-2 lateral flow device results. . 2021; ():1.
Chicago/Turabian StyleLouise Oni; Daniel Hawcutt; Iain Buchan; Malcom G Semple. 2021. "Soft drinks can be misused to give false false positive SARS-CoV-2 lateral flow device results." , no. : 1.
Background The long-term sequelae of coronavirus disease 2019 (Covid-19) in children remain poorly characterised. This study aimed to assess long-term outcomes in children previously hospitalised with Covid-19 and associated risk factors. Methods This is a prospective cohort study of children (≤18 years old) admitted with confirmed Covid-19. Children admitted to the hospital between April 2, 2020 and August 26, 2020, were included. Telephone interview using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Covid-19 Health and Wellbeing paediatric follow-up survey. Persistent symptoms (>5 months) were further categorised by system(s) involved. Findings 518 of 853 (61%) of eligible children were available for the follow-up assessment and included in the study. Median age was 10.4 years (IQR, 3–15.2) and 270 (52.1%) were girls; median follow-up since hospital discharge was 256 (223–271) days. At the time of the follow-up interview 126 (24.3%) participants reported persistent symptoms among which fatigue (53, 10.7%), sleep disturbance (36, 6.9%,) and sensory problems (29, 5.6%) were the most common. Multiple symptoms were experienced by 44 (8.4%) participants. Risk factors for persistent symptoms were: older age “6–11 years” (odds ratio 2.74 (95% confidence interval 1.37 to 5.75) and “12–18 years” (2.68, 1.41 to 5.4); and a history of allergic diseases (1.67, 1.04 to 2.67). Interpretation A quarter of children experienced persistent symptoms months after hospitalization with acute covid-19 infection, with almost one in ten experiencing multi-system involvement. Older age and allergic diseases were associated with higher risk of persistent symptoms at follow-up.
Ismail M Osmanov; Ekaterina Spiridonova; Polina Bobkova; Aysylu Gamirova; Anastasia Shikhaleva; Margarita Andreeva; Oleg Blyuss; Yasmin El-Taravi; Audrey DunnGalvin; Pasquale Comberiati; Diego G Peroni; Christian Apfelbacher; Jon Genuneit; Lyudmila Mazankova; Alexandra Miroshina; Evgeniya Chistyakova; Elmira Samitova; Svetlana Borzakova; Elena Bondarenko; Anatoliy A Korsunskiy; Irina Konova; Sarah Wulf Hanson; Gail Carson; Louise Sigfrid; Janet T Scott; Matthew Greenhawt; Elizabeth A Whittaker; Elena Garralda; Olivia Swann; Danilo Buonsenso; Dasha E Nicholls; Frances Simpson; Christina Jones; Malcolm G Semple; John O Warner; Theo Vos; Piero Olliaro; Daniel Munblit. Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study. European Respiratory Journal 2021, 2101341 .
AMA StyleIsmail M Osmanov, Ekaterina Spiridonova, Polina Bobkova, Aysylu Gamirova, Anastasia Shikhaleva, Margarita Andreeva, Oleg Blyuss, Yasmin El-Taravi, Audrey DunnGalvin, Pasquale Comberiati, Diego G Peroni, Christian Apfelbacher, Jon Genuneit, Lyudmila Mazankova, Alexandra Miroshina, Evgeniya Chistyakova, Elmira Samitova, Svetlana Borzakova, Elena Bondarenko, Anatoliy A Korsunskiy, Irina Konova, Sarah Wulf Hanson, Gail Carson, Louise Sigfrid, Janet T Scott, Matthew Greenhawt, Elizabeth A Whittaker, Elena Garralda, Olivia Swann, Danilo Buonsenso, Dasha E Nicholls, Frances Simpson, Christina Jones, Malcolm G Semple, John O Warner, Theo Vos, Piero Olliaro, Daniel Munblit. Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study. European Respiratory Journal. 2021; ():2101341.
Chicago/Turabian StyleIsmail M Osmanov; Ekaterina Spiridonova; Polina Bobkova; Aysylu Gamirova; Anastasia Shikhaleva; Margarita Andreeva; Oleg Blyuss; Yasmin El-Taravi; Audrey DunnGalvin; Pasquale Comberiati; Diego G Peroni; Christian Apfelbacher; Jon Genuneit; Lyudmila Mazankova; Alexandra Miroshina; Evgeniya Chistyakova; Elmira Samitova; Svetlana Borzakova; Elena Bondarenko; Anatoliy A Korsunskiy; Irina Konova; Sarah Wulf Hanson; Gail Carson; Louise Sigfrid; Janet T Scott; Matthew Greenhawt; Elizabeth A Whittaker; Elena Garralda; Olivia Swann; Danilo Buonsenso; Dasha E Nicholls; Frances Simpson; Christina Jones; Malcolm G Semple; John O Warner; Theo Vos; Piero Olliaro; Daniel Munblit. 2021. "Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study." European Respiratory Journal , no. : 2101341.
Background We aimed to compare the prevalence and severity of fatigue in survivors of Covid-19 versus non-Covid-19 critical illness, and to explore potential associations between baseline characteristics and worse recovery. Methods We conducted a secondary analysis of two prospectively collected datasets. The population included was 92 patients who received invasive mechanical ventilation (IMV) with Covid-19, and 240 patients who received IMV with non-Covid-19 illness before the pandemic. Follow-up data was collected post-hospital discharge using self-reported questionnaires. The main outcome measures were self-reported fatigue severity and the prevalence of severe fatigue (severity >7/10) 3 and 12-months post-hospital discharge. Results Covid-19 IMV-patients were significantly younger with less prior comorbidity, and more males, than pre-pandemic IMV-patients. At 3-months, the prevalence (38.9% [7/18] vs. 27.1% [51/188]) and severity (median 5.5/10 vs. 5.0/10) of fatigue was similar between the Covid-19 and pre-pandemic populations respectively. At 6-months, the prevalence (10.3% [3/29] vs. 32.5% [54/166]) and severity (median 2.0/10 vs. 5.7/10) of fatigue was less in the Covid-19 cohort. In the Covid-19 population, women under 50 experienced more severe fatigue, breathlessness, and worse overall health state compared to other Covid-19 IMV-patients. There were no significant sex differences in long-term outcomes in the pre-pandemic population. In the total sample of IMV-patients included (i.e. all Covid-19 and pre-pandemic patients), having Covid-19 was significantly associated with less severe fatigue (severity <7/10) after adjusting for age, sex, and prior comorbidity (adjusted OR 0.35 (95%CI 0.15-0.76, p=0.01). Conclusion. Fatigue may be less severe after Covid-19 than after other critical illness.
Ellen E Pauley; Thomas M Drake; David M Griffith; Nazir I Lone; Ewen M Harrison; J Kenneth Baillie; Janet T Scott; Timothy S Walsh; Malcolm G Semple; Annemarie B Docherty. Recovery from Covid-19 critical illness: a secondary analysis of the ISARIC4C CCP-UK cohort study and the RECOVER trial. 2021, 1 .
AMA StyleEllen E Pauley, Thomas M Drake, David M Griffith, Nazir I Lone, Ewen M Harrison, J Kenneth Baillie, Janet T Scott, Timothy S Walsh, Malcolm G Semple, Annemarie B Docherty. Recovery from Covid-19 critical illness: a secondary analysis of the ISARIC4C CCP-UK cohort study and the RECOVER trial. . 2021; ():1.
Chicago/Turabian StyleEllen E Pauley; Thomas M Drake; David M Griffith; Nazir I Lone; Ewen M Harrison; J Kenneth Baillie; Janet T Scott; Timothy S Walsh; Malcolm G Semple; Annemarie B Docherty. 2021. "Recovery from Covid-19 critical illness: a secondary analysis of the ISARIC4C CCP-UK cohort study and the RECOVER trial." , no. : 1.
