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A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications #MMPMID34000678
Frontera JA; Yang D; Lewis A; Patel P; Medicherla C; Arena V; Fang T; Andino A; Snyder T; Madhavan M; Gratch D; Fuchs B; Dessy A; Canizares M; Jauregui R; Thomas B; Bauman K; Olivera A; Bhagat D; Sonson M; Park G; Stainman R; Sunwoo B; Talmasov D; Tamimi M; Zhu Y; Rosenthal J; Dygert L; Ristic M; Ishii H; Valdes E; Omari M; Gurin L; Huang J; Czeisler BM; Kahn DE; Zhou T; Lin J; Lord AS; Melmed K; Meropol S; Troxel AB; Petkova E; Wisniewski T; Balcer L; Morrison C; Yaghi S; Galetta S
J Neurol Sci 2021[Jul]; 426 (?): 117486 PMID34000678show ga
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.
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J+Neurol+Sci 2021 ; 426 (?): 117486
