Life stressors significantly impact long-term outcomes and post-acute symptoms 12-months after COVID-19 hospitalization.
Anxiety
COVID-19
Cognition
Depression
Disability
Long-COVID
Long-hauler
Outcomes
Post-COVID syndrome
Post-acute sequelae of COVID
Predictors
Quality of life
SARS-CoV-2
Journal
Journal of the neurological sciences
ISSN: 1878-5883
Titre abrégé: J Neurol Sci
Pays: Netherlands
ID NLM: 0375403
Informations de publication
Date de publication:
15 12 2022
15 12 2022
Historique:
received:
20
07
2022
revised:
12
10
2022
accepted:
01
11
2022
pubmed:
16
11
2022
medline:
1
12
2022
entrez:
15
11
2022
Statut:
ppublish
Résumé
Limited data exists evaluating predictors of long-term outcomes after hospitalization for COVID-19. We conducted a prospective, longitudinal cohort study of patients hospitalized for COVID-19. The following outcomes were collected at 6 and 12-months post-diagnosis: disability using the modified Rankin Scale (mRS), activities of daily living assessed with the Barthel Index, cognition assessed with the telephone Montreal Cognitive Assessment (t-MoCA), Neuro-QoL batteries for anxiety, depression, fatigue and sleep, and post-acute symptoms of COVID-19. Predictors of these outcomes, including demographics, pre-COVID-19 comorbidities, index COVID-19 hospitalization metrics, and life stressors, were evaluated using multivariable logistic regression. Of 790 COVID-19 patients who survived hospitalization, 451(57%) completed 6-month (N = 383) and/or 12-month (N = 242) follow-up, and 77/451 (17%) died between discharge and 12-month follow-up. Significant life stressors were reported in 121/239 (51%) at 12-months. In multivariable analyses, life stressors including financial insecurity, food insecurity, death of a close contact and new disability were the strongest independent predictors of worse mRS, Barthel Index, depression, fatigue, and sleep scores, and prolonged symptoms, with adjusted odds ratios ranging from 2.5 to 20.8. Other predictors of poor outcome included older age (associated with worse mRS, Barthel, t-MoCA, depression scores), baseline disability (associated with worse mRS, fatigue, Barthel scores), female sex (associated with worse Barthel, anxiety scores) and index COVID-19 severity (associated with worse Barthel index, prolonged symptoms). Life stressors contribute substantially to worse functional, cognitive and neuropsychiatric outcomes 12-months after COVID-19 hospitalization. Other predictors of poor outcome include older age, female sex, baseline disability and severity of index COVID-19.
Sections du résumé
BACKGROUND
Limited data exists evaluating predictors of long-term outcomes after hospitalization for COVID-19.
METHODS
We conducted a prospective, longitudinal cohort study of patients hospitalized for COVID-19. The following outcomes were collected at 6 and 12-months post-diagnosis: disability using the modified Rankin Scale (mRS), activities of daily living assessed with the Barthel Index, cognition assessed with the telephone Montreal Cognitive Assessment (t-MoCA), Neuro-QoL batteries for anxiety, depression, fatigue and sleep, and post-acute symptoms of COVID-19. Predictors of these outcomes, including demographics, pre-COVID-19 comorbidities, index COVID-19 hospitalization metrics, and life stressors, were evaluated using multivariable logistic regression.
RESULTS
Of 790 COVID-19 patients who survived hospitalization, 451(57%) completed 6-month (N = 383) and/or 12-month (N = 242) follow-up, and 77/451 (17%) died between discharge and 12-month follow-up. Significant life stressors were reported in 121/239 (51%) at 12-months. In multivariable analyses, life stressors including financial insecurity, food insecurity, death of a close contact and new disability were the strongest independent predictors of worse mRS, Barthel Index, depression, fatigue, and sleep scores, and prolonged symptoms, with adjusted odds ratios ranging from 2.5 to 20.8. Other predictors of poor outcome included older age (associated with worse mRS, Barthel, t-MoCA, depression scores), baseline disability (associated with worse mRS, fatigue, Barthel scores), female sex (associated with worse Barthel, anxiety scores) and index COVID-19 severity (associated with worse Barthel index, prolonged symptoms).
CONCLUSIONS
Life stressors contribute substantially to worse functional, cognitive and neuropsychiatric outcomes 12-months after COVID-19 hospitalization. Other predictors of poor outcome include older age, female sex, baseline disability and severity of index COVID-19.
Identifiants
pubmed: 36379135
pii: S0022-510X(22)00349-5
doi: 10.1016/j.jns.2022.120487
pmc: PMC9637014
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
120487Subventions
Organisme : NINDS NIH HHS
ID : U24 NS113844
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG066512
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG077422
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NHLBI NIH HHS
ID : OT2 HL161847
Pays : United States
Investigateurs
Shashank Agarwal
(S)
Andres Andino
(A)
Vito Arena
(V)
Samuel Baskharoun
(S)
Kristie Bauman
(K)
Lena Bell
(L)
Stephen Berger
(S)
Dhristie Bhagat
(D)
Matthew Bokhari
(M)
Steven Bondi
(S)
Melanie Canizares
(M)
Alexander Chervinsky
(A)
Barry M Czeisler
(BM)
Levi Dygert
(L)
Taolin Fang
(T)
Brent Flusty
(B)
Daniel Friedman
(D)
David Friedman
(D)
Benjamin Fuchs
(B)
Andre Granger
(A)
Daniel Gratch
(D)
Lindsey Gurin
(L)
Josef Gutman
(J)
Lisena Hasanaj
(L)
Manisha Holmes
(M)
Jennifer Horng
(J)
Joshua Huang
(J)
Haruki Ishii
(H)
Ruben Jauregui
(R)
Yuan Ji
(Y)
D Ethan Kahn
(DE)
Ethan Koch
(E)
Penina Krieger
(P)
Alexandra Kvernland
(A)
Rebecca Lalchan
(R)
Kaitlyn Lillemoe
(K)
Jessica Lin
(J)
Susan B Liu
(SB)
Maya Madhavan
(M)
Chaitanya Medicherla
(C)
Patricio Millar-Vernetti
(P)
Nicole Morgan
(N)
Anlys Olivera
(A)
Mirza Omari
(M)
George Park
(G)
Palak Patel
(P)
Milan Ristic
(M)
Jonathan Rosenthal
(J)
Michael Sonson
(M)
Thomas Snyder
(T)
Rebecca S Stainman
(RS)
Brian Sunwoo
(B)
Daniel Talmasov
(D)
Michael Tamimi
(M)
Betsy Thomas
(B)
Eduard Valdes
(E)
Ting Zhou
(T)
Yingrong Zhu
(Y)
Informations de copyright
Copyright © 2022 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Potential conflict of interest: JAF receives funding for the following COVID-19-related grants: NIH/NIA R01AG077422, NIH/NINDS 3U24NS11384401S1, NIH/NHLBI 1OT2HL161847-01; LJB and ST receive funding for the following COVID-19-related grant: NIH/NHLBI 1OT2HL161847-01. TW receives funding for the following COVID-19 related grant: NIH/NIA R01AG077422. JAF and TW have received funding for the COVID-19 related grant: NIH/NIA 3P30AG066512-01S1. AdH, SY, SS, DY, AL, ASL, KM, and SLG do not report any relevant conflicts of interest.
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