Long-Term Functional Limitations and Predictors of Recovery After COVID-19: A Multicenter Prospective Cohort Study - 25/09/24
, Renata Kirkwood, PhD a, MyLinh Duong, MSc, MBBS, FRACP b, c, Terence Ho, MD, MSc, FRCPC b, c, Parminder Raina, PhD d, Rebecca Kruisselbrink, MD, MPH, FRCPC b, Aaron Jones, PhD d, Carla Girolametto, MSc e, Andrew Costa, PhD dfor the
COREG Functional Recovery Investigators
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Highlights |
• | Long-lasting deficits in function and cognition persisted for a year post-COVID-19. |
• | Better recovery was associated with higher premorbid mobility, male sex, shorter hospital stays, fewer comorbidities, and higher force expiratory volume in the first second (FEV1 % pred). |
• | Early targeted interventions are crucial for restoring prior functioning. |
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 |
A total of 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.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, Mobility, Lung function, Physical assessment
Plan
| Funding: The COREG Registry and COREG-FR are funded by a Canadian Institutes of Health Research grant (172754). The COREG Registry is also funded by a Hamilton Academic Health Sciences Organisation grant (HAH-21–04). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of this manuscript. |
|
| Conflict of Interest: None. |
|
| Authorship: MB: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. RK: Writing – review & editing, Writing – original draft, Validation, Methodology, Investigation, Formal analysis, Conceptualization, MLD: Writing – review & editing, Methodology, Conceptualization, TH: Writing – review & editing, Methodology, Conceptualization, PR: Writing – review & editing, Formal analysis, Data curation, RK: Writing – review & editing, Methodology, Conceptualization, AJ: Writing – review & editing, Formal analysis, Data curation, CG: Writing – review & editing, Resources, Project administration, AC: Writing – review & editing, Validation, Supervision, Methodology, Funding acquisition, Data curation, Conceptualization. |
|
| All authors had access to the data and a role in writing this manuscript. |
Vol 137 - N° 10
P. 990-1000 - octobre 2024 Retour au numéro
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