TY - JOUR
T1 - Patient-reported functional outcomes 30 days after hospitalization for COVID-19
AU - Qin, Evelyn S.
AU - Gold, Laura S.
AU - Hough, Catherine L.
AU - Katz, Patricia P.
AU - Bunnell, Aaron E.
AU - Wysham, Katherine D.
AU - Andrews, James S.
N1 - Funding Information:
Dr Andrews indicates grants from the National Institutes of Health (K23AG058756) and National Institute of Aging (K23AG058756‐03S2) outside the submitted work.
Publisher Copyright:
© 2021 American Academy of Physical Medicine and Rehabilitation.
PY - 2022/2
Y1 - 2022/2
N2 - Background: Many coronavirus disease 2019 (COVID-19) survivors experience persistent symptoms, such as fatigue, dyspnea, and musculoskeletal pain. However, less is known about the impact of COVID-19 on longer term functional outcomes. Objective: To evaluate patient-reported activity of daily living (ADL) function and fatigue symptoms 30 days after hospitalization for COVID-19. Design: Cross-sectional study. Setting: Tertiary care university hospital. Participants: Adults 18 years or older hospitalized for COVID-19 and survived to 30 days after discharge. Methods: A standardized telephone questionnaire was administered 30 days after hospital discharge. Main Outcome Measures: Ability to perform basic and instrumental ADLs and fatigue symptoms severity (Patient-Reported Outcome Measurement Information System [PROMIS] Fatigue Short Form 7a) were assessed by self-report. Results: Participants (n = 55) were 22-95 years old. Compared to pre-COVID hospitalization, 52% developed new difficulty and 6% new dependence with performing basic ADLs (bADLs), 48% developed new difficulty and 11% new dependence with instrumental ADLs (iADLs), and 69% experienced a clinically significant worsening in their fatigue symptom severity. The average fatigue symptom severity T-score before hospitalization was 44.2 ± 7.4 and after hospitalization was 54.5 ± 9.8. In exploratory multivariate analyses, each additional COVID symptom at presentation was associated with a predicted increase of 1.43 units (95% confidence interval [CI], 0.45–2.42) in the 30-day fatigue symptom severity T-score, each additional day of hospitalization was associated with an 1.2 times increased odds of worsening fatigue (95% CI, 0.98–1.5; p =.08), and each unit increase in baseline body mass index was associated with 0.8 times decreased odds of new bADL or iADL dependence at 30 days (95% CI, 0.65–0.99). Conclusions: New functional impairments are common at 30 days after discharge among survivors of hospitalization for COVID-19. Early rehabilitation, advance care planning, and referrals to appropriate therapies should be considered in postacute COVID-19 care to maximize patients' functional outcomes. However, ongoing research is still needed regarding management of these patients.
AB - Background: Many coronavirus disease 2019 (COVID-19) survivors experience persistent symptoms, such as fatigue, dyspnea, and musculoskeletal pain. However, less is known about the impact of COVID-19 on longer term functional outcomes. Objective: To evaluate patient-reported activity of daily living (ADL) function and fatigue symptoms 30 days after hospitalization for COVID-19. Design: Cross-sectional study. Setting: Tertiary care university hospital. Participants: Adults 18 years or older hospitalized for COVID-19 and survived to 30 days after discharge. Methods: A standardized telephone questionnaire was administered 30 days after hospital discharge. Main Outcome Measures: Ability to perform basic and instrumental ADLs and fatigue symptoms severity (Patient-Reported Outcome Measurement Information System [PROMIS] Fatigue Short Form 7a) were assessed by self-report. Results: Participants (n = 55) were 22-95 years old. Compared to pre-COVID hospitalization, 52% developed new difficulty and 6% new dependence with performing basic ADLs (bADLs), 48% developed new difficulty and 11% new dependence with instrumental ADLs (iADLs), and 69% experienced a clinically significant worsening in their fatigue symptom severity. The average fatigue symptom severity T-score before hospitalization was 44.2 ± 7.4 and after hospitalization was 54.5 ± 9.8. In exploratory multivariate analyses, each additional COVID symptom at presentation was associated with a predicted increase of 1.43 units (95% confidence interval [CI], 0.45–2.42) in the 30-day fatigue symptom severity T-score, each additional day of hospitalization was associated with an 1.2 times increased odds of worsening fatigue (95% CI, 0.98–1.5; p =.08), and each unit increase in baseline body mass index was associated with 0.8 times decreased odds of new bADL or iADL dependence at 30 days (95% CI, 0.65–0.99). Conclusions: New functional impairments are common at 30 days after discharge among survivors of hospitalization for COVID-19. Early rehabilitation, advance care planning, and referrals to appropriate therapies should be considered in postacute COVID-19 care to maximize patients' functional outcomes. However, ongoing research is still needed regarding management of these patients.
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U2 - 10.1002/pmrj.12716
DO - 10.1002/pmrj.12716
M3 - Article
C2 - 34585858
AN - SCOPUS:85118485534
SN - 1934-1482
VL - 14
SP - 173
EP - 182
JO - PM and R
JF - PM and R
IS - 2
ER -