The long-term sequelae of COVID-19: an international consensus on research priorities for patients with pre-existing and new-onset airways disease

Davies Adeloye, Omer Elneima, Luke Daines, Krisnah Poinasamy, Jennifer K Quint, Samantha Walker, Chris E Brightling, Salman Siddiqui, John R Hurst, James D Chalmers, Paul E Pfeffer, Petr Novotny, Thomas M Drake, Liam G Heaney, Igor Rudan, Aziz Sheikh, Anthony De Soyza, International COVID-19 Airways Diseases Group, Davies Adeloye, Omer Elneima, Luke Daines, Krisnah Poinasamy, Jennifer K Quint, Samantha Walker, Chris E Brightling, Salman Siddiqui, John R Hurst, James D Chalmers, Paul E Pfeffer, Petr Novotny, Thomas M Drake, Mohammad Abdollahi, Dhiraj Agarwal, Riyad Al-Lehebi, Peter J Barnes, Jagadeesh Bayry, Marcel Bonay, Louis J Bont, Arnaud Bourdin, Thomas Brown, Gaetano Caramori, Amy Hai Yan Chan, David H Dockrell, Simon Doe, Jamie Duckers, Anthony D'Urzo, Magnus Ekström, Cristóbal Esteban, Catherine M Greene, Atul Gupta, Jennifer L Ingram, Ee Ming Khoo, Fanny Wai San Ko, Gerard H Koppelman, Brian J Lipworth, Karin Lisspers, Michael Loebinger, Jose Luis Lopez-Campos, Matthew Maddocks, David Mannino, Miguel A Martinez-Garcia, Renae Mcnamara, Marc Miravitlles, Pisirai Ndarukwa, Alison Pooler, Chin Kook Rhee, Peter Schwarz, Dominick Shaw, Michael Steiner, Andrew Tai, Charlotte Suppli Ulrik, Paul Walker, Michelle C Williams, Liam G Heaney, Igor Rudan, Aziz Sheikh, Anthony De Soyza, Davies Adeloye, Omer Elneima, Luke Daines, Krisnah Poinasamy, Jennifer K Quint, Samantha Walker, Chris E Brightling, Salman Siddiqui, John R Hurst, James D Chalmers, Paul E Pfeffer, Petr Novotny, Thomas M Drake, Liam G Heaney, Igor Rudan, Aziz Sheikh, Anthony De Soyza, International COVID-19 Airways Diseases Group, Davies Adeloye, Omer Elneima, Luke Daines, Krisnah Poinasamy, Jennifer K Quint, Samantha Walker, Chris E Brightling, Salman Siddiqui, John R Hurst, James D Chalmers, Paul E Pfeffer, Petr Novotny, Thomas M Drake, Mohammad Abdollahi, Dhiraj Agarwal, Riyad Al-Lehebi, Peter J Barnes, Jagadeesh Bayry, Marcel Bonay, Louis J Bont, Arnaud Bourdin, Thomas Brown, Gaetano Caramori, Amy Hai Yan Chan, David H Dockrell, Simon Doe, Jamie Duckers, Anthony D'Urzo, Magnus Ekström, Cristóbal Esteban, Catherine M Greene, Atul Gupta, Jennifer L Ingram, Ee Ming Khoo, Fanny Wai San Ko, Gerard H Koppelman, Brian J Lipworth, Karin Lisspers, Michael Loebinger, Jose Luis Lopez-Campos, Matthew Maddocks, David Mannino, Miguel A Martinez-Garcia, Renae Mcnamara, Marc Miravitlles, Pisirai Ndarukwa, Alison Pooler, Chin Kook Rhee, Peter Schwarz, Dominick Shaw, Michael Steiner, Andrew Tai, Charlotte Suppli Ulrik, Paul Walker, Michelle C Williams, Liam G Heaney, Igor Rudan, Aziz Sheikh, Anthony De Soyza

