Cognitive and psychological recovery patterns across different care pathways 12 months after hospitalization for COVID-19: A multicenter cohort study (CO-FLOW) - 12/07/23
, Merel E Hellemons b, Julia C Berentschot b, Marieke M Visser c, Susanne M Huijts b, Jasper van Bommel d, Michel E van Genderen d, Joachim GJV Aerts b, Gerard M Ribbers a, c, Rita JG van den Berg-Emons a, 1, Majanka H Heijenbrok-Kal a, c, 1on behalf of the
CO-FLOW collaboration Group⁎⁎
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Highlights |
• | Cognitive and psychological issues post-COVID-19 are reported across care pathways. |
• | Most cognitive and psychological recovery occurred within the first 6 months. |
• | At 1 year, 21.3% of participants had cognitive deficits and 15.4% had psychological problems. |
• | People receiving medical rehabilitation had the fewest cognitive deficits, but the most psychological sequelae. |
• | Additional cognitive or psychological support might be needed in some care pathways. |
Abstract |
Background |
The comparison of recovery patterns for different care pathways following COVID-19 is necessary for optimizing rehabilitation strategies.
Objectives |
To evaluate cognitive and psychological outcomes across different care pathways up to 12 months after hospitalization for COVID-19.
Methods |
CO-FLOW is an ongoing multicenter prospective cohort study with assessments at 3, 6, and 12 months after hospitalization for COVID-19. The main outcomes are cognitive deficits (Montreal Cognitive Assessment, score <26), cognitive failure (Cognitive Failure Questionnaire, score >43), posttraumatic stress disorder (PTSD; Impact of Event Scale-Revised, score ≥33), and anxiety and depression (Hospital Anxiety and Depression Scale, subscale score ≥11).
Results |
In total, data from 617 participants were analyzed. Mean age was 59.7 (SD 11.4) years and 188 (31%) were female. Significant recovery occurred within the first 6 months post-discharge (p ≤ 0.001). Cognitive deficits persisted in 21% (101/474), and psychological problems in 15% (74/482) of people at 12 months. Significantly improved cognition scores were reported for people who did not receive rehabilitation (‘No-rehab’; 124/617, 20%; mean difference, MD 2.32, 95% CI 1.47 to 3.17; p<0.001), those who received community-based rehabilitation (‘Com-rehab’; 327/617, 53%; MD 1.27, 95% CI 0.77 to 1.78; p<0.001), and those who received medical rehabilitation (‘Med-rehab’; 86/617, 14%; MD 1.63, 95% CI 0.17 to 3.10; p = 0.029). Med-rehab participants experienced more cognitive failure from 3 to 6 months (MD 4.24, 95% 1.63 to 6.84; p = 0.001). Com-rehab showed recovery for PTSD (MD −2.43, 95% −3.50 to −1.37; p<0.001), anxiety (MD −0.67, 95% −1.02 to −0.32; p<0.001), and depression (MD −0.60, 95% −0.96 to −0.25; p<0.001), but symptoms persisted at 12 months.
Conclusions |
Survivors of COVID-19 showed cognitive and psychological recovery, especially within the first 6 months after hospitalization. Most persistent problems were related to cognitive functioning at 12 months. Recovery differed rehabilitation settings. Additional cognitive or psychological support might be warranted in people who medical or community-based rehabilitation.
El texto completo de este artículo está disponible en PDF.Keywords : COVID-19, Rehabilitation, Cognition, Depression, Anxiety, PTSD
Abbreviations : BMI, CFQ, CO-FLOW, Com-rehab, COVID-19, EPR, GEE, HADS, HADS-A, HADS-D, ICU, IES-R, iMCQ, IMTA, LOS, MD, Med-rehab, MoCA, No-rehab, PTSD, SNF, SNF-rehab
Esquema
Vol 66 - N° 5
Artículo 101737- juin 2023 Regresar al número
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