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; p5mg/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. Funding: UK Research and Innovation and National Institute for Health Research

Dynamic stability of coral reefs on the West Australian coast

Monitoring changes in coral cover and composition through space and time can provide insights to reef health and assist the focus of management and conservation efforts. We used a meta-analytical approach to assess coral cover data across latitudes 10-35°S along the west Australian coast, including 25 years of data from the Ningaloo region. Current estimates of coral cover ranged between 3 and 44% in coral habitats. Coral communities in the northern regions were dominated by corals from the families Acroporidae and Poritidae, which became less common at higher latitudes. At Ningaloo Reef coral cover has remained relatively stable through time (∼28%), although north-eastern and southern areas have experienced significant declines in overall cover. These declines are likely related to periodic disturbances such as cyclones and thermal anomalies, which were particularly noticeable around 1998/1999 and 2010/2011. Linear mixed effects models (LME) suggest latitude explains 10% of the deviance in coral cover through time at Ningaloo. Acroporidae has decreased in abundance relative to other common families at Ningaloo in the south, which might be related to persistence of more thermally and mechanically tolerant families. We identify regions where quantitative time-series data on coral cover and composition are lacking, particularly in north-western Australia. Standardising routine monitoring methods used by management and research agencies at these, and other locations, would allow a more robust assessment of coral condition and a better basis for conservation of coral reefs

MARCO POLO: near earth object sample return mission

MARCO POLO is a joint European--Japanese sample return mission to a Near-Earth Object. This Euro-Asian mission will go to a primitive Near-Earth Object (NEO), which we anticipate will contain primitive materials without any known meteorite analogue, scientifically characterize it at multiple scales, and bring samples back to Earth for detailed scientific investigation. Small bodies, as primitive leftover building blocks of the Solar System formation process, offer important clues to the chemical mixture from which the planets formed some 4.6 billion years ago. Current exobiological scenarios for the origin of Life invoke an exogenous delivery of organic matter to the early Earth: it has been proposed that primitive bodies could have brought these complex organic molecules capable of triggering the pre-biotic synthesis of biochemical compounds. Moreover, collisions of NEOs with the Earth pose a finite hazard to life. For all these reasons, the exploration of such objects is particularly interesting and urgent. The scientific objectives of MARCO POLO will therefore contribute to a better understanding of the origin and evolution of the Solar System, the Earth, and possibly Life itself. Moreover, MARCO POLO provides important information on the volatile-rich (e.g. water) nature of primitive NEOs, which may be particularly important for future space resource utilization as well as providing critical information for the security of Earth. MARCO POLO is a proposal offering several options, leading to great flexibility in the actual implementation. The baseline mission scenario is based on a launch with a Soyuz-type launcher and consists of a Mother Spacecraft (MSC) carrying a possible Lander named SIFNOS, small hoppers, sampling devices, a re-entry capsule and scientific payloads. The MSC leaves Earth orbit, cruises toward the target with ion engines, rendezvous with the target, conducts a global characterization of the target to select a sampling site, and delivers small hoppers (MINERVA type, JAXA) and SIFNOS. The latter, if added, will perform a soft landing, anchor to the target surface, and make various in situ measurements of surface/subsurface materials near the sampling site. Two surface samples will be collected by the MSC using ``touch and go'' manoeuvres. Two complementary sample collection devices will be used in this phase: one developed by ESA and another provided by JAXA, mounted on a retractable extension arm. After the completion of the sampling and ascent of the MSC, the arm will be retracted to transfer the sample containers into the MSC. The MSC will then make its journey back to Earth and release the re-entry capsule into the Earth's atmosphere

The state of Western Australia’s coral reefs

Western Australia’s coral reefs have largely escaped the chronic pressures affecting other reefs around the world, but are regularly affected by seasonal storms and cyclones, and increasingly by heat stress and coral bleaching. Reef systems north of 18°S have been impacted by heat stress and coral bleaching during strong El Niño phases and those further south during strong La Niña phases. Cumulative heat stress and the extent of bleaching throughout the northern reefs in 2016 were higher than at any other time on record. To assess the changing regime of disturbance to reef systems across Western Australia (WA), we linked their site-specific exposure to damaging waves and heat stress since 1990 with mean changes in coral cover. Since 2010, there has been a noticeable increase in heat stress and coral bleaching across WA. Over half the reef systems have been severely impacted by coral bleaching since 2010, which was further compounded by cyclones at some reefs. For most (75%) reef systems with long-term data (5–26 yrs), mean coral cover is currently at (or near) the lowest on record and a full recovery is unlikely if disturbances continue to intensify with climate change. However, some reefs have not yet experienced severe bleaching and their coral cover has remained relatively stable or increased in recent years. Additionally, within all reef systems the condition of communities and their exposure to disturbances varied spatially. Identifying the communities least susceptible to future disturbances and linking them through networks of protected areas, based on patterns of larval connectivity, are important research and management priorities in coming years while the causes of climate change are addressed