Physical, psychological, and cognitive outcomes after coronavirus disease 2019 hospitalization: a prospective study with 3-month follow-up of a Brazilian cohort

Abstract

Context: Post–coronavirus disease (COVID) is associated with multiple impairments. Aims: To identify consequences of COVID 2019 (COVID-19) hospitalization, and risk factors for functional dependence 3 months after discharge. Settings and design: Prospective cohort in a verticalized health care network. Material and methods: Individuals hospitalized from June to November 2020 due to COVID-19 were investigated assessing outcomes pertaining to physical and respiratory symptoms, mental health, and physical, swallow and vocal, and cognitive function at baseline, and after 1 and 3 months. Those admitted to the intensive care unit were compared with those in the ward. Statistical analysis used: Within and between-group comparison and across time points using T test paired samples, Wilcoxon test, 1-way analysis of variance and Kruskal-Wallis, Pearson χ2 and Fisher exact test, with a statistical power of 80% and α = 5%, and a post hoc univariable and multivariable logistic regression. Results: Participants (n = 326) had a mean of 70.3 (9.2) years and were hospitalized for a median (interquartile range) of 5 (3–8) days. In the 3-month follow-up, participants persisted with fatigue (64.7%), breathlessness (44.5%), aches, and pains (18.5%). Dyspnea and fatigue rates worsened during the same time period. Multivariable regression showed Timed Up and Go (test) ≥20 seconds at discharge as a predictor of functional dependence for IADL at the 3-month follow-up [odds ratio =3.12 (95% CI: 1.25–7.84)]. Conclusions: The impact of COVID-19 persisted for at least 3 months, with improvement of only some outcomes in the period. A poor performance at the Timed Up and Go test at baseline was a predictor of functional dