Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

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Exploring meaning in life through a brief photo-ethnographic intervention using Instagram: a Bayesian growth modelling approach

The 4th Industrial Revolution has provided several digital platforms through which to disseminate scalable and cost-effective interventions (e.g. Apps and Social media). Instagram, a popular visual-ethnographic social media platform, could be employed to implement and scale interventions aimed at aiding individuals in discovering meaning in life and gratitude through capturing and reflecting upon photographs of meaningful moments. The purpose of this study was to evaluate the long-term effectiveness of a brief photo-ethnographic meaningful-moments intervention aimed at enhancing wellbeing (life satisfaction) and managing common mental health problems (stress/depression/anxiety) through Instagram. A 4 × 1 treatment-only intervention design was used to assess the immediate and long-term changes in meaning, gratitude, life satisfaction, and depression/stress/anxiety. Within-person development on the subscales was evaluated with Bayesian level and shape models. The results showed significant improvements in all factors directly after the intervention. Over the long term, significant changes with baseline measures for the presence of meaning, appreciation for others, and life satisfaction was found. Participants also reported a significant but small change in depression over the long term. Instagram could therefore be an interesting tool to consider when the aim is to enhance wellbeing and manage common mental health problems in the short-, medium- and long-term

Exploring meaning in life through a brief photo-ethnographic intervention using Instagram:a Bayesian growth modelling approach

The 4th Industrial Revolution has provided several digital platforms through which to disseminate scalable and cost-effective interventions (e.g. Apps and Social media). Instagram, a popular visual-ethnographic social media platform, could be employed to implement and scale interventions aimed at aiding individuals in discovering meaning in life and gratitude through capturing and reflecting upon photographs of meaningful moments. The purpose of this study was to evaluate the long-term effectiveness of a brief photo-ethnographic meaningful-moments intervention aimed at enhancing wellbeing (life satisfaction) and managing common mental health problems (stress/depression/anxiety) through Instagram. A 4x1 treatment-only intervention design was used to assess the immediate and long-term changes in meaning, gratitude, life satisfaction, and depression/stress/anxiety. Within-person development on the subscales was evaluated with Bayesian level and shape models. The results showed significant improvements in all factors directly after the intervention. Over the long term, significant changes with baseline measures for the presence of meaning, appreciation for others, and life satisfaction was found. Participants also reported a significant but small change in depression over the long term. Instagram could therefore be an interesting tool to consider when the aim is to enhance wellbeing and manage common mental health problems in the short-, medium- and long-term

Exploring meaning in life through a brief photo-ethnographic intervention using Instagram: a Bayesian growth modelling approach

The 4th Industrial Revolution has provided several digital platforms through which to disseminate scalable and cost-effective interventions (e.g. Apps and Social media). Instagram, a popular visual-ethnographic social media platform, could be employed to implement and scale interventions aimed at aiding individuals in discovering meaning in life and gratitude through capturing and reflecting upon photographs of meaningful moments. The purpose of this study was to evaluate the long-term effectiveness of a brief photo-ethnographic meaningful-moments intervention aimed at enhancing wellbeing (life satisfaction) and managing common mental health problems (stress/depression/anxiety) through Instagram. A 4 × 1 treatment-only intervention design was used to assess the immediate and long-term changes in meaning, gratitude, life satisfaction, and depression/stress/anxiety. Within-person development on the subscales was evaluated with Bayesian level and shape models. The results showed significant improvements in all factors directly after the intervention. Over the long term, significant changes with baseline measures for the presence of meaning, appreciation for others, and life satisfaction was found. Participants also reported a significant but small change in depression over the long term. Instagram could therefore be an interesting tool to consider when the aim is to enhance wellbeing and manage common mental health problems in the short-, medium- and long-term