Cognitive and psychological recovery patterns across different care pathways 12 months after hospitalization for COVID-19: A multicenter cohort study (CO-FLOW).

Autor: Bek LM; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address: l.bek@erasmusmc.nl., Hellemons ME; Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands., Berentschot JC; Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands., Visser MM; Rijndam Rehabilitation, Rotterdam, the Netherlands., Huijts SM; Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands., van Bommel J; Department of Adult Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands., van Genderen ME; Department of Adult Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands., Aerts JG; Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands., Ribbers GM; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Rijndam Rehabilitation, Rotterdam, the Netherlands., van den Berg-Emons RJ; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Heijenbrok-Kal MH; Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Rijndam Rehabilitation, Rotterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Annals of physical and rehabilitation medicine [Ann Phys Rehabil Med] 2023 Jun; Vol. 66 (5), pp. 101737. Date of Electronic Publication: 2023 Feb 10.
DOI: 10.1016/j.rehab.2023.101737
Abstrakt: Background: The comparison of recovery patterns for different care pathways following COVID-19 is necessary for optimizing rehabilitation strategies.
Objectives: To evaluate cognitive and psychological outcomes across different care pathways up to 12 months after hospitalization for COVID-19.
Methods: CO-FLOW is an ongoing multicenter prospective cohort study with assessments at 3, 6, and 12 months after hospitalization for COVID-19. The main outcomes are cognitive deficits (Montreal Cognitive Assessment, score <26), cognitive failure (Cognitive Failure Questionnaire, score >43), posttraumatic stress disorder (PTSD; Impact of Event Scale-Revised, score ≥33), and anxiety and depression (Hospital Anxiety and Depression Scale, subscale score ≥11).
Results: In total, data from 617 participants were analyzed. Mean age was 59.7 (SD 11.4) years and 188 (31%) were female. Significant recovery occurred within the first 6 months post-discharge (p ≤ 0.001). Cognitive deficits persisted in 21% (101/474), and psychological problems in 15% (74/482) of people at 12 months. Significantly improved cognition scores were reported for people who did not receive rehabilitation ('No-rehab'; 124/617, 20%; mean difference, MD 2.32, 95% CI 1.47 to 3.17; p<0.001), those who received community-based rehabilitation ('Com-rehab'; 327/617, 53%; MD 1.27, 95% CI 0.77 to 1.78; p<0.001), and those who received medical rehabilitation ('Med-rehab'; 86/617, 14%; MD 1.63, 95% CI 0.17 to 3.10; p = 0.029). Med-rehab participants experienced more cognitive failure from 3 to 6 months (MD 4.24, 95% 1.63 to 6.84; p = 0.001). Com-rehab showed recovery for PTSD (MD -2.43, 95% -3.50 to -1.37; p<0.001), anxiety (MD -0.67, 95% -1.02 to -0.32; p<0.001), and depression (MD -0.60, 95% -0.96 to -0.25; p<0.001), but symptoms persisted at 12 months.
Conclusions: Survivors of COVID-19 showed cognitive and psychological recovery, especially within the first 6 months after hospitalization. Most persistent problems were related to cognitive functioning at 12 months. Recovery differed rehabilitation settings. Additional cognitive or psychological support might be warranted in people who medical or community-based rehabilitation.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
Databáze: MEDLINE
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