Article ; Online: Calculating Route: Functional Trajectories and Long-Term Outcomes in Survivors of Severe COVID-19.
The journal of nutrition, health & aging
2023 Volume 27, Issue 12, Page(s) 1168–1173
Abstract: Objectives: We investigated functional trajectories after severe COVID-19 and estimated their associations with adverse outcomes (falls, rehospitalizations, institutionalization, or death), cognition and post COVID-19 condition within 1-year of hospital ...
| Abstract | Objectives: We investigated functional trajectories after severe COVID-19 and estimated their associations with adverse outcomes (falls, rehospitalizations, institutionalization, or death), cognition and post COVID-19 condition within 1-year of hospital discharge. Design: Prospective cohort study. Setting: A large academic medical center in Sao Paulo, Brazil. Participants: Survivors of COVID-19 admissions to an intensive care unit. Interventions: None. Measurements: We evaluated participants' disability status before hospital admission and three, six, nine, and twelve months after discharge using 15 activities of daily living. During follow-up, cognition and post COVID-19 condition (defined as persistent symptoms with duration ≥2 months) were assessed. A latent class growth analysis was performed to investigate functional trajectories after discharge. Results: We included 422 participants (median age 63 years, 13.5% were frail before COVID-19). Four distinct functional trajectories could be identified: "minimal disability trajectory" (37.4% of participants), "mild disability trajectory" (37.9%), "moderate disability trajectory" (16.8%), and "severe disability trajectory" (7.8%). Compared with minimal disability trajectory, the odds ratios (95% confidence interval) for 1-year adverse outcomes were 2.28 (1.38-3.76) for minor disability trajectory; 4.21 (2.10-8.42) for moderate disability trajectory; and 4.16 (1.51-11.46) for severe disability trajectory, even after adjustments. The occurrence of post COVID-19 condition was 67.5% and associated with functional trajectories (p=0.004). Cognition was also associated with functional trajectories. Conclusion: Severe COVID-19 survivors can experience diverse functional trajectories, with those presenting higher levels of disability at increased risk for long-term adverse outcomes. Further investigations are essential to confirm our findings and assess the effectiveness of rehabilitation interventions, aiming to improve health outcomes in those who survived severe COVID-19 and other causes of sepsis. |
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| MeSH term(s) | Humans ; Activities of Daily Living ; Prospective Studies ; COVID-19/complications ; Brazil/epidemiology ; Hospitalization ; Chronic Disease |
| Language | English |
| Publishing date | 2023-12-24 |
| Publishing country | France |
| Document type | Journal Article |
| ZDB-ID | 2081921-3 |
| ISSN | 1760-4788 ; 1279-7707 |
| ISSN (online) | 1760-4788 |
| ISSN | 1279-7707 |
| DOI | 10.1007/s12603-023-2036-4 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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