Background Remdesivir was given UK early-access approval for use in COVID-19 in people aged 12 years and older on 26th May 2020 on the basis of unmet clinical need. Evidence on the side effects, complications of therapy and effectiveness of this therapy is lacking or conflicting. Methods Adults with severe COVID-19 treated with remdesivir were compared with propensity-score matched controls, identified from the ISARIC WHO Clinical Characterisation Protocol study of UK hospitalised patients with COVID-19. Remdesivir patients were matched to controls according to baseline underlying 14-day mortality risk. The effect of remdesivir on short-term outcomes was investigated (primary outcome: 14-day mortality). Effect sizes were estimated and adjusted for potential confounders using multivariable modelling. Results 1,549 patients given remdesivir and 4,964 matched controls were identified satisfying inclusion and exclusion criteria. The balance diagnostic threshold was achieved. Patients had symptoms for a median of 6 days prior to baseline; 62% were male, with mean (SD) age 63.1 (15.6) years, and 80% categorised as White ethnicity. Fourteen-day mortality was not statistically significantly associated with treatment (9.3% remdesivir vs. 11.9% controls, odds-ratio 0.80, [95% CI 0.60-1.07], p=0.116, adjusted for age, sex, number of key comorbidities, dexamethasone use, and diagnosis of viral pneumonia. Findings Treatment with remdesivir was not associated with a reduction in mortality in our primary endpoint at 14 days. Interpretation Remdesivir did not significantly improve mortality in this study. The findings are subject to the limitations of an observational study. Balance was achieved for measured baseline factors, but unmeasured confounders may account for observed treatment effect sizes. Funding Medical Research Council UK & National Institute of Health Research
Barbara N Arch; Dorottya Kovacs; Janet T Scott; Ashley P Jones; Ewen M Harrison; Anna Rosala-Hallas; Carrol G Gamble; Peter Jm Openshaw; J Kenneth Baillie; Malcolm Gracie Semple. Evaluation of the effectiveness of remdesivir in treating severe COVID-19 using data from the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, national cohort study. 2021, 1 .
AMA StyleBarbara N Arch, Dorottya Kovacs, Janet T Scott, Ashley P Jones, Ewen M Harrison, Anna Rosala-Hallas, Carrol G Gamble, Peter Jm Openshaw, J Kenneth Baillie, Malcolm Gracie Semple. Evaluation of the effectiveness of remdesivir in treating severe COVID-19 using data from the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, national cohort study. . 2021; ():1.
Chicago/Turabian StyleBarbara N Arch; Dorottya Kovacs; Janet T Scott; Ashley P Jones; Ewen M Harrison; Anna Rosala-Hallas; Carrol G Gamble; Peter Jm Openshaw; J Kenneth Baillie; Malcolm Gracie Semple. 2021. "Evaluation of the effectiveness of remdesivir in treating severe COVID-19 using data from the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, national cohort study." , no. : 1.
Population level data from 131 679 patients show that COVID-19 pneumothorax occurs in 0.97% of admitted patients, especially males and smokers, and is associated with increased mortality.
Stefan J. Marciniak; James Farrell; Anthony Rostron; Ian Smith; Peter J. M. Openshaw; J. Kenneth Baillie; Annemarie Docherty; Malcolm G. Semple. COVID-19 Pneumothorax in the United Kingdom: a prospective observational study using the ISARIC WHO clinical characterisation protocol. European Respiratory Journal 2021, 2100929 .
AMA StyleStefan J. Marciniak, James Farrell, Anthony Rostron, Ian Smith, Peter J. M. Openshaw, J. Kenneth Baillie, Annemarie Docherty, Malcolm G. Semple. COVID-19 Pneumothorax in the United Kingdom: a prospective observational study using the ISARIC WHO clinical characterisation protocol. European Respiratory Journal. 2021; ():2100929.
Chicago/Turabian StyleStefan J. Marciniak; James Farrell; Anthony Rostron; Ian Smith; Peter J. M. Openshaw; J. Kenneth Baillie; Annemarie Docherty; Malcolm G. Semple. 2021. "COVID-19 Pneumothorax in the United Kingdom: a prospective observational study using the ISARIC WHO clinical characterisation protocol." European Respiratory Journal , no. : 2100929.
Background: The COVID-19 pandemic has reinforced, amplified and created new health inequalities. There is less evidence on how COVID-19 prevalence varies by measures of work and occupation which represent a key social determinant of health. The aim of the study is to evaluate how occupational inequalities in the prevalence of COVID-19 varies across England and their possible explanatory factors. Methods: We used data for 363,651 individuals (2,178,835 observations) aged 18 years and over between 1st May 2020 and 31st January 2021 from the ONS Covid Infection Survey, a representative longitudinal survey of individuals in England. We focus on two measures of work; employment status for all adults, and work sector of individuals currently working. Multi-level binomial regression models were used to estimate the likelihood of testing positive of COVID-19, adjusting for known explanatory covariates. Results: 0.9% of participants tested positive for COVID-19 over the study period. COVID-19 prevalence was higher among adults who were students or furloughed (i.e., temporarily not working). Among adults currently working, COVID-19 prevalence was highest in adults employed in the hospitality sector, with higher prevalence for individuals employed in transport, social care, retail, health care and educational sectors. Inequalities by work were not consistent over time. Conclusions: We find an unequal distribution of infections relating to COVID-19 by work and employment status. Our findings demonstrate the need for greater workplace interventions to protect employees, but also that a large proportion of SARS-CoV-2 transmission occurs outside of work. In particular, populations who experienced social and economic harms through being furloughed were also more likely to experience a double burden of increased likelihood of COVID-19.
Mark A. Green; Malcolm G. Semple. Occupational inequalities in the prevalence of COVID-19: A longitudinal observational study of England, August 2020 to January 2021. 2021, 1 .
AMA StyleMark A. Green, Malcolm G. Semple. Occupational inequalities in the prevalence of COVID-19: A longitudinal observational study of England, August 2020 to January 2021. . 2021; ():1.
Chicago/Turabian StyleMark A. Green; Malcolm G. Semple. 2021. "Occupational inequalities in the prevalence of COVID-19: A longitudinal observational study of England, August 2020 to January 2021." , no. : 1.
Studies have repeatedly shown that children less frequently and less severely manifest acute COVID-19 infection1 However, as with the whole of the world population, children have been subjected to the direct and indirect effects of lockdowns, restricted education and social interactions, with potential lifelong impacts on mental and physical health.2
Daniel Munblit; Frances Simpson; Jeremy Mabbitt; Audrey Dunn-Galvin; Calum Semple; John O Warner. Legacy of COVID-19 infection in children: long-COVID will have a lifelong health/economic impact. Archives of Disease in Childhood 2021, 1 .
AMA StyleDaniel Munblit, Frances Simpson, Jeremy Mabbitt, Audrey Dunn-Galvin, Calum Semple, John O Warner. Legacy of COVID-19 infection in children: long-COVID will have a lifelong health/economic impact. Archives of Disease in Childhood. 2021; ():1.
Chicago/Turabian StyleDaniel Munblit; Frances Simpson; Jeremy Mabbitt; Audrey Dunn-Galvin; Calum Semple; John O Warner. 2021. "Legacy of COVID-19 infection in children: long-COVID will have a lifelong health/economic impact." Archives of Disease in Childhood , no. : 1.
Summary Treatment of severe COVID-19 is currently limited by clinical heterogeneity and incomplete understanding of potentially druggable immune mediators of disease. To advance this, we present a comprehensive multi-omic blood atlas in patients with varying COVID-19 severity and compare with influenza, sepsis and healthy volunteers. We identify immune signatures and correlates of host response. Hallmarks of disease severity revealed cells, their inflammatory mediators and networks as potential therapeutic targets, including progenitor cells and specific myeloid and lymphocyte subsets, features of the immune repertoire, acute phase response, metabolism and coagulation. Persisting immune activation involving AP-1/p38MAPK was a specific feature of COVID-19. The plasma proteome enabled sub-phenotyping into patient clusters, predictive of severity and outcome. Tensor and matrix decomposition of the overall dataset revealed feature groupings linked with disease severity and specificity. Our systems-based integrative approach and blood atlas will inform future drug development, clinical trial design and personalised medicine approaches for COVID-19.
