Janssen, Emma B N J

Importance Little research has been done on post-COVID symptoms at 24 months postinfection and on the association these may have on health-related quality of life (HRQOL). Objective We assessed the prevalence and severity of post-COVID symptoms and quantified EuroQol 5 Dimension 5 Level (EQ-5D-5L), self-perceived health question (EuroQol Visual Analogue Scale (EQ-VAS)) and health utility scores (HUS) up to 24 months follow-up. Design The longitudinal multiple cohort CORona Follow-Up (CORFU) study combines seven COVID-19 patient cohorts and a survey among the general public. The participants received questionnaires on several time points. Participants were stratified by: without a known SARS-CoV-2 infection (control group), proven SARS-CoV-2 infection but non-hospitalised, proven SARS-CoV-2 infection hospitalised to the ward, and proven SARS-CoV-2 infection hospitalised to the intensive care unit (ICU). Setting In this study, data of seven COVID-19 patient cohorts and a survey among the general public are included. Participants Former COVID-19 patients and controls participated in this cohort study. Main outcomes and measures Former COVID-19 patients and non-COVID-19 controls were sent questionnaires on symptoms associated with post-COVID condition. The CORFU questionnaire included 14 symptom questions on post-COVID condition using a five-level Likert-scale format. Furthermore, HRQOL was quantified using the EuroQol EQ-5D-5L questionnaire: EQ-VAS and the EQ-5D-5L utility score. The EQ-5D-5L questionnaire includes five domains that are scored on a five-point Likert scale: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Results A total of 901 participants (and 434 controls) responded at 24 months follow-up. In all former COVID-19 patients, the presence of post-COVID condition at 24 months was observed in 62 (42.5%, 95% CI 34.3% to 50.9%) of the non-hospitalised patients, 333 (65.0%, 95% CI 60.7% to 69.2%) of the hospitalised ward patients and 156 (63.2%, 95% CI 56.8% to 69.2%) of the ICU patients, respectively (p<0.001). The most common symptoms included fatigue, sleep problems, muscle weakness/pain and breathing issues, with hospitalised participants reporting most often having symptoms. Multiple post-COVID symptoms were significantly associated with EQ-5D-5L measures. The mean and SD of the EQ-VAS were 71.6 (17.9), 70.0 (17.3) and 71.4 (17.5) for non-hospitalised, ward and ICU participants, respectively, and 75.6 (17.7) for the controls (p<0.001). The HUS resulted in 0.81 (0.20), 0.77 (0.19) and 0.79 (0.22) for non-hospitalised, hospitalised ward and ICU participants, respectively, and 0.84 (0.19) for the control group (CG) (p<0.001). Conclusions Many former COVID-19 patients experience post-COVID symptoms at 24 months follow-up, with the highest prevalence in hospitalised participants. Also, former patients reported a lower HRQOL. Trial registration number The CORFU study was registered at clinicaltrials.gov (registration number NCT05240742).

