Assessment of Symptom, Disability, and Financial Trajectories in Patients Hospitalized for COVID-19 at 6 Months
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Published:2023-02-14
Issue:2
Volume:6
Page:e2255795
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ISSN:2574-3805
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Container-title:JAMA Network Open
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language:en
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Short-container-title:JAMA Netw Open
Author:
Admon Andrew J.1234, Iwashyna Theodore J.13456, Kamphuis Lee A.3, Gundel Stephanie J.7, Sahetya Sarina K.8, Peltan Ithan D.910, Chang Steven Y.11, Han Jin H.1213, Vranas Kelly C.1415, Mayer Kirby P.16, Hope Aluko A.17, Jolley Sarah E.18, Caldwell Ellen19, Monahan Max L.620, Hauschildt Katrina621, Brown Samuel M.910, Aggarwal Neil R.18, Thompson B. Taylor21, Hough Catherine L.2223, Abi Fadel Francois24, Aboodi Michael24, Acquah Samuel24, Adams Jason Y24, Aggarwal Neil24, Alappan Narendrakumar24, Albertson Timothy E24, Al-Jaghbeer Mohammed24, Almasri Eyad24, Andrews James S24, Angus Derek C24, Baker Jason V24, Baron Rebecca24, Baumann Michael24, Becker Torben24, Biehl Michelle24, Bixby Billie A24, Bledsoe Joseph R24, Bloom John W24, Bose Somnath24, Boyle Katherine L24, Bradley Patrick24, Branson Rich D24, Brown Samuel24, Burnham Ellen L24, Calfee Carolyn24, Callahan Sean J24, Cancelliere Alessandro24, Carson Shannon24, Casey Jonathan D24, Chang Steven Y24, Chekuri Sweta24, Chen Peter24, Chen Tina24, Chenoweth James24, Choi Philip24, Co Ivan24, Collins Sean24, Costa Monteiro Ana Carolina24, Couper Mick24, Cox Christopher24, Daich Jonathan24, de Wit Marjolein24, deBoisblanc Ben P24, Dettmer Matthew R24, Dhar Sanjay24, Dillon David24, Doernberg Sarah24, Doshi Pratik B24, Douglas Ivor S24, Driver Brian24, Dugar Siddharth P24, Duggal Abhijit24, Elie Marie-Carmelle24, Enfield Kyle B24, Eppensteiner John24, Fein Daniel24, Filbin Michael24, Files Clark24, Finigan James H24, Flannery Alexander H24, Foulkes Andrea24, Fowler Alpha A24, Frisch Adam24, Fung Monica24, Gaillard John24, Galbraith James W24, Gandotra Sheetal24, Gardner-Gray Jayna M24, Gay Elizabeth A24, Gibbs Kevin24, Gill Evanpaul24, Ginde Adit24, Girard Timothy D24, Go Pauline H24, Goel Neha N24, Goligher Ewan C24, Gomez-Arroyo Jose24, Gong Michelle Ng24, Goodwin Andrew J24, Gordon Richard D24, Grissom Colin K24, Gunnerson Kyle24, Han Jin Ho24, Hanane Tarik24, Hansen Christopher K24, Happel Kyle24, Harris Estelle S24, Haukoos Jason24, Hendey Gregory W24, Hendrickson Carolyn M24, Hibbert Kathryn A24, Hirshberg Ellie24, Hite R. Duncan24, Hope Aluko A24, Hoth Jason24, Hou Peter C24, Hough Terri24, Howrylak Judie A24, Huang David T24, Hudock Kristin24, Huebinger Ryan24, Hurst Gina24, Hypes Cameron D24, Hyzy Robert C24, Iovine Nicole24, Islam Marjan24, Israel Jennifer24, Iwashyna Jack24, Jaffer Faraz24, Janssen William24, Jayaprakash Namita24, Jia Shijing24, Johnson Nicholas J24, Jolley Sarah24, Jones Alan24, Jones Elizabeth Jones B24, Kadl Alex24, Kangelaris Kirsten N24, Kashiouris Markos G24, Kass Lawrence E24, Keller Marla24, Khan Akram24, Khosravi Mehdi24, Khouli Hassan24, Kinni Harish24, Kiyatkin Michael E24, Knox Daniel24, Krishnan Amita24, Kurtzman Nicholas24, Lammi Matthew R24, Lanspa Michael J24, Le Viet24, Leither Lindsay M24, Levitt Joseph24, L'Heureux Michael24, Lim George24, Limkakeng Alexander24, Lin Michael Y24, Lindsell Christopher24, Liu Kathleen24, Lyn-Kew Kenneth24, Lyons Patrick G24, Mackay Fraser C24, Maher Patrick J24, Mahler Simon A24, Malhotra Anita24, Malley Brian E24, Matthay Michael A24, May Teresa24, Mayer Katherine24, Mayer Kirby P24, McSparron Jakob I24, McVerry Bryan J24, Miller Chadwick D24, Miller Stephen24, Minear Steven C24, Mireles Eduardo24, Mock Jason24, Mohamed Amira24, Montgomery-Yates Ashley A24, Morris Peter24, Mosier Jarrod M24, Moskowitz Ari24, Moss Marc24, Mucha Simon R24, Munroe Elizabeth24, Nair Rahul24, Nandi Utsav24, Nassisi Denise24, Nkemdirim William24, Norton Dustin L24, O'Gara Brian24, O'Hearn Daniel J24, OMahony Darragh Shane24, Page David B24, Paine Robert24, Park Pauline K24, Pasha Sara24, Patarroyo Aponte Gabriel D24, Patel Avignat24, Patel Bela24, Peltan Ithan D24, Perman Sarah24, Pflaum-Carlson Jacqueline Marie24, Phang-Lyn Simone24, Pinto-Plata Victor24, Prekker Matthew E24, Puskarich Mike24, Qadir Nida24, Reddy Raju M24, Rice Todd W24, Richardson Lynne D24, Riker Richard R24, Rivers Emanuel P24, Robinson Bryce RH24, Rogers Angela J24, Russell Derek W24, Sahoo Debasis24, Sandrock Christian24, Sanne Shane24, Scheraga Rachel G24, Schmidt Eric24, Schooler Jordan B24, Schwab Kristin24, Self Wesley H24, Semler Matthew W24, Sergot Paulina24, Shah Faraaz24, Shapiro Nate24, Shaw Daniel L24, Sherwin Robert24, Siuba Matthew24, Sjoding Michael24, Smithline Howard24, Sochor Mark R24, Spurzem John R24, Srinivasan Vasisht24, Steel Tessa L24, Steingrub Jay S24, Stenson Bryan24, Sterling Sarah A24, Stopyra Jason24, Stubblefield William-May B24, Sturek Jeffrey M24, Sturgill Jamie L24, Swiderek Jennifer24, Syed Aamer24, Talmor Daniel24, Tatem Geneva24, Thiruchelvam Nirosshan24, Thompson Taylor24, Thompson Bastin Melissa L24, Tidswell Mark24, Torbati Sam S24, Trent Stacy A24, Trott Terren24, Van der Kloot Thomas E24, Vranas Kelly C24, Wang Bonnie24, Wang Ralph24, Ware Lorraine24, Waters Christopher M24, Weissman Alexandra J24, Wick Katherine D24, Wilkin Aimee M24, Wilson David M24, Wilson Jenny G24, Wyles David L24, Yanta Joseph H24, Yealy Donald M24, Youngquist Scott24, Zaman Tanzira24,