COvid-19 Multi-omics Blood ATlas (COMBAT) Consortium; David J Ahern; Zhichao Ai; Mark Ainsworth; Chris Allan; Alice Allcock; Azim Ansari; Carolina V Arancibia-Carcamo; Dominik Aschenbrenner; Moustafa Attar; J. Kenneth Baillie; Eleanor Barnes; Rachael Bashford-Rogers; Archana Bashyal; Sally Beer; Georgina Berridge; Amy Beveridge; Sagida Bibi; Tihana Bicanic; Luke Blackwell; Paul Bowness; Andrew Brent; Andrew Brown; John Broxholme; David Buck; Katie L Burnham; Helen Byrne; Susana Camara; Ivan Candido Ferreira; Philip Charles; Wentao Chen; Yi-Ling Chen; Amanda Chong; Elizabeth Clutterbuck; Mark Coles; Christopher P Conlon; Richard Cornall; Adam P Cribbs; Fabiola Curion; Emma E Davenport; Neil Davidson; Simon Davis; Calliope Dendrou; Julie Dequaire; Lea Dib; James Docker; Christina Dold; Tao Dong; Damien Downes; Alexander Drakesmith; Susanna J Dunachie; David A Duncan; Chris Eijsbouts; Robert Esnouf; Alexis Espinosa; Rachel Etherington; Benjamin Fairfax; Rory Fairhead; Hai Fang; Shayan Fassih; Sally Felle; Maria Fernandez Mendoza; Ricardo Ferreira; Roman Fischer; Thomas Foord; Aden Forrow; John Frater; Anastasia Fries; Veronica Gallardo Sanchez; Lucy Garner; Clementine Geeves; Dominique Georgiou; Leila Godfrey; Tanya Golubchik; Maria Gomez Vazquez; Angie Green; Hong Harper; Heather A Harrington; Raphael Heilig; Svenja Hester; Jennifer Hill; Charles Hinds; Clare Hird; Ling-Pei Ho; Renee Hoekzema; Benjamin Hollis; Jim Hughes; Paula Hutton; Matthew Jackson; Ashwin Jainarayanan; Anna James-Bott; Kathrin Jansen; Katie Jeffery; Elizabeth Jones; Luke Jostins; Georgina Kerr; David Kim; Paul Klenerman; Julian C Knight; Vinod Kumar; Piyush Kumar Sharma; Prathiba Kurupati; Andrew Kwok; Angela Lee; Aline Linder; Teresa Lockett; Lorne Lonie; Maria Lopopolo; Martyna Lukoseviciute; Jian Luo; Spyridoula Marinou; Brian Marsden; Jose Martinez; Philippa Matthews; Michalina Mazurczyk; Simon McGowan; Stuart McKechnie; Adam Mead; Alexander J Mentzer; Yuxin Mi; Claudia Monaco; Ruddy Montadon; Giorgio Napolitani; Isar Nassiri; Alex Novak; Darragh O'Brien; Daniel O'Connor; Denise O'Donnell; Graham Ogg; Lauren Overend; Inhye Park; Ian Pavord; Yanchun Peng; Frank Penkava; Mariana Pereira Pinho; Elena Perez; Andrew J Pollard; Fiona Powrie; Bethan Psaila; T. Phuong Quan; Emmanouela Repapi; Santiago Revale; Laura Silva-Reyes; Jean-Baptiste Richard; Charlotte Rich-Griffin; Thomas Ritter; Christine S Rollier; Matthew Rowland; Fabian Ruehle; Mariolina Salio; Stephen N Sansom; Alberto Santos Delgado; Tatjana Sauka-Spengler; Ron Schwessinger; Giuseppe Scozzafava; Gavin Screaton; Anna Seigal; Malcolm G Semple; Martin Sergeant; Christina Simoglou Karali; David Sims; Donal Skelly; Hubert Slawinski; Alberto Sobrinodiaz; Nikolaos Sousos; Lizzie Stafford; Lisa Stockdale; Marie Strickland; Otto Sumray; Bo Sun; Chelsea Taylor; Stephen Taylor; Adan Taylor; Supat Thongjuea; Hannah Thraves; John A Todd; Adriana Tomic; Orion Tong; Amy Trebes; Dominik Trzupek; Felicia A Tucci; Lance Turtle; Irina Udalova; Holm Uhlig; Erinke van Grinsven; Iolanda Vendrell; Marije Verheul; Alexandru Voda; Guanlin Wang; Lihui Wang; Dapeng Wang; Peter Watkinson; Robert Watson; Michael Weinberger; Justin Whalley; Lorna Witty; Katherine Wray; Luzheng Xue; Hing Yuen Yeung; Zixi Yin; Rebecca K Young; Jonathan Youngs; Ping Zhang; Yasemin-Xiomara Zurke. A blood atlas of COVID-19 defines hallmarks of disease severity and specificity. 2021, 1 .
AMA StyleCOvid-19 Multi-omics Blood ATlas (COMBAT) Consortium, David J Ahern, Zhichao Ai, Mark Ainsworth, Chris Allan, Alice Allcock, Azim Ansari, Carolina V Arancibia-Carcamo, Dominik Aschenbrenner, Moustafa Attar, J. Kenneth Baillie, Eleanor Barnes, Rachael Bashford-Rogers, Archana Bashyal, Sally Beer, Georgina Berridge, Amy Beveridge, Sagida Bibi, Tihana Bicanic, Luke Blackwell, Paul Bowness, Andrew Brent, Andrew Brown, John Broxholme, David Buck, Katie L Burnham, Helen Byrne, Susana Camara, Ivan Candido Ferreira, Philip Charles, Wentao Chen, Yi-Ling Chen, Amanda Chong, Elizabeth Clutterbuck, Mark Coles, Christopher P Conlon, Richard Cornall, Adam P Cribbs, Fabiola Curion, Emma E Davenport, Neil Davidson, Simon Davis, Calliope Dendrou, Julie Dequaire, Lea Dib, James Docker, Christina Dold, Tao Dong, Damien Downes, Alexander Drakesmith, Susanna J Dunachie, David A Duncan, Chris Eijsbouts, Robert Esnouf, Alexis Espinosa, Rachel Etherington, Benjamin Fairfax, Rory Fairhead, Hai Fang, Shayan Fassih, Sally Felle, Maria Fernandez Mendoza, Ricardo Ferreira, Roman Fischer, Thomas Foord, Aden Forrow, John Frater, Anastasia Fries, Veronica Gallardo Sanchez, Lucy Garner, Clementine Geeves, Dominique Georgiou, Leila Godfrey, Tanya Golubchik, Maria Gomez Vazquez, Angie Green, Hong Harper, Heather A Harrington, Raphael Heilig, Svenja Hester, Jennifer Hill, Charles Hinds, Clare Hird, Ling-Pei Ho, Renee Hoekzema, Benjamin Hollis, Jim Hughes, Paula Hutton, Matthew Jackson, Ashwin Jainarayanan, Anna James-Bott, Kathrin Jansen, Katie Jeffery, Elizabeth Jones, Luke Jostins, Georgina Kerr, David Kim, Paul Klenerman, Julian C Knight, Vinod Kumar, Piyush Kumar Sharma, Prathiba Kurupati, Andrew Kwok, Angela Lee, Aline Linder, Teresa Lockett, Lorne Lonie, Maria Lopopolo, Martyna Lukoseviciute, Jian Luo, Spyridoula Marinou, Brian Marsden, Jose Martinez, Philippa Matthews, Michalina Mazurczyk, Simon McGowan, Stuart McKechnie, Adam Mead, Alexander J Mentzer, Yuxin Mi, Claudia Monaco, Ruddy Montadon, Giorgio Napolitani, Isar Nassiri, Alex Novak, Darragh O'Brien, Daniel O'Connor, Denise O'Donnell, Graham Ogg, Lauren Overend, Inhye Park, Ian Pavord, Yanchun Peng, Frank Penkava, Mariana Pereira Pinho, Elena Perez, Andrew J Pollard, Fiona Powrie, Bethan Psaila, T. Phuong Quan, Emmanouela Repapi, Santiago Revale, Laura Silva-Reyes, Jean-Baptiste Richard, Charlotte Rich-Griffin, Thomas Ritter, Christine S Rollier, Matthew Rowland, Fabian Ruehle, Mariolina Salio, Stephen N Sansom, Alberto Santos Delgado, Tatjana Sauka-Spengler, Ron Schwessinger, Giuseppe Scozzafava, Gavin Screaton, Anna Seigal, Malcolm G Semple, Martin Sergeant, Christina Simoglou Karali, David Sims, Donal Skelly, Hubert Slawinski, Alberto Sobrinodiaz, Nikolaos Sousos, Lizzie Stafford, Lisa Stockdale, Marie Strickland, Otto Sumray, Bo Sun, Chelsea Taylor, Stephen Taylor, Adan Taylor, Supat Thongjuea, Hannah Thraves, John A Todd, Adriana Tomic, Orion Tong, Amy Trebes, Dominik Trzupek, Felicia A Tucci, Lance Turtle, Irina Udalova, Holm Uhlig, Erinke van Grinsven, Iolanda Vendrell, Marije Verheul, Alexandru Voda, Guanlin Wang, Lihui Wang, Dapeng Wang, Peter Watkinson, Robert Watson, Michael Weinberger, Justin Whalley, Lorna Witty, Katherine Wray, Luzheng Xue, Hing Yuen Yeung, Zixi Yin, Rebecca K Young, Jonathan Youngs, Ping Zhang, Yasemin-Xiomara Zurke. A blood atlas of COVID-19 defines hallmarks of disease severity and specificity. . 2021; ():1.
