Respiratory complications for 1 in 5 patients with severe COVID-19


One in five people hospitalised with COVID-19 develop a respiratory complication, a large trial reports.

The observational ISARIC WHO Clinical Characterisation Protocol UK study published in The Lancet involving 73,197 patients found that almost 1 in 3 died and 1 in 2 developed at least one complication.  

Renal issues were the most common complication affecting almost 1 in 4 people, followed by respiratory (1 in 5 people) and systemic complications (1 in 6). 

Cardiovascular complications were reported in around one in eight participants and while neurological complications affected less than one in 20, they were associated with the worst functional outcomes. 

Overall, acute kidney injury, probable acute respiratory distress syndrome, liver injury, anaemia, and cardiac arrhythmia were the most common specific complications.

The authors reported that complication rates were high in every age group and increased with age, with males significantly more likely to develop a complication compared to females.

The findings have important implications for clinicians as interventions targeted at preventing in-hospital complications or reducing their impact could plausibly improve outcomes, the research team say.

The results are also a wake up call for health-care systems and policy makers who should prepare for increases in population morbidity arising from COVID-19 and its subsequent complications. 

“As complications following COVID-19 are common across all age groups and comorbidities, public health messaging around the risk COVID-19 poses to younger otherwise healthy people should be considered alongside vaccine prioritisation,” they said. 

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