Affiliation:
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor 2. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor 3. VA Center for Clinical Management Research, LTC Charles Kettles VA Medical Center, Ann Arbor, Michigan 4. University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor 5. Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 6. Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland 7. Department of Emergency Medicine, Harborview Medical Center, Seattle, Washington 8. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 9. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center, Murray, Utah 10. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City 11. Ronald Reagan-UCLA Medical Center, Pulmonary & Critical Care Medicine, David Geffen School of Medicine at University of California, Los Angeles 12. Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 13. Geriatric Research, Education, and Clinical Center, VA Tennessee Valley Healthcare System, Nashville 14. Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland 15. Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Oregon Health and Science University, Portland, Oregon 16. Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington 17. Division of Pulmonary and Critical Care Medicine, Department of Mundeledicine, Oregon Health and Science University School of Medicine, Portland 18. Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver 19. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Washington, Seattle 20. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan 21. Division of Pulmonary and Critical Medicine, Massachusetts General Hospital, Boston, Massachusetts 22. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University School of Medicine, Portland 23. The National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Network 24. for the National Heart, Lung, and Blood Institute PETAL Network
Abstract
ImportanceIndividuals who survived COVID-19 often report persistent symptoms, disabilities, and financial consequences. However, national longitudinal estimates of symptom burden remain limited.ObjectiveTo measure the incidence and changes over time in symptoms, disability, and financial status after COVID-19–related hospitalization.Design, Setting, and ParticipantsA national US multicenter prospective cohort study with 1-, 3-, and 6-month postdischarge visits was conducted at 44 sites participating in the National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Network's Biology and Longitudinal Epidemiology: COVID-19 Observational (BLUE CORAL) study. Participants included hospitalized English- or Spanish-speaking adults without severe prehospitalization disabilities or cognitive impairment. Participants were enrolled between August 24, 2020, and July 20, 2021, with follow-up occurring through March 30, 2022.ExposureHospitalization for COVID-19 as identified with a positive SARS-CoV-2 molecular test.Main Outcomes and MeasuresNew or worsened cardiopulmonary symptoms, financial problems, functional impairments, perceived return to baseline health, and quality of life. Logistic regression was used to identify factors associated with new cardiopulmonary symptoms or financial problems at 6 months.ResultsA total of 825 adults (444 [54.0%] were male, and 379 [46.0%] were female) met eligibility criteria and completed at least 1 follow-up survey. Median age was 56 (IQR, 43-66) years; 253 (30.7%) participants were Hispanic, 145 (17.6%) were non-Hispanic Black, and 360 (43.6%) were non-Hispanic White. Symptoms, disabilities, and financial problems remained highly prevalent among hospitalization survivors at month 6. Rates increased between months 1 and 6 for cardiopulmonary symptoms (from 67.3% to 75.4%; P = .001) and fatigue (from 40.7% to 50.8%; P < .001). Decreases were noted over the same interval for prevalent financial problems (from 66.1% to 56.4%; P < .001) and functional limitations (from 55.3% to 47.3%; P = .004). Participants not reporting problems at month 1 often reported new symptoms (60.0%), financial problems (23.7%), disabilities (23.8%), or fatigue (41.4%) at month 6.Conclusions and RelevanceThe findings of this cohort study of people discharged after COVID-19 hospitalization suggest that recovery in symptoms, functional status, and fatigue was limited at 6 months, and some participants reported new problems 6 months after hospital discharge.
Publisher
American Medical Association (AMA)
Reference38 articles.
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