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A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications

BACKGROUND: Little is known regarding long-term outcomes of patients hospitalized with COVID-19. METHODS: We 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-mat...

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Autores principales: Frontera, Jennifer A., Yang, Dixon, Lewis, Ariane, Patel, Palak, Medicherla, Chaitanya, Arena, Vito, Fang, Taolin, Andino, Andres, Snyder, Thomas, Madhavan, Maya, Gratch, Daniel, Fuchs, Benjamin, Dessy, Alexa, Canizares, Melanie, Jauregui, Ruben, Thomas, Betsy, Bauman, Kristie, Olivera, Anlys, Bhagat, Dhristie, Sonson, Michael, Park, George, Stainman, Rebecca, Sunwoo, Brian, Talmasov, Daniel, Tamimi, Michael, Zhu, Yingrong, Rosenthal, Jonathan, Dygert, Levi, Ristic, Milan, Ishii, Haruki, Valdes, Eduard, Omari, Mirza, Gurin, Lindsey, Huang, Joshua, Czeisler, Barry M., Kahn, D. Ethan, Zhou, Ting, Lin, Jessica, Lord, Aaron S., Melmed, Kara, Meropol, Sharon, Troxel, Andrea B., Petkova, Eva, Wisniewski, Thomas, Balcer, Laura, Morrison, Chris, Yaghi, Shadi, Galetta, Steven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier B.V. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8113108/
https://www.ncbi.nlm.nih.gov/pubmed/34000678
http://dx.doi.org/10.1016/j.jns.2021.117486
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author Frontera, Jennifer A.
Yang, Dixon
Lewis, Ariane
Patel, Palak
Medicherla, Chaitanya
Arena, Vito
Fang, Taolin
Andino, Andres
Snyder, Thomas
Madhavan, Maya
Gratch, Daniel
Fuchs, Benjamin
Dessy, Alexa
Canizares, Melanie
Jauregui, Ruben
Thomas, Betsy
Bauman, Kristie
Olivera, Anlys
Bhagat, Dhristie
Sonson, Michael
Park, George
Stainman, Rebecca
Sunwoo, Brian
Talmasov, Daniel
Tamimi, Michael
Zhu, Yingrong
Rosenthal, Jonathan
Dygert, Levi
Ristic, Milan
Ishii, Haruki
Valdes, Eduard
Omari, Mirza
Gurin, Lindsey
Huang, Joshua
Czeisler, Barry M.
Kahn, D. Ethan
Zhou, Ting
Lin, Jessica
Lord, Aaron S.
Melmed, Kara
Meropol, Sharon
Troxel, Andrea B.
Petkova, Eva
Wisniewski, Thomas
Balcer, Laura
Morrison, Chris
Yaghi, Shadi
Galetta, Steven
author_facet Frontera, Jennifer A.
Yang, Dixon
Lewis, Ariane
Patel, Palak
Medicherla, Chaitanya
Arena, Vito
Fang, Taolin
Andino, Andres
Snyder, Thomas
Madhavan, Maya
Gratch, Daniel
Fuchs, Benjamin
Dessy, Alexa
Canizares, Melanie
Jauregui, Ruben
Thomas, Betsy
Bauman, Kristie
Olivera, Anlys
Bhagat, Dhristie
Sonson, Michael
Park, George
Stainman, Rebecca
Sunwoo, Brian
Talmasov, Daniel
Tamimi, Michael
Zhu, Yingrong
Rosenthal, Jonathan
Dygert, Levi
Ristic, Milan
Ishii, Haruki
Valdes, Eduard
Omari, Mirza
Gurin, Lindsey
Huang, Joshua
Czeisler, Barry M.
Kahn, D. Ethan
Zhou, Ting
Lin, Jessica
Lord, Aaron S.
Melmed, Kara
Meropol, Sharon
Troxel, Andrea B.
Petkova, Eva
Wisniewski, Thomas
Balcer, Laura
Morrison, Chris
Yaghi, Shadi
Galetta, Steven
author_sort Frontera, Jennifer A.
collection PubMed
description BACKGROUND: Little is known regarding long-term outcomes of patients hospitalized with COVID-19. METHODS: We 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. RESULTS: Of 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 1.98, 95%CI 1.23–3.48, P = 0.02), 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. CONCLUSIONS: Abnormalities 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.
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spelling pubmed-81131082021-05-12 A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications Frontera, Jennifer A. Yang, Dixon Lewis, Ariane Patel, Palak Medicherla, Chaitanya Arena, Vito Fang, Taolin Andino, Andres Snyder, Thomas Madhavan, Maya Gratch, Daniel Fuchs, Benjamin Dessy, Alexa Canizares, Melanie Jauregui, Ruben Thomas, Betsy Bauman, Kristie Olivera, Anlys Bhagat, Dhristie Sonson, Michael Park, George Stainman, Rebecca Sunwoo, Brian Talmasov, Daniel Tamimi, Michael Zhu, Yingrong Rosenthal, Jonathan Dygert, Levi Ristic, Milan Ishii, Haruki Valdes, Eduard Omari, Mirza Gurin, Lindsey Huang, Joshua Czeisler, Barry M. Kahn, D. Ethan Zhou, Ting Lin, Jessica Lord, Aaron S. Melmed, Kara Meropol, Sharon Troxel, Andrea B. Petkova, Eva Wisniewski, Thomas Balcer, Laura Morrison, Chris Yaghi, Shadi Galetta, Steven J Neurol Sci Article BACKGROUND: Little is known regarding long-term outcomes of patients hospitalized with COVID-19. METHODS: We 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. RESULTS: Of 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 1.98, 95%CI 1.23–3.48, P = 0.02), 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. CONCLUSIONS: Abnormalities 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. Elsevier B.V. 2021-07-15 2021-05-12 /pmc/articles/PMC8113108/ /pubmed/34000678 http://dx.doi.org/10.1016/j.jns.2021.117486 Text en © 2021 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Frontera, Jennifer A.
Yang, Dixon
Lewis, Ariane
Patel, Palak
Medicherla, Chaitanya
Arena, Vito
Fang, Taolin
Andino, Andres
Snyder, Thomas
Madhavan, Maya
Gratch, Daniel
Fuchs, Benjamin
Dessy, Alexa
Canizares, Melanie
Jauregui, Ruben
Thomas, Betsy
Bauman, Kristie
Olivera, Anlys
Bhagat, Dhristie
Sonson, Michael
Park, George
Stainman, Rebecca
Sunwoo, Brian
Talmasov, Daniel
Tamimi, Michael
Zhu, Yingrong
Rosenthal, Jonathan
Dygert, Levi
Ristic, Milan
Ishii, Haruki
Valdes, Eduard
Omari, Mirza
Gurin, Lindsey
Huang, Joshua
Czeisler, Barry M.
Kahn, D. Ethan
Zhou, Ting
Lin, Jessica
Lord, Aaron S.
Melmed, Kara
Meropol, Sharon
Troxel, Andrea B.
Petkova, Eva
Wisniewski, Thomas
Balcer, Laura
Morrison, Chris
Yaghi, Shadi
Galetta, Steven
A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
title A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
title_full A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
title_fullStr A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
title_full_unstemmed A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
title_short A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
title_sort prospective study of long-term outcomes among hospitalized covid-19 patients with and without neurological complications
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8113108/
https://www.ncbi.nlm.nih.gov/pubmed/34000678
http://dx.doi.org/10.1016/j.jns.2021.117486
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