1. Trajectories of Neurological Recovery 12 Months after Hospitalization for COVID-19: A Prospective Longitudinal Study
- Author
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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 B. Liu, Anlys Olivera, Jonathan Rosenthal, Thomas Snyder, Rebecca S. 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, and Steven L. Galetta
- Abstract
Background/ObjectivesLittle is known about trajectories of recovery 12-months after hospitalization for severe COVID.MethodsWe conducted a prospective, longitudinal cohort study of patients with and without neurological complications during index hospitalization for COVID-19 from March 10, 2020-May 20, 2020. Phone follow-up batteries were performed at 6- and 12-months post-COVID symptom onset. The primary 12-month outcome was the modified Rankin Scale (mRS) comparing patients with or without neurological complications using multivariable ordinal analysis. Secondary outcomes included: activities of daily living (Barthel Index), telephone Montreal Cognitive Assessment (t-MoCA) and Neuro-QoL batteries for anxiety, depression, fatigue and sleep. Changes in outcome scores from 6 to 12-months were compared using non-parametric paired-samples sign test.ResultsTwelve-month follow-up was completed in N=242 patients (median age 65, 64% male, 34% intubated during hospitalization) and N=174 completed both 6- and 12-month follow-up. At 12-months 197/227 (87%) had ≥1 abnormal metric: mRS>0 (75%), Barthel50% of patients.DiscussionAt 12-months post-hospitalization for severe COVID, 87% of patients had ongoing abnormalities in functional, cognitive or Neuro-QoL metrics and abnormal cognition persisted in 50% of patients without a prior history of dementia/cognitive abnormality. Only fatigue severity differed significantly between patients with or without neurological 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- to 12-months. These results may not be generalizable to those with mild/moderate COVID.
- Published
- 2022