Chicago/Turabian StyleCOvid-19 Multi-omics Blood ATlas (COMBAT) Consortium; David J Ahern; Zhichao Ai; Mark Ainsworth; Chris Allan; Alice Allcock; Azim Ansari; Carolina V Arancibia-Carcamo; Dominik Aschenbrenner; Moustafa Attar; J. Kenneth Baillie; Eleanor Barnes; Rachael Bashford-Rogers; Archana Bashyal; Sally Beer; Georgina Berridge; Amy Beveridge; Sagida Bibi; Tihana Bicanic; Luke Blackwell; Paul Bowness; Andrew Brent; Andrew Brown; John Broxholme; David Buck; Katie L Burnham; Helen Byrne; Susana Camara; Ivan Candido Ferreira; Philip Charles; Wentao Chen; Yi-Ling Chen; Amanda Chong; Elizabeth Clutterbuck; Mark Coles; Christopher P Conlon; Richard Cornall; Adam P Cribbs; Fabiola Curion; Emma E Davenport; Neil Davidson; Simon Davis; Calliope Dendrou; Julie Dequaire; Lea Dib; James Docker; Christina Dold; Tao Dong; Damien Downes; Alexander Drakesmith; Susanna J Dunachie; David A Duncan; Chris Eijsbouts; Robert Esnouf; Alexis Espinosa; Rachel Etherington; Benjamin Fairfax; Rory Fairhead; Hai Fang; Shayan Fassih; Sally Felle; Maria Fernandez Mendoza; Ricardo Ferreira; Roman Fischer; Thomas Foord; Aden Forrow; John Frater; Anastasia Fries; Veronica Gallardo Sanchez; Lucy Garner; Clementine Geeves; Dominique Georgiou; Leila Godfrey; Tanya Golubchik; Maria Gomez Vazquez; Angie Green; Hong Harper; Heather A Harrington; Raphael Heilig; Svenja Hester; Jennifer Hill; Charles Hinds; Clare Hird; Ling-Pei Ho; Renee Hoekzema; Benjamin Hollis; Jim Hughes; Paula Hutton; Matthew Jackson; Ashwin Jainarayanan; Anna James-Bott; Kathrin Jansen; Katie Jeffery; Elizabeth Jones; Luke Jostins; Georgina Kerr; David Kim; Paul Klenerman; Julian C Knight; Vinod Kumar; Piyush Kumar Sharma; Prathiba Kurupati; Andrew Kwok; Angela Lee; Aline Linder; Teresa Lockett; Lorne Lonie; Maria Lopopolo; Martyna Lukoseviciute; Jian Luo; Spyridoula Marinou; Brian Marsden; Jose Martinez; Philippa Matthews; Michalina Mazurczyk; Simon McGowan; Stuart McKechnie; Adam Mead; Alexander J Mentzer; Yuxin Mi; Claudia Monaco; Ruddy Montadon; Giorgio Napolitani; Isar Nassiri; Alex Novak; Darragh O'Brien; Daniel O'Connor; Denise O'Donnell; Graham Ogg; Lauren Overend; Inhye Park; Ian Pavord; Yanchun Peng; Frank Penkava; Mariana Pereira Pinho; Elena Perez; Andrew J Pollard; Fiona Powrie; Bethan Psaila; T. Phuong Quan; Emmanouela Repapi; Santiago Revale; Laura Silva-Reyes; Jean-Baptiste Richard; Charlotte Rich-Griffin; Thomas Ritter; Christine S Rollier; Matthew Rowland; Fabian Ruehle; Mariolina Salio; Stephen N Sansom; Alberto Santos Delgado; Tatjana Sauka-Spengler; Ron Schwessinger; Giuseppe Scozzafava; Gavin Screaton; Anna Seigal; Malcolm G Semple; Martin Sergeant; Christina Simoglou Karali; David Sims; Donal Skelly; Hubert Slawinski; Alberto Sobrinodiaz; Nikolaos Sousos; Lizzie Stafford; Lisa Stockdale; Marie Strickland; Otto Sumray; Bo Sun; Chelsea Taylor; Stephen Taylor; Adan Taylor; Supat Thongjuea; Hannah Thraves; John A Todd; Adriana Tomic; Orion Tong; Amy Trebes; Dominik Trzupek; Felicia A Tucci; Lance Turtle; Irina Udalova; Holm Uhlig; Erinke van Grinsven; Iolanda Vendrell; Marije Verheul; Alexandru Voda; Guanlin Wang; Lihui Wang; Dapeng Wang; Peter Watkinson; Robert Watson; Michael Weinberger; Justin Whalley; Lorna Witty; Katherine Wray; Luzheng Xue; Hing Yuen Yeung; Zixi Yin; Rebecca K Young; Jonathan Youngs; Ping Zhang; Yasemin-Xiomara Zurke. 2021. "A blood atlas of COVID-19 defines hallmarks of disease severity and specificity." , no. : 1.
Background The long-term sequelae of coronavirus disease 2019 (Covid-19) in children remain poorly characterised. This study aimed to assess long-term outcomes in children previously hospitalised with Covid-19 and associated risk factors. Methods This is a prospective cohort study of children (18 years old and younger) admitted with confirmed Covid-19 to Z.A. Bashlyaeva Children's Municipal Clinical Hospital in Moscow, Russia. Children admitted to the hospital during the first wave of the pandemic, between April 2, 2020 and August 26, 2020, were included. Telephone interview using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Covid-19 Health and Wellbeing paediatric follow up survey. Persistent symptoms (>5 months) were further categorised by system(s) involved. Findings Overall, 518 of 853 (61%) of eligible children were available for the follow-up assessment and included in the study. Median age was 10.4 years (IQR, 3-15.2) and 270 (52.1%) were girls; median follow-up since hospital discharge was 256 (223-271) days. At the time of the follow-up interview 126 (24.3%) participants reported persistent symptoms among which fatigue (53, 10.7%), sleep disturbance (36, 6.9%,) and sensory problems (29, 5.6%) were the most common. Multiple symptoms were experienced by 44 (8.4%) participants. Risk factors for persistent symptoms were: age "6-11 years" (odds ratio 2.74 (95% confidence interval 1.37 to 5.75) and "12-18 years" (2.68, 1.41 to 5.4), and a history of allergic diseases (1.67, 1.04 to 2.67). Interpretation A quarter of children experienced persistent symptoms months after hospitalization with acute covid-19 infection, with almost one in ten experiencing multi-system involvement. Older age and allergic diseases were associated with higher risk of persistent symptoms at follow-up. Our findings highlight the need for replication and further investigation of potential mechanisms as well as clinical support to improve long term outcomes in children. Funding None.
