Evidence Synthesis Program (ESP) Center
Minneapolis VA Health Care System
Timothy J. Wilt, MD, MPH, Director
Wei Duan-Porter, MD, PhD, Associate Director
Greer N, Bart B, Billington C, Diem SJ, Ensrud KE, Kaka A, Klein M, Melzer
A, Reule S, Shaukat A, Sheets K, Starks J, Vardeny O, McKenzie L, Stroebel, B, Duan-Porter W, Wilt,
TJ. COVID-19 Post-acute Care Major Organ Damage: A Living Rapid Review. Updated June 2021.
Evidence Synthesis Program, Health Services Research and Development Service, Office of Research
and Development, Department of Veterans Affairs. VA ESP Project #09-009; 2021.
Our living systematic review yielded limited published data on post-acute COVID-19 major organ damage and healthcare/service use needs. Frequently reported outcomes included pulmonary fibrosis (7%-61%), pericardial effusions (0%-20%), need for renal replacement (4%-31%), readmission (0%-15%), and discharge disposition other than home (3%-47%). Interpretation of findings is difficult due to study limitations. Applicability of findings to sub-groups (eg, age, gender, COVID severity) and non-hospitalized patients is unknown. Future updates are likely to identify additional relevant data.
Coronavirus disease-2019 (COVID-19) is a viral illness caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and was declared a pandemic in March 2020. As of 06/07/21, there have been over 33 million cases and over 597,000 deaths in the US. This systematic review examined post-acute prevalence of major organ damage and healthcare/service use needs among adults hospitalized with or for COVID-19.
We identified 90 reports of post-acute major organ damage or healthcare/service use outcomes in adults hospitalized with or for COVID-19. Among organ systems, pulmonary outcomes were most frequently reported with fewer studies of cardiovascular, gastrointestinal, hematologic, neural, or renal outcomes and no studies of endocrine or rheumatologic/musculoskeletal outcomes. Among healthcare/service use outcomes, discharge disposition and readmission were most frequently reported with little or no information about post-hospital care, monitoring, or treatments required. Available data are largely from studies of convenience samples with poorly described study populations and primarily physiologic outcomes; few included control groups for comparison of COVID-19 and non-COVID-19 patients. Most studies had short follow-up post-discharge; long-term outcomes are unknown. Applicability of findings to non-hospitalized patients is also unknown.