Abstract

Persistent ill health after acute COVID-19-referred to as long COVID, the post-acute COVID-19 syndrome, or the post-COVID-19 condition-has emerged as a major concern. We undertook an international consensus exercise to identify research priorities with the aim of understanding the long-term effects of acute COVID-19, with a focus on people with pre-existing airways disease and the occurrence of new-onset airways disease and associated symptoms. 202 international experts were invited to submit a minimum of three research ideas. After a two-phase internal review process, a final list of 98 research topics was scored by 48 experts. Patients with pre-existing or post-COVID-19 airways disease contributed to the exercise by weighting selected criteria. The highest-ranked research idea focused on investigation of the relationship between prognostic scores at hospital admission and morbidity at 3 months and 12 months after hospital discharge in patients with and without pre-existing airways disease. High priority was also assigned to comparisons of the prevalence and severity of post-COVID-19 fatigue, sarcopenia, anxiety, depression, and risk of future cardiovascular complications in patients with and without pre-existing airways disease. Our approach has enabled development of a set of priorities that could inform future research studies and funding decisions. This prioritisation process could also be adapted to other, non-respiratory aspects of long COVID.

Conflict of interest statement

Declaration of interests CEB reports grants from the Post-hospitalisation COVID-19 study during the conduct of the study. JRH reports personal fees and non-financial support from pharmaceutical companies (AstraZeneca and GlaxoSmithKline) that make medicines to treat chronic obstructive pulmonary disease, outside the submitted work. JDC reports grants and personal fees from AstraZeneca and Boehringer Ingelheim, and personal fees from GlaxoSmithKline, Insmed, Novartis, Chiesi, and Zambon, outside the submitted work. PEP reports personal fees and non-financial support from AstraZeneca, and a grant and non-financial support from GlaxoSmithKline, outside the submitted work. AS reports grants from the Health Data Research UK BREATHE Hub, the Medical Research Council, and the National Institute for Health Research, during the conduct of the study. ADS has received medical education grant support for BRONCH-UK, a UK bronchiectasis network, from GlaxoSmithKline, Gilead, Chiesi, and Forest labs, and his institution receives fees for his work as coordinating investigator on a phase 3 trial in bronchiectasis sponsored by Bayer. All other authors declare no competing interests.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Figures

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Figure
Process for setting research priorities CHNRI=Child Health and Nutrition Research Initiative. PHOSP-COVID=Post-hospitalisation COVID-19 study.

