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

Long COVID and cardiovascular disease: a prospective cohort study

Background Pre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known. Objectives To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors. Methods In a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months. Patients were stratified by the presence of either CVD or cardiovascular risk factors prior to hospitalisation with COVID-19 and compared with controls with neither. Full recovery was determined by the response to a patient-perceived evaluation of full recovery from COVID-19 in the context of physical, physiological and cognitive determinants of health. Results From a total population of 2545 patients (38.8% women), 472 (18.5%) and 1355 (53.2%) had CVD or cardiovascular risk factors, respectively. Compared with controls (n=718), patients with CVD and cardiovascular risk factors were older and more likely to have had severe COVID-19. Full recovery was significantly lower at 12 months in patients with CVD (adjusted OR (aOR) 0.62, 95% CI 0.43 to 0.89) and cardiovascular risk factors (aOR 0.66, 95% CI 0.50 to 0.86). Conclusion Patients with CVD or cardiovascular risk factors had a delayed recovery at 12 months following hospitalisation with COVID-19. Targeted interventions to reduce the impact of COVID-19 in patients with cardiovascular disease remain an unmet need

Trap attributes influencing capture of Diabrotica speciosa (Coleoptera: Chrysomelidae) on common bean fields Atributos da armadilha influenciam captura de Diabrotica speciosa (Coleoptera: Chrysomelidae) em feijoeiro

Refinements in trap characteristics may improve ability to monitor and mass-trap beetles. Field assays were conducted in common bean fields to assess responses of Diabrotica speciosa (Germar) to some trap characteristics. Golden yellow plastic cups (750 mL) traps caught more D. speciosa females and males than did clear traps. Carrot slices in Petri dishes baited with Lagenaria vulagaris L. powder (cucurbitacin source - 0.28%) caught more beetles than did dishes with carrot alone. Dispensers for the floral volatile attractant 1,4-dimethoxybenze were also compared. Rubber septa dispenser attracted more beetles than did control (dental wicks saturated with acetone). Captures on dental wick, starch matrix and feminine pad dispensers were intermediate and did not differ from those on rubber septa and unbaited controls. Perforated bottle traps (2000 mL), when baited with the floral attractant, caught more beetles than did window bottle traps (both traps contained L. vulgaris powder) in most assessments done from two to ten days after trap placement in the field. Traps with the insecticide carbaryl captured more beetles than did traps without it, 2-4 and 8-10 days after trap placement in the field, but not in the remaining periods (0-2, 4-6 and 6-8 days). Traps baited with 1,4-dimethoxybenzene captured more beetles than did the unbaited ones in all assessments (each other day from two to ten days after trap placement in the field). Finally, similar amounts of beetles were captured using plastic bottle traps (2000 mL): perforated, window (both with cucurbitacin) and sticky (without cucurbitacin) traps, when were baited with the floral attractant.<br>Refinamentos em caraterísticas de armadilhas podem incrementar sua habilidade para monitorar e capturar em massa os insetos. Experimentos foram conduzidos em lavoura de feijoeiro para verificar as respostas de Diabrotica speciosa (Germar) a algumas características de armadilhas. Armadilhas de copos plástico (750 mL) amarelo ouro capturaram mais fêmeas e machos de D. speciosa do que transparentes. Placas de Petri com pedaços de cenoura, com pó seco de purungo, Lagenaria vulgaris L. (fonte de cucurbitacina - 0,28%) capturaram mais insetos do que placas com somente cenoura. Liberadores para o atraente floral 1,4-dimetoxibenzeno foram também comparados. Liberador de septo de borracha atraiu mais insetos do que o controle (flocos dentais saturados com acetona). Capturas nos tratamentos com liberadores de floco dental, matriz borato e absorvente higiênico foram intermediárias mas não diferiram da testemunha e septo. Modelo de armadilha de garrafa (2000 mL) furada capturou mais insetos do que armadilha vazada ("janelas") (ambas contendo pó seco de purungo) na maioria das avaliações, dos dois até os dez dias após a instalação das armadilhas no campo. Armadilhas com inseticida carbaryl capturaram mais insetos do que armadilhas sem, nos intervalos de 2-4 e 9-10 dias após a instalação das armadilhas no campo. Nos períodos restantes (0-2, 4-6- e 6-8 dias), diferenças não foram detectadas. Armadilhas com 1,4-dimetoxibenzeno capturaram mais insetos do que armadilhas sem o volátil (avaliações a cada dois dias dos dois aos dez dias após a instalação no campo). Finalmente, quantidades similares de insetos foram capturadas usando armadilhas de garrafa pet (2000 mL): vazadas ("janelas"), furadas (ambas com cucurbitacina) e adesivas quando estas foram iscadas com o atraente floral