Ismail M Osmanov; Ekaterina Spiridonova; Polina Bobkova; Aysylu Gamirova; Anastasia Shikhaleva; Margarita Andreeva; Oleg Blyuss; Yasmin El-Taravi; Audrey DunnGalvin; Pasquale Comberiati; Diego G Peroni; Christian Apfelbacher; Jon Genuneit; Lyudmila Mazankova; Alexandra Miroshina; Evgeniya Chistyakova; Elmira Samitova; Svetlana Borzakova; Elena Bondarenko; Anatoliy A Korsunskiy; Irina Konova; Sarah Wulf Hanson; Gail Carson; Louise Sigfrid; Janet T Scott; Matthew Greenhawt; Elizabeth A Whittaker; Elena Garralda; Olivia Swann; Danilo Buonsenso; Dasha E Nicholls; Frances Simpson; Christina Jones; Malcolm G Semple; John O Warner; Theo Vos; Piero Olliaro; Daniel Munblit; Sechenov StopCOVID Research Team. Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study. 2021, 1 .
AMA StyleIsmail M Osmanov, Ekaterina Spiridonova, Polina Bobkova, Aysylu Gamirova, Anastasia Shikhaleva, Margarita Andreeva, Oleg Blyuss, Yasmin El-Taravi, Audrey DunnGalvin, Pasquale Comberiati, Diego G Peroni, Christian Apfelbacher, Jon Genuneit, Lyudmila Mazankova, Alexandra Miroshina, Evgeniya Chistyakova, Elmira Samitova, Svetlana Borzakova, Elena Bondarenko, Anatoliy A Korsunskiy, Irina Konova, Sarah Wulf Hanson, Gail Carson, Louise Sigfrid, Janet T Scott, Matthew Greenhawt, Elizabeth A Whittaker, Elena Garralda, Olivia Swann, Danilo Buonsenso, Dasha E Nicholls, Frances Simpson, Christina Jones, Malcolm G Semple, John O Warner, Theo Vos, Piero Olliaro, Daniel Munblit, Sechenov StopCOVID Research Team. Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study. . 2021; ():1.
Chicago/Turabian StyleIsmail M Osmanov; Ekaterina Spiridonova; Polina Bobkova; Aysylu Gamirova; Anastasia Shikhaleva; Margarita Andreeva; Oleg Blyuss; Yasmin El-Taravi; Audrey DunnGalvin; Pasquale Comberiati; Diego G Peroni; Christian Apfelbacher; Jon Genuneit; Lyudmila Mazankova; Alexandra Miroshina; Evgeniya Chistyakova; Elmira Samitova; Svetlana Borzakova; Elena Bondarenko; Anatoliy A Korsunskiy; Irina Konova; Sarah Wulf Hanson; Gail Carson; Louise Sigfrid; Janet T Scott; Matthew Greenhawt; Elizabeth A Whittaker; Elena Garralda; Olivia Swann; Danilo Buonsenso; Dasha E Nicholls; Frances Simpson; Christina Jones; Malcolm G Semple; John O Warner; Theo Vos; Piero Olliaro; Daniel Munblit; Sechenov StopCOVID Research Team. 2021. "Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study." , no. : 1.
Serological detection of antibodies to SARS-CoV-2 is essential for establishing rates of seroconversion in populations, and for seeking evidence for a level of antibody that may be protective against COVID-19 disease. Several high-performance commercial tests have been described, but these require centralised laboratory facilities that are comparatively expensive, and therefore not available universally. Red cell agglutination tests do not require special equipment, are read by eye, have short development times, low cost and can be applied at the Point of Care. Here we describe a quantitative Haemagglutination test (HAT) for the detection of antibodies to the receptor binding domain of the SARS-CoV-2 spike protein. The HAT has a sensitivity of 90% and specificity of 99% for detection of antibodies after a PCR diagnosed infection. We will supply aliquots of the test reagent sufficient for ten thousand test wells free of charge to qualified research groups anywhere in the world.
Alain Townsend; Pramila Rijal; Julie Xiao; Tiong Kit Tan; Kuan-Ying A. Huang; Lisa Schimanski; Jiandong Huo; Nimesh Gupta; Rolle Rahikainen; Philippa C. Matthews; Derrick Crook; Sarah Hoosdally; Susanna Dunachie; Eleanor Barnes; Teresa Street; Christopher P. Conlon; John Frater; Carolina V. Arancibia-Cárcamo; Justine Rudkin; Nicole Stoesser; Fredrik Karpe; Matthew Neville; Rutger Ploeg; Marta Oliveira; David J. Roberts; Abigail A. Lamikanra; Hoi Pat Tsang; Abbie Bown; Richard Vipond; Alexander J. Mentzer; Julian C. Knight; Andrew J. Kwok; Gavin R. Screaton; Juthathip Mongkolsapaya; Wanwisa Dejnirattisai; Piyada Supasa; Paul Klenerman; Christina Dold; J. Kenneth Baillie; Shona C. Moore; Peter J. M. Openshaw; Malcolm G. Semple; Lance C. W. Turtle; Mark Ainsworth; Alice Allcock; Sally Beer; Sagida Bibi; Donal Skelly; Lizzy Stafford; Katie Jeffrey; Denise O’Donnell; Elizabeth Clutterbuck; Alexis Espinosa; Maria Mendoza; Dominique Georgiou; Teresa Lockett; Jose Martinez; Elena Perez; Veronica Gallardo Sanchez; Giuseppe Scozzafava; Alberto Sobrinodiaz; Hannah Thraves; Etienne Joly. A haemagglutination test for rapid detection of antibodies to SARS-CoV-2. Nature Communications 2021, 12, 1 -12.
AMA StyleAlain Townsend, Pramila Rijal, Julie Xiao, Tiong Kit Tan, Kuan-Ying A. Huang, Lisa Schimanski, Jiandong Huo, Nimesh Gupta, Rolle Rahikainen, Philippa C. Matthews, Derrick Crook, Sarah Hoosdally, Susanna Dunachie, Eleanor Barnes, Teresa Street, Christopher P. Conlon, John Frater, Carolina V. Arancibia-Cárcamo, Justine Rudkin, Nicole Stoesser, Fredrik Karpe, Matthew Neville, Rutger Ploeg, Marta Oliveira, David J. Roberts, Abigail A. Lamikanra, Hoi Pat Tsang, Abbie Bown, Richard Vipond, Alexander J. Mentzer, Julian C. Knight, Andrew J. Kwok, Gavin R. Screaton, Juthathip Mongkolsapaya, Wanwisa Dejnirattisai, Piyada Supasa, Paul Klenerman, Christina Dold, J. Kenneth Baillie, Shona C. Moore, Peter J. M. Openshaw, Malcolm G. Semple, Lance C. W. Turtle, Mark Ainsworth, Alice Allcock, Sally Beer, Sagida Bibi, Donal Skelly, Lizzy Stafford, Katie Jeffrey, Denise O’Donnell, Elizabeth Clutterbuck, Alexis Espinosa, Maria Mendoza, Dominique Georgiou, Teresa Lockett, Jose Martinez, Elena Perez, Veronica Gallardo Sanchez, Giuseppe Scozzafava, Alberto Sobrinodiaz, Hannah Thraves, Etienne Joly. A haemagglutination test for rapid detection of antibodies to SARS-CoV-2. Nature Communications. 2021; 12 (1):1-12.
