1. A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
- Author
-
Michael Tamimi, Yingrong Zhu, Palak Patel, Michael Sonson, Chaitanya Medicherla, Jessica Lin, Kristie Bauman, George Park, Eva Petkova, Benjamin Fuchs, Taolin Fang, Haruki Ishii, Vito Arena, Lindsey Gurin, Milan Rustic, Kara Melmed, Eduard Valdes, Sharon B. Meropol, Dixon Yang, Steven L. Galetta, Chris Morrison, Brian Sunwoo, Laura J. Balcer, Maya Madhavan, Dhristie Bhagat, Levi Dygert, Rebecca Stainman, Jennifer A. Frontera, Joshua Huang, Andres Andino, Ting Zhou, Barry M Czseiler, Ariane Lewis, Daniel Talmasov, Melanie Canizares, Anlys Olivera, Betsy Thomas, Daniel Gratch, Shadi Yaghi, D. Ethan Kahn, Jonathan Rosenthal, Mirza Omari, Ruben Jauregui, Thomas Wisniewski, Andrea B. Troxel, Aaron Lord, Alexa Dessy, and Thomas Snyder
- Subjects
Quality of life ,medicine.medical_specialty ,Activities of daily living ,Cognitive ,Coronavirus disease 2019 (COVID-19) ,Post-acute sequelae of COVID ,Outcomes ,Anxiety ,Article ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Internal medicine ,Activities of Daily Living ,Long term outcomes ,Long-hauler ,Neurologic ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Function ,Prospective cohort study ,Post-COVID syndrome ,Depression (differential diagnoses) ,Fatigue ,business.industry ,SARS-CoV-2 ,Depression ,Montreal Cognitive Assessment ,COVID-19 ,Brain ,Long-COVID ,Neurology ,Neurology (clinical) ,medicine.symptom ,business ,Sleep ,030217 neurology & neurosurgery ,Readmission - Abstract
BackgroundLittle is known regarding long-term outcomes of patients hospitalized with COVID-19.MethodsWe conducted a prospective study of 6-month outcomes of hospitalized COVID-19 patients. Patients with new neurological complications during hospitalization who survived were propensity score-matched to COVID-19 survivors without neurological complications hospitalized during the same period. The primary 6-month outcome was multivariable ordinal analysis of the modified Rankin Scale(mRS) comparing patients with or without neurological complications. Secondary outcomes included: activities of daily living (ADLs;Barthel Index), telephone Montreal Cognitive Assessment and Neuro-QoL batteries for anxiety, depression, fatigue and sleep.ResultsOf 606 COVID-19 patients with neurological complications, 395 survived hospitalization and were matched to 395 controls; N=196 neurological patients and N=186 controls completed follow-up. Overall, 346/382 (91%) patients had at least one abnormal outcome: 56% had limited ADLs, 50% impaired cognition, 47% could not return to work and 62% scored worse than average on ≥1 Neuro-QoL scale (worse anxiety 46%, sleep 38%, fatigue 36%, and depression 25%). In multivariable analysis, patients with neurological complications had worse 6-month mRS (median 4 vs. 3 among controls, adjusted OR 2.03, 95%CI 1.22-3.40, P=0.01), worse ADLs (aOR 0.38, 95%CI 0.29-0.74, P=0.01) and were less likely to return to work than controls (41% versus 64%, P=0.04). Cognitive and Neuro-QOL metrics were similar between groups.ConclusionsAbnormalities in functional outcomes, ADLs, anxiety, depression and sleep occurred in over 90% of patients 6-months after hospitalization for COVID-19. In multivariable analysis, patients with neurological complications during index hospitalization had significantly worse 6-month functional outcomes than those without.
- Published
- 2021