ABSTRACT Objective Pre‐eclampsia complicates up to 8% of pregnancies and is associated with increased risk of ischemic cardiac and cerebral disease, which may be prevented through management of cardiovascular risk when early disease stages are detected. This meta‐analysis aimed to determine the prevalence of clinical and subclinical atherosclerosis in women after pre‐eclamptic vs non‐pre‐eclamptic pregnancy with advancing maternal age. Methods A systematic search of the literature was conducted in PubMed, Embase and Web of Science for studies reporting on the prevalence of atherosclerosis in women with a previous pre‐eclamptic pregnancy and those with a previous uncomplicated pregnancy. Any systemic atherosclerosis documented using ultrasound or computed tomography was included. Random‐effects meta‐analysis was used to compute the odds ratio (OR) with 95% CI for the association between pre‐eclampsia and the presence of atherosclerosis. Subgroup analysis was conducted according to average maternal age at evaluation. Results A total of 11 articles were included (13 217 participants). The average maternal age at evaluation ranged from 32 to 60 years. Within this age range, the pooled OR for the presence of atherosclerotic plaque after pre‐eclampsia was 1.57 (95% CI, 1.39–1.78). The pooled OR of developing atherosclerotic plaque after a pre‐eclamptic vs non‐pre‐eclamptic pregnancy increased gradually with advancing maternal age. The OR was not significant in the 30–39‐year‐old group (0.64 (95% CI, 0.10–4.15)), but the odds of finding an atherosclerotic plaque were significantly increased after pre‐eclamptic pregnancy in the 40–49‐year‐old group (OR, 1.59 (95% CI, 1.34–1.89)) and 50–60‐year‐old group (OR, 2.00 (95% CI, 1.30–3.08)). At any given age, the percentage plaque prevalence in formerly pre‐eclamptic women was roughly equal to that seen 10 years later in women with a previous non‐pre‐eclamptic pregnancy. Conclusions Women with a previous pre‐eclamptic pregnancy exhibit atherosclerosis more frequently and approximately 10 years earlier compared with women with a previous non‐pre‐eclamptic pregnancy. Targeted primary prevention is required to reduce morbidity and mortality from premature cardiovascular disease in women after pre‐eclampsia. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Abstract Background Up to eight percent of pregnant women have pre-eclampsia. These women have an increased risk of future ischemic heart and cerebral disease. This warrants early cardiovascular risk management in early disease stages. This meta-analysis determines how the prevalence of subclinical atherosclerosis in women after pre-eclamptic compared to non-pre-eclamptic pregnancies changes over time. Methods A systematic search was used. Studies reporting the prevalence of systemic atherosclerosis using ultrasound or computed tomography in formerly pre-eclamptic and non-pre-eclamptic women were included. A random-effects meta-analysis provided overall odds ratio’s (OR (95% confidence interval (CI)) for the association between pre-eclampsia and the prevalence of atherosclerosis. Results Eleven articles could be included with a total of 13,217 participants. Maternal age ranged from 33 to 60 years. Within this age period, pooled OR of developing atherosclerosis after pre-eclampsia was 1.57 (95%CI 1.39-1.78). The pooled odds of developing atherosclerotic plaque after a pre-eclamptic versus a non-pre-eclamptic pregnancy increased gradually with age. The odds ratio was not significantly different in the 30-39 age group (OR 0.64 (95%CI 0.10-4.15)), but there was a statistically significantly increased odds of finding an atherosclerotic plaque in the 40-49 (OR 1.59 (95%CI 1.34-1.89)) and 50-60 age groups (OR 2.00 (95%CI 1.30-3.08)) after pre-eclamptic pregnancies compared to non-pre-eclamptic pregnancies. Conclusions Formerly pre-eclamptic women have earlier and more frequent atherosclerosis and occurs ten years earlier than in non-pre-eclamptic women. Targeted prevention strategies are required to prevent premature cardiovascular disease morbidity and mortality in formerly pre-eclamptic women.

Introduction The variety, time patterns and long-term prognosis of persistent COVID-19 symptoms (long COVID-19) in patients who suffered from mild to severe acute COVID-19 are incompletely understood. Cohort studies will be combined to describe the prevalence of long COVID-19 symptoms, and to explore the pathophysiological mechanisms and impact on health-related quality of life. A prediction model for long COVID-19 will be developed and internally validated to guide care in future patients. Methods and analysis Data from seven COVID-19 cohorts will be aggregated in the longitudinal multiple cohort CORona Follow Up (CORFU) study. CORFU includes Dutch patients who suffered from COVID-19 at home, were hospitalised without or with intensive care unit treatment, needed inpatient or outpatient rehabilitation and controls who did not suffer from COVID-19. Individual cohort study designs were aligned and follow-up has been synchronised. Cohort participants will be followed up for a maximum of 24 months after acute infection. Next to the clinical characteristics measured in individual cohorts, the CORFU questionnaire on long COVID-19 outcomes and determinants will be administered digitally at 3, 6, 12, 18 and 24 months after the infection. The primary outcome is the prevalence of long COVID-19 symptoms up to 2 years after acute infection. Secondary outcomes are health-related quality of life (eg, EQ-5D), physical functioning, and the prevalence of thromboembolic complications, respiratory complications, cardiovascular diseases and endothelial dysfunction. A prediction model and a patient platform prototype will be developed. Ethics and dissemination Approval was obtained from the medical research ethics committee of Maastricht University Medical Center+ and Maastricht University (METC 2021-2990) and local committees of the participating cohorts. The project is supported by ZonMW and EuroQol Research Foundation. Results will be published in open access peer-reviewed scientific journals and presented at (inter)national conferences. Trial registration number NCT05240742 .