Chicago/Turabian StyleAlain Townsend; Pramila Rijal; Julie Xiao; Tiong Kit Tan; Kuan-Ying A. Huang; Lisa Schimanski; Jiandong Huo; Nimesh Gupta; Rolle Rahikainen; Philippa C. Matthews; Derrick Crook; Sarah Hoosdally; Susanna Dunachie; Eleanor Barnes; Teresa Street; Christopher P. Conlon; John Frater; Carolina V. Arancibia-Cárcamo; Justine Rudkin; Nicole Stoesser; Fredrik Karpe; Matthew Neville; Rutger Ploeg; Marta Oliveira; David J. Roberts; Abigail A. Lamikanra; Hoi Pat Tsang; Abbie Bown; Richard Vipond; Alexander J. Mentzer; Julian C. Knight; Andrew J. Kwok; Gavin R. Screaton; Juthathip Mongkolsapaya; Wanwisa Dejnirattisai; Piyada Supasa; Paul Klenerman; Christina Dold; J. Kenneth Baillie; Shona C. Moore; Peter J. M. Openshaw; Malcolm G. Semple; Lance C. W. Turtle; Mark Ainsworth; Alice Allcock; Sally Beer; Sagida Bibi; Donal Skelly; Lizzy Stafford; Katie Jeffrey; Denise O’Donnell; Elizabeth Clutterbuck; Alexis Espinosa; Maria Mendoza; Dominique Georgiou; Teresa Lockett; Jose Martinez; Elena Perez; Veronica Gallardo Sanchez; Giuseppe Scozzafava; Alberto Sobrinodiaz; Hannah Thraves; Etienne Joly. 2021. "A haemagglutination test for rapid detection of antibodies to SARS-CoV-2." Nature Communications 12, no. 1: 1-12.
Background The impact of COVID-19 on physical and mental health, and employment following hospitalisation is poorly understood. Methods PHOSP-COVID is a multi-centre, UK, observational study of adults discharged from hospital with a clinical diagnosis of COVID-19 involving an assessment between two- and seven-months later including detailed symptom, physiological and biochemical testing. Multivariable logistic regression was performed for patient-perceived recovery with age, sex, ethnicity, body mass index (BMI), co-morbidities, and severity of acute illness as co-variates. Cluster analysis was performed using outcomes for breathlessness, fatigue, mental health, cognition and physical function. Findings We report findings of 1077 patients discharged in 2020, from the assessment undertaken a median 5 [IQR4 to 6] months later: 36% female, mean age 58 [SD 13] years, 69% white ethnicity, 27% mechanical ventilation, and 50% had at least two co-morbidities. At follow-up only 29% felt fully recovered, 20% had a new disability, and 19% experienced a health-related change in occupation. Factors associated with failure to recover were female, middle-age, white ethnicity, two or more co-morbidities, and more severe acute illness. The magnitude of the persistent health burden was substantial and weakly related to acute severity. Four clusters were identified with different severities of mental and physical health impairment: 1) Very severe (17%), 2) Severe (21%), 3) Moderate with cognitive impairment (17%), 4) Mild (46%), with 3%, 7%, 36% and 43% feeling fully recovered, respectively. Persistent systemic inflammation determined by C-reactive protein was related to cluster severity, but not acute illness severity. Interpretation We identified factors related to recovery from a hospital admission with COVID-19 and four different phenotypes relating to the severity of physical, mental, and cognitive health five months later. The implications for clinical care include the potential to stratify care and the need for a pro-active approach with wide-access to COVID-19 holistic clinical services. Funding: UKRI and NIHR
PHOSP-COVID Collaborative Group; Rachael Andrea Evans; Hamish McAuley; Ewen M Harrison; Aarti Shikotra; Amisha Singapuri; Marco Sereno; Omer Elneima; Annemarie B Docherty; Nazir I Lone; Olivia C Leavy; Luke Daines; J Kenneth Baillie; Jeremy S Brown; Trudie Chalder; Anthony De Soyza; Nawar Diar Bakerly; Nicholas Easom; John R Geddes; Neil J Greening; Nick Hart; Liam G Heaney; Simon Heller; Luke Howard; Joseph Jacob; R Gisli Jenkins; Caroline Jolley; Steven Kerr; Onn M Kon; Keir Lewis; Janet M Lord; Gerry P McCann; Stefan Neubauer; Peter Jm Openshaw; Paul Pfeffer; Matthew Rowland; Malcolm G Semple; Sally J Singh; Aziz Sheikh; David Thomas; Mark Toshner; James D Chalmers; Ling-Pei Ho; Alex Horsley; Michael Marks; Krisnah Poinasamy; Louise V Wain; Christopher E Brightling. Physical, cognitive and mental health impacts of COVID-19 following hospitalisation – a multi-centre prospective cohort study. 2021, 1 .
AMA StylePHOSP-COVID Collaborative Group, Rachael Andrea Evans, Hamish McAuley, Ewen M Harrison, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Omer Elneima, Annemarie B Docherty, Nazir I Lone, Olivia C Leavy, Luke Daines, J Kenneth Baillie, Jeremy S Brown, Trudie Chalder, Anthony De Soyza, Nawar Diar Bakerly, Nicholas Easom, John R Geddes, Neil J Greening, Nick Hart, Liam G Heaney, Simon Heller, Luke Howard, Joseph Jacob, R Gisli Jenkins, Caroline Jolley, Steven Kerr, Onn M Kon, Keir Lewis, Janet M Lord, Gerry P McCann, Stefan Neubauer, Peter Jm Openshaw, Paul Pfeffer, Matthew Rowland, Malcolm G Semple, Sally J Singh, Aziz Sheikh, David Thomas, Mark Toshner, James D Chalmers, Ling-Pei Ho, Alex Horsley, Michael Marks, Krisnah Poinasamy, Louise V Wain, Christopher E Brightling. Physical, cognitive and mental health impacts of COVID-19 following hospitalisation – a multi-centre prospective cohort study. . 2021; ():1.
Chicago/Turabian StylePHOSP-COVID Collaborative Group; Rachael Andrea Evans; Hamish McAuley; Ewen M Harrison; Aarti Shikotra; Amisha Singapuri; Marco Sereno; Omer Elneima; Annemarie B Docherty; Nazir I Lone; Olivia C Leavy; Luke Daines; J Kenneth Baillie; Jeremy S Brown; Trudie Chalder; Anthony De Soyza; Nawar Diar Bakerly; Nicholas Easom; John R Geddes; Neil J Greening; Nick Hart; Liam G Heaney; Simon Heller; Luke Howard; Joseph Jacob; R Gisli Jenkins; Caroline Jolley; Steven Kerr; Onn M Kon; Keir Lewis; Janet M Lord; Gerry P McCann; Stefan Neubauer; Peter Jm Openshaw; Paul Pfeffer; Matthew Rowland; Malcolm G Semple; Sally J Singh; Aziz Sheikh; David Thomas; Mark Toshner; James D Chalmers; Ling-Pei Ho; Alex Horsley; Michael Marks; Krisnah Poinasamy; Louise V Wain; Christopher E Brightling. 2021. "Physical, cognitive and mental health impacts of COVID-19 following hospitalisation – a multi-centre prospective cohort study." , no. : 1.
Objective To investigate the association of obesity with in‐hospital COVID‐19 outcomes in different ethnic groups. Methods Patients admitted to hospital with COVID‐19 in the United Kingdom through the Clinical Characterisation Protocol UK (CCP‐UK) developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) were included from 6th February to 12th October 2020. Ethnicity was classified as: white, South Asian, black and other minority ethnic groups. Outcomes were admission to critical care, mechanical ventilation and in‐hospital mortality, adjusted for age, sex and chronic diseases. Results 54,254 (age = 76 years; 45.0% women) white, 3,728 (57 years; 41.1%) South Asian, 2,523 (58 years; 44.9%) black and 5,427 (61 years; 40.8%) other ethnicities were included. Obesity was associated with all outcomes in all ethnic groups, with associations strongest for black ethnicities. When stratified by ethnicity and obesity status, the OR for admission to critical care, mechanical ventilation and mortality in black ethnicities with obesity were 3.91 (3.13, 4.88), 5.03 (3.94, 6.63), 1.93 (1.49, 2.51) respectively, compared to white ethnicities without obesity. Conclusions Obesity was associated with an elevated risk of in‐hospital COVID‐19 outcomes in all ethnic groups, with associations strongest in black ethnicities.
