학술논문
Long-Term Functional Limitations and Predictors of Recovery after COVID-19: A Multicenter Prospective Cohort Study.
Document Type
Academic Journal
Author
Beauchamp M; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada. Electronic address: beaucm1@mcmaster.ca.; Kirkwood R; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.; Duong M; Department of Medicine, McMaster University, Hamilton, ON, Canada; Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, ON, Canada.; Ho T; Department of Medicine, McMaster University, Hamilton, ON, Canada; Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, ON, Canada.; Raina P; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.; Kruisselbrink R; Department of Medicine, McMaster University, Hamilton, ON, Canada.; Jones A; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.; Girolametto C; Director of Research, Innovation and Clinical Trials, Grand River Hospital, Kitchener, ON, Canada.; Costa A; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Source
Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0267200 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-7162 (Electronic) Linking ISSN: 00029343 NLM ISO Abbreviation: Am J Med Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Limited data exist on post-severe COVID-19 functional trajectory, particularly considering premorbid status. We characterized 1-year functional recovery post-hospitalization for COVID-19, highlighting predictors of long-term recovery.
Methods: We enrolled adult patients with lab-confirmed SARS-CoV-2 infection and hospitalized for COVID-19 sequelae, from five major Ontario, Canada hospitals in a prospective cohort study. Assessments included telephone interviews on admission followed by telephone and in-person assessments at 3-, 6-, 9-, and 12-months post-discharge. The Activity-Measure for Post-Acute Care (AM-PAC) Mobility and Cognition scales were administered at baseline and every 3 months for 1 year. Secondary outcomes included symptoms, spirometry, physical performance, dyspnea, fatigue, distress, anxiety and depression, and quality of life.
Results: 254 patients (57.1% male) with a mean age of 60.0 (±13.1) years and an average hospital stay of 14.3 (±19.7) days agreed to participate. At 12 months, 55.3% demonstrated clinically important deficits in mobility and 38.8% had cognitive deficits compared to premorbid levels. Fatigue was reported in 44.2%, followed by difficulty walking long distances in 35.8% and dyspnea in 33.0%. Almost 40% of patients had an FEV1(% Pred) < 80% at 12 months, 60.3% had impairments in physical performance, and 44.5% had problems with anxiety or depression. Predictors of better mobility at 12 months included higher premorbid mobility status, male sex, shorter hospital stay, fewer comorbidities, and higher FEV1 (% pred) at the 3-month follow-up.
Conclusions: Our study provides compelling evidence of the long-term impact of COVID-19 on functional and cognitive status 1-year post-infection.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Inc.)
Methods: We enrolled adult patients with lab-confirmed SARS-CoV-2 infection and hospitalized for COVID-19 sequelae, from five major Ontario, Canada hospitals in a prospective cohort study. Assessments included telephone interviews on admission followed by telephone and in-person assessments at 3-, 6-, 9-, and 12-months post-discharge. The Activity-Measure for Post-Acute Care (AM-PAC) Mobility and Cognition scales were administered at baseline and every 3 months for 1 year. Secondary outcomes included symptoms, spirometry, physical performance, dyspnea, fatigue, distress, anxiety and depression, and quality of life.
Results: 254 patients (57.1% male) with a mean age of 60.0 (±13.1) years and an average hospital stay of 14.3 (±19.7) days agreed to participate. At 12 months, 55.3% demonstrated clinically important deficits in mobility and 38.8% had cognitive deficits compared to premorbid levels. Fatigue was reported in 44.2%, followed by difficulty walking long distances in 35.8% and dyspnea in 33.0%. Almost 40% of patients had an FEV1(% Pred) < 80% at 12 months, 60.3% had impairments in physical performance, and 44.5% had problems with anxiety or depression. Predictors of better mobility at 12 months included higher premorbid mobility status, male sex, shorter hospital stay, fewer comorbidities, and higher FEV1 (% pred) at the 3-month follow-up.
Conclusions: Our study provides compelling evidence of the long-term impact of COVID-19 on functional and cognitive status 1-year post-infection.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Inc.)