References

    1. World Health Organization WHO Coronavirus disease dashboard.
    1. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8:475–481.
    1. Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584:430–436.
    1. Brodin P. Immune determinants of COVID-19 disease presentation and severity. Nat Med. 2021;27:28–33.
    1. Schultze A, Walker AJ, MacKenna B, et al. Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform. Lancet Respir Med. 2020;8:1106–1120.
    1. Adeloye D, Chua S, Lee C, et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health. 2015;5
    1. Global Asthma Network . Global Asthma Network; Auckland, New Zealand: 2018. The Global Asthma Report 2018.
    1. Leung JM, Niikura M, Yang CWT, Sin DD. COVID-19 and COPD. Eur Respir J. 2020;56
    1. Skevaki C, Karsonova A, Karaulov A, Xie M, Renz H. Asthma-associated risk for COVID-19 development. J Allergy Clin Immunol. 2020;146:1295–1301.
    1. Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397:220–232.
    1. UK Government COVID-19: long-term health effects. 2021.
    1. World Health Organization What we know about Long-term effects of COVID-19. 2020. (in French).
    1. Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network—United States, March–June 2020. MMWR Morb Mortal Wkly Rep. 2020;69:993–998.
    1. Office for National Statistics The prevalence of long COVID symptoms and COVID-19 complications. 2020.
    1. Mandal S, Barnett J, Brill SE, et al. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2021;76:396–398.
    1. Hester KL, Macfarlane JG, Tedd H, et al. Fatigue in bronchiectasis. QJM. 2012;105:235–240.
    1. Zhang H, Wu F, Yi H, et al. Gender differences in chronic obstructive pulmonary disease symptom clusters. Int J Chron Obstruct Pulmon Dis. 2021;16:1101–1107.
    1. Heslop K, Newton J, Baker C, Burns G, Carrick-Sen D, De Soyza A. Effectiveness of cognitive behavioural therapy (CBT) interventions for anxiety in patients with chronic obstructive pulmonary disease (COPD) undertaken by respiratory nurses: the COPD CBT CARE study: (ISRCTN55206395) BMC Pulm Med. 2013;13:62.
    1. Dodd JW, Getov SV, Jones PW. Cognitive function in COPD. Eur Respir J. 2010;35:913–922.
    1. Børvik T, Brækkan SK, Enga K, et al. COPD and risk of venous thromboembolism and mortality in a general population. Eur Respir J. 2016;47:473–481.
    1. Raj SR, Arnold AC, Barboi A, et al. Long-COVID postural tachycardia syndrome: an American Autonomic Society statement. Clin Auton Res. 2021;31:365–368.
    1. Roig M, Eng JJ, Road JD, Reid WD. Falls in patients with chronic obstructive pulmonary disease: a call for further research. Respir Med. 2009;103:1257–1269.
    1. Gemelli Against C-P-ACSG Post-COVID-19 global health strategies: the need for an interdisciplinary approach. Aging Clin Exp Res. 2020;32:1613–1620.
    1. Rudan I, El Arifeen S, Bhutta ZA, et al. Setting research priorities to reduce global mortality from childhood pneumonia by 2015. PLoS Med. 2011;8
    1. Fontaine O, Kosek M, Bhatnagar S, et al. Setting research priorities to reduce global mortality from childhood diarrhoea by 2015. PLoS Med. 2009;6:e41.
    1. Rudan I, Yoshida S, Chan KY, et al. Setting health research priorities using the CHNRI method: VII. A review of the first 50 applications of the CHNRI method. J Glob Health. 2017;7
    1. Rudan I, Yoshida S, Wazny K, Chan KY, Cousens S. Setting health research priorities using the CHNRI method: V. Quantitative properties of human collective knowledge. J Glob Health. 2016;6
    1. Yoshida S, Rudan I, Cousens S. Setting health research priorities using the CHNRI method: VI. Quantitative properties of human collective opinion. J Glob Health. 2016;6
    1. Rudan I, Yoshida S, Chan KY, et al. Setting health research priorities using the CHNRI method: I. Involving funders. J Glob Health. 2016;6
    1. Yoshida S, Cousens S, Wazny K, Chan KY. Setting health research priorities using the CHNRI method: II. Involving researchers. J Glob Health. 2016;6
    1. Yoshida S, Wazny K, Cousens S, Chan KY. Setting health research priorities using the CHNRI method: III. Involving stakeholders. J Glob Health. 2016;6
    1. Rudan I. Setting health research priorities using the CHNRI method: IV. Key conceptual advances. J Glob Health. 2016;6
    1. Rudan I, Gibson JL, Ameratunga S, et al. Setting priorities in global child health research investments: guidelines for implementation of CHNRI method. Croat Med J. 2008;49:720–733.
    1. Knight SR, Ho A, Pius R, et al. Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score. BMJ. 2020;370
    1. Alqahtani JS, Njoku CM, Bereznicki B, et al. Risk factors for all-cause hospital readmission following exacerbation of COPD: a systematic review and meta-analysis. Eur Respir Rev. 2020;29
    1. Beurnier A, Jutant EM, Jevnikar M, et al. Characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who require hospitalisation. Eur Respir J. 2020;56
    1. Izquierdo JL, Almonacid C, González Y, et al. The impact of COVID-19 on patients with asthma. Eur Respir J. 2021;57
    1. Zafar MH, Panos RJ, Ko J, et al. Reliable adherence to a COPD care bundle mitigates system-level failures and reduces COPD readmissions: a system redesign using improvement science. BMJ Qual Saf. 2017;26:908–918.
    1. Yelin D, Wirtheim E, Vetter P, et al. Long-term consequences of COVID-19: research needs. Lancet Infect Dis. 2020;20:1115–1117.

Source: PubMed

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