Thomas Yates; Francesco Zaccardi; Nazrul Islam; Cameron Razieh; Clare L Gillies; Claire A. Lawson; Yogini Chudasama; Alex Rowlands; Melanie J Davies; Annemarie B Docherty; Peter Jm Openshaw; J Kenneth Baillie; Malcolm G Semple; ISARIC4C investigators; Kamlesh Khunti. Obesity, ethnicity and risk of critical care, mechanical ventilation and mortality in patients admitted to hospital with COVID‐19: Analysis of the ISARIC CCP‐UK cohort. Obesity 2021, 29, 1223 -1230.
AMA StyleThomas Yates, Francesco Zaccardi, Nazrul Islam, Cameron Razieh, Clare L Gillies, Claire A. Lawson, Yogini Chudasama, Alex Rowlands, Melanie J Davies, Annemarie B Docherty, Peter Jm Openshaw, J Kenneth Baillie, Malcolm G Semple, ISARIC4C investigators, Kamlesh Khunti. Obesity, ethnicity and risk of critical care, mechanical ventilation and mortality in patients admitted to hospital with COVID‐19: Analysis of the ISARIC CCP‐UK cohort. Obesity. 2021; 29 (7):1223-1230.
Chicago/Turabian StyleThomas Yates; Francesco Zaccardi; Nazrul Islam; Cameron Razieh; Clare L Gillies; Claire A. Lawson; Yogini Chudasama; Alex Rowlands; Melanie J Davies; Annemarie B Docherty; Peter Jm Openshaw; J Kenneth Baillie; Malcolm G Semple; ISARIC4C investigators; Kamlesh Khunti. 2021. "Obesity, ethnicity and risk of critical care, mechanical ventilation and mortality in patients admitted to hospital with COVID‐19: Analysis of the ISARIC CCP‐UK cohort." Obesity 29, no. 7: 1223-1230.
Evidence before this study It is emerging that long-term symptoms are often present in people who have had acute COVID-19 disease. These symptoms affect a range of organ systems including respiratory, cardiovascular and neurological systems. It is not clear how many patients who required hospitalisation develop these symptoms and the impact they have on quality of life. We searched PubMed on 24th March 2021 using the terms ‘COVID-19’, ‘long-Covid’, ‘long-term’ and ‘outcomes’. This was supplemented by hand searching relevant references and news reports. We identified several small studies focussing on specific symptoms or diseases, studies of patients in community settings and studies of patients who were hospitalised for acute COVID-19 in Italy, Russia and China. There were no peer-reviewed published data at the time of searching which captured outcomes of patients within the United Kingdom. Added Value of this study We found that over half of patients reported not feeling fully recovered several months after onset of Covid-19 symptoms. The most common symptoms reported were fatigue, followed by breathlessness. Patients reported significant increases in new or worse disability, increases in MRC dyspnoea scale and worse quality of life as measured by EQ5D-5L summary index at the time of follow-up compared to before onset of acute COVID-19 symptoms. Our study found that women, in particular women under the age of 50 were significantly more likely to not feel fully recovered, were more breathless, more fatigued and had higher rates of new or worsened disability, even after taking severity of acute disease into account when compared to men of the same age. Implications of all available evidence Long-term symptoms following hospitalisation for COVID-19 are very common and have significant impacts on quality of life. Women under 50 were most likely to have the worst outcomes. Policy makers need to ensure there is long-term support for people experiencing long-Covid and should plan for lasting long-term population morbidity. Funding for research to understand mechanisms underlying long-Covid and identify potential interventions for testing in randomised trials is urgently required. Structured Abstract Background This study sought to establish the long-term effects of Covid-19 following hospitalisation. Methods 327 hospitalised participants, with SARS-CoV-2 infection were recruited into a prospective multicentre cohort study at least 3 months post-discharge. The primary outcome was self-reported recovery at least ninety days after initial Covid-19 symptom onset. Secondary outcomes included new symptoms, disability (Washington group short scale), breathlessness (MRC Dyspnoea scale) and quality of life (EQ5D-5L). Findings 55% of participants reported not feeling fully recovered. 93% reported persistent symptoms, with fatigue the most common (83%), followed by breathlessness (54%). 47% reported an increase in MRC dyspnoea scale of at least one grade. New or worse disability was reported by 24% of participants. The EQ5D-5L summary index was significantly worse at follow-up (median difference 0.1 points on a scale of 0 to 1, IQR: −0.2 to 0.0). Females under the age of 50 years were five times less likely to report feeling recovered (adjusted OR 5.09, 95% CI 1.64 to 15.74), were more likely to have greater disability (adjusted OR 4.22, 95% CI 1.12 to 15.94), twice as likely to report worse fatigue (adjusted OR 2.06, 95% CI 0.81 to 3.31) and seven times more likely to become more breathless (adjusted OR 7.15, 95% CI 2.24 to 22.83) than men of the same age. Interpretation Survivors of Covid-19 experienced long-term symptoms, new disability, increased breathlessness, and reduced quality of life. These findings were present in young, previously healthy working age adults, and were most common in younger females. Role of the funder: The study sponsors and funders had no role in the study design, collection, analysis, interpretation of data, writing of the report, or the decision to submit the article for publication. Investigators were independent from funders and the authors have full access to all of the data, including any statistical analysis and tables.
Louise Sigfrid; Thomas M Drake; Ellen Pauley; Edwin C Jesudason; Piero Olliaro; Wei Shen Lim; Annelise Gillesen; Colin Berry; David J Lowe; Joanne McPeake; Nazir Lone; Muge Cevik; Daniel J Munblit; Anna Casey; Peter Bannister; Clark D Russell; Lynsey Goodwin; Antonia Ho; Lance Turtle; Margaret E O’Hara; Claire Hastie; Chloe Donohue; Rebecca Spencer; Janet Harrison; Cara Donegan; Alison Gummery; Hayley Hardwick; Laura Merson; Gail Carson; J Kenneth Baillie; Peter Jm Openshaw; Ewen M Harrison; Annemarie B Docherty; Malcom G Semple; Janet T Scott. Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol. 2021, 1 .
AMA StyleLouise Sigfrid, Thomas M Drake, Ellen Pauley, Edwin C Jesudason, Piero Olliaro, Wei Shen Lim, Annelise Gillesen, Colin Berry, David J Lowe, Joanne McPeake, Nazir Lone, Muge Cevik, Daniel J Munblit, Anna Casey, Peter Bannister, Clark D Russell, Lynsey Goodwin, Antonia Ho, Lance Turtle, Margaret E O’Hara, Claire Hastie, Chloe Donohue, Rebecca Spencer, Janet Harrison, Cara Donegan, Alison Gummery, Hayley Hardwick, Laura Merson, Gail Carson, J Kenneth Baillie, Peter Jm Openshaw, Ewen M Harrison, Annemarie B Docherty, Malcom G Semple, Janet T Scott. Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol. . 2021; ():1.
Chicago/Turabian StyleLouise Sigfrid; Thomas M Drake; Ellen Pauley; Edwin C Jesudason; Piero Olliaro; Wei Shen Lim; Annelise Gillesen; Colin Berry; David J Lowe; Joanne McPeake; Nazir Lone; Muge Cevik; Daniel J Munblit; Anna Casey; Peter Bannister; Clark D Russell; Lynsey Goodwin; Antonia Ho; Lance Turtle; Margaret E O’Hara; Claire Hastie; Chloe Donohue; Rebecca Spencer; Janet Harrison; Cara Donegan; Alison Gummery; Hayley Hardwick; Laura Merson; Gail Carson; J Kenneth Baillie; Peter Jm Openshaw; Ewen M Harrison; Annemarie B Docherty; Malcom G Semple; Janet T Scott. 2021. "Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol." , no. : 1.
