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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier B.V.
2021
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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. |
format | Online Article Text |
id | pubmed-8113108 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier B.V. |
record_format | MEDLINE/PubMed |
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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