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

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:426

Article

Frontera, Jennifer A.¹  Yang, Dixon¹  Lewis, Ariane¹  Patel, Palak¹  Medicherla, Chaitanya¹  Arena, Vito¹  Fang, Taolin¹  Andino, Andres¹  Snyder, Thomas¹  Madhavan, Maya¹  Gratch, Daniel¹  Fuchs, Benjamin¹  Dessy, Alexa¹  Canizares, Melanie¹  Jauregui, Ruben¹  Thomas, Betsy¹  Bauman, Kristie¹  Olivera, Anlys¹  Bhagat, Dhristie¹  Sonson, Michael¹  Park, George¹  Stainman, Rebecca¹  Sunwoo, Brian¹  Talmasov, Daniel¹  Tamimi, Michael¹  Zhu, Yingrong¹  Rosenthal, Jonathan¹  Dygert, Levi¹  Ristic, Milan¹  Ishii, Haruki¹  Valdes, Eduard¹  Omari, Mirza¹  Gurin, Lindsey¹  Huang, Joshua¹  Czeisler, Barry M.¹  Kahn, D. Ethan¹  Zhou, Ting¹  Lin, Jessica¹  Lord, Aaron S.¹  Melmed, Kara¹  Meropol, Sharon¹  Troxel, Andrea B.¹  Petkova, Eva¹  Wisniewski, Thomas¹  Balcer, Laura¹  Morrison, Chris¹  Yaghi, Shadi¹  Galetta, Steven¹ 

[1] NYU, Grossman Sch Med, New York, NY USA

关键词: Post-acute sequelae of COVID;    Post-COVID syndrome;    Long-hauler;    Long-COVID;    COVID-19;    SARS-CoV-2;    Outcomes;    Cognitive;    Quality of life;    Readmission;    Neurologic;    Brain;    Function;    Anxiety;    Depression;    Fatigue;    Sleep;   

DOI  :  10.1016/j.jns.2021.117486

来源: Elsevier

【 摘 要 】

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 6month 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.

【 授权许可】

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