| Autor: |
Jennifer A. Frontera, Dixon Yang, Chaitanya Medicherla, Samuel Baskharoun, Kristie Bauman, Lena Bell, Dhristie Bhagat, Steven Bondi, Alexander Chervinsky, Levi Dygert, Benjamin Fuchs, Daniel Gratch, Lisena Hasanaj, Jennifer Horng, Joshua Huang, Ruben Jauregui, Yuan Ji, D. Ethan Kahn, Ethan Koch, Jessica Lin, Susan Liu, Anlys Olivera, Jonathan Rosenthal, Thomas Snyder, Rebecca Stainman, Daniel Talmasov, Betsy Thomas, Eduard Valdes, Ting Zhou, Yingrong Zhu, Ariane Lewis, Aaron S. Lord, Kara Melmed, Sharon B. Meropol, Sujata Thawani, Andrea B. Troxel, Shadi Yaghi, Laura J. Balcer, Thomas Wisniewski, Steven Galetta |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Neurology |
| Popis: |
Background and ObjectiveLittle is known about trajectories of recovery 12 months after hospitalization for severe COVID-19.MethodsWe conducted a prospective, longitudinal cohort study of patients with and without neurologic complications during index hospitalization for COVID-19 from March 10, 2020, to May 20, 2020. Phone follow-up batteries were performed at 6 and 12 months after COVID-19 onset. The primary 12-month outcome was the modified Rankin Scale (mRS) score comparing patients with or without neurologic complications using multivariable ordinal analysis. Secondary outcomes included activities of daily living (Barthel Index), telephone Montreal Cognitive Assessment (t-MoCA), and Quality of Life in Neurologic Disorders (Neuro-QoL) batteries for anxiety, depression, fatigue, and sleep. Changes in outcome scores from 6 to 12 months were compared using nonparametric paired-samples sign test.ResultsTwelve-month follow-up was completed in 242 patients (median age 65 years, 64% male, 34% intubated during hospitalization) and 174 completed both 6- and 12-month follow-up. At 12 months, 197/227 (87%) had ≥1 abnormal metric: mRS >0 (75%), Barthel Index p = 0.037). Significant improvements in outcome trajectories from 6 to 12 months were observed in t-MoCA scores (56% improved, median difference 1 point; p = 0.002) and Neuro-QoL anxiety scores (45% improved; p = 0.003). Nonsignificant improvements occurred in fatigue, sleep, and depression scores in 48%, 48%, and 38% of patients, respectively. Barthel Index and mRS scores remained unchanged between 6 and 12 months in >50% of patients.DiscussionAt 12 months after hospitalization for severe COVID-19, 87% of patients had ongoing abnormalities in functional, cognitive, or Neuro-QoL metrics and abnormal cognition persisted in 50% of patients without a history of dementia/cognitive abnormality. Only fatigue severity differed significantly between patients with or without neurologic complications during index hospitalization. However, significant improvements in cognitive (t-MoCA) and anxiety (Neuro-QoL) scores occurred in 56% and 45% of patients, respectively, between 6 and 12 months. These results may not be generalizable to those with mild or moderate COVID-19. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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