COVID and Cognition: Preliminary Findings of a NYC Inpatient Rehabilitation Unit

RESEARCH OBJECTIVES: To investigate the impact of COVID-19 on cognition and independence with functional tasks of patients admitted to an inpatient rehabilitation unit (IRU). DESIGN: Cross-sectional observational study with assessments at admission and discharge of 94 COVID-19 patients admitted to an urban inpatient rehabilitation unit (IRU) between March 2020 - August 2020. SETTING: This study took place in an urban acute care hospital 22-bed IRU. PARTICIPANTS: 94 individuals admitted to the IRU with a diagnosis of COVID-19. 77 patients received an admission cognitive assessment, 45 also received discharge cognitive assessment. All received admission and discharge Quality Indicator for Self-Care (QI SC) Score. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Montreal Cognitive Assessment (MoCA) administered to identify cognitive impairment. The Uniform Data System (UDS) Quality Indicators (on Self-Care (QI-SC) scored for functional status. RESULTS: 75/77 (97%) patients received an admission cognitive assessment coded as independent with ADL and cognitive tasks prior to admittance. 62/77 (80.5%) patients demonstrated cognitive deficits on the MoCA at admission: 39/77 (50.6%) mildly impaired, 20/77 (26%) moderately impaired, and 3/77 (3.9%) severely impaired. 32/45 patients discharge scores improved and met the MoCA minimally clinically important difference (MCID); however, 35/45 continued to score in the impaired range. Patients who met the MoCA MCID demonstrated significantly greater QI-SC score gains than those that did not meet the MCID. 70/77 (91%) were discharged home with recommendation for continued therapy services. CONCLUSIONS: Cognitive impairment is common amongst patients requiring prolonged hospitalization and acute inpatient rehabilitation for COVID-19. Most patients admitted to the IRU demonstrated intact independence and cognition prior to disease onset and hospitalization. Although most patients on the IRU showed improvements in cognition according to the MoCA; these patients were recommended for continued therapy and/or assistance for functional tasks post discharge. Since cognitive deficits were still present at discharge, the need for standardized assessment and follow-up is indicated, especially given the association with functional outcome. AUTHOR(S) DISCLOSURES: None.