Introduction The UK government stockpiles co-amoxiclav to treat bacterial complications during influenza pandemics. This pragmatic trial examines whether early co-amoxiclav use reduces re-consultation due to clinical deterioration in “at risk” children presenting with influenza-like illness (ILI) in primary or ambulatory care. Methods “At risk” children aged 6 months to 12 years presenting within f5 days of ILI onset were randomly assigned to oral co-amoxiclav 400/57 or placebo twice daily for 5 days (dosing based on age±weight). “At risk” groups included children with respiratory, cardiac, and neurological conditions. Randomisation was stratified by region and used a non-deterministic minimisation algorithm to balance age and current seasonal influenza vaccination status. Our target sample size was 650 children, which would have allowed us to detect a reduction in the proportion of children re-consulting due to clinical deterioration from 40% to 26% with 90% power and 5% two-tailed alpha error, including allowance for 25% loss to follow-up and an inflation factor of 1.041. Participants, caregivers and investigators were blinded to treatment allocation. Intention-to-treat analysis included all randomised participants with primary outcome data on re-consultation due to clinical deterioration within 28 days. Safety analysis included all randomised participants. Trial registration: ISRCTN 70714783. EudraCT 2013-002822-21. Results We recruited 271 children between February 11, 2015 and April 20, 2018. Primary outcome data were available for 265 children. Only 61/265 children (23.0%) re-consulted due to clinical deterioration. No evidence of a treatment effect was observed for re-consultation due to clinical deterioration (co-amoxiclav 33/133 (24.8%), placebo 28/132 (21.2%), adjusted risk ratio [RR] 1.16, 95% confidence interval [CI] 0.75 to 1.80). There was also no evidence of a difference between groups in the proportion of children for whom one or more adverse events were reported (co-amoxiclav 32/136 (23.5%), placebo 22/135 (16.3%), adjusted RR 1.45, 95% CI 0.90 to 2.34). Sixty-six adverse events were reported in total (co-amoxiclav n=37, placebo n=29). Nine serious adverse events were reported per group; none were considered related to study medication. Conclusion Our trial did not find evidence that treatment with co-amoxiclav reduces risk of re-consultation due to clinical deterioration in “at risk” children who present early with ILI during influenza season. Our findings therefore do not support early co-amoxiclav use in children with seasonal ILI.
Kay Wang; Malcolm G Semple; Michael Moore; Alastair D Hay; Sharon Tonner; Ushma Galal; Jenna Grabey; Tricia Carver; Rafael Perera; Ly-Mee Yu; Jill Mollison; Paul Little; Andrew Farmer; Christopher C Butler; Anthony Harnden. The early use of Antibiotics for at Risk CHildren with InfluEnza-like illness (ARCHIE): a double-blind randomised placebo-controlled trial. European Respiratory Journal 2021, 2002819 .
AMA StyleKay Wang, Malcolm G Semple, Michael Moore, Alastair D Hay, Sharon Tonner, Ushma Galal, Jenna Grabey, Tricia Carver, Rafael Perera, Ly-Mee Yu, Jill Mollison, Paul Little, Andrew Farmer, Christopher C Butler, Anthony Harnden. The early use of Antibiotics for at Risk CHildren with InfluEnza-like illness (ARCHIE): a double-blind randomised placebo-controlled trial. European Respiratory Journal. 2021; ():2002819.
Chicago/Turabian StyleKay Wang; Malcolm G Semple; Michael Moore; Alastair D Hay; Sharon Tonner; Ushma Galal; Jenna Grabey; Tricia Carver; Rafael Perera; Ly-Mee Yu; Jill Mollison; Paul Little; Andrew Farmer; Christopher C Butler; Anthony Harnden. 2021. "The early use of Antibiotics for at Risk CHildren with InfluEnza-like illness (ARCHIE): a double-blind randomised placebo-controlled trial." European Respiratory Journal , no. : 2002819.
Although it is now widely accepted that host inflammatory responses contribute to lung injury, the pathways that drive severity and distinguish coronavirus disease 2019 (COVID-19) from other viral lung diseases remain poorly characterized. We analyzed plasma samples from 471 hospitalized patients recruited through the prospective multicenter ISARIC4C study and 39 outpatients with mild disease, enabling extensive characterization of responses across a full spectrum of COVID-19 severity. Progressive elevation of levels of numerous inflammatory cytokines and chemokines [including interleukin-6 (IL-6), CXCL10, and granulocyte-macrophage colony-stimulating factor (GM-CSF)] was associated with severity and accompanied by elevated markers of endothelial injury and thrombosis. Principal component and network analyses demonstrated central roles for IL-6 and GM-CSF in COVID-19 pathogenesis. Comparing these profiles with archived samples from patients with fatal influenza, IL-6 was equally elevated in both conditions, whereas GM-CSF was prominent only in COVID-19. These findings further identify the key inflammatory, thrombotic, and vascular factors that characterize and distinguish severe and fatal COVID-19.
Ryan S. Thwaites; Ashley Sanchez Sevilla Uruchurtu; Matthew K. Siggins; Felicity Liew; Clark D. Russell; Shona C. Moore; Cameron Fairfield; Edwin Carter; Simon Abrams; Charlotte-Eve Short; Thilipan Thaventhiran; Emma Bergstrom; Zoe Gardener; Stephanie Ascough; Christopher Chiu; Annemarie B. Docherty; David Hunt; Yanick J. Crow; Tom Solomon; Graham P. Taylor; Lance Turtle; Ewen M. Harrison; Jake Dunning; Malcolm G. Semple; J. Kenneth Baillie; Peter J. M. Openshaw; on behalf of the ISARIC4C investigators**. Inflammatory profiles across the spectrum of disease reveal a distinct role for GM-CSF in severe COVID-19. Science Immunology 2021, 6, eabg9873 .
AMA StyleRyan S. Thwaites, Ashley Sanchez Sevilla Uruchurtu, Matthew K. Siggins, Felicity Liew, Clark D. Russell, Shona C. Moore, Cameron Fairfield, Edwin Carter, Simon Abrams, Charlotte-Eve Short, Thilipan Thaventhiran, Emma Bergstrom, Zoe Gardener, Stephanie Ascough, Christopher Chiu, Annemarie B. Docherty, David Hunt, Yanick J. Crow, Tom Solomon, Graham P. Taylor, Lance Turtle, Ewen M. Harrison, Jake Dunning, Malcolm G. Semple, J. Kenneth Baillie, Peter J. M. Openshaw, on behalf of the ISARIC4C investigators**. Inflammatory profiles across the spectrum of disease reveal a distinct role for GM-CSF in severe COVID-19. Science Immunology. 2021; 6 (57):eabg9873.
Chicago/Turabian StyleRyan S. Thwaites; Ashley Sanchez Sevilla Uruchurtu; Matthew K. Siggins; Felicity Liew; Clark D. Russell; Shona C. Moore; Cameron Fairfield; Edwin Carter; Simon Abrams; Charlotte-Eve Short; Thilipan Thaventhiran; Emma Bergstrom; Zoe Gardener; Stephanie Ascough; Christopher Chiu; Annemarie B. Docherty; David Hunt; Yanick J. Crow; Tom Solomon; Graham P. Taylor; Lance Turtle; Ewen M. Harrison; Jake Dunning; Malcolm G. Semple; J. Kenneth Baillie; Peter J. M. Openshaw; on behalf of the ISARIC4C investigators**. 2021. "Inflammatory profiles across the spectrum of disease reveal a distinct role for GM-CSF in severe COVID-19." Science Immunology 6, no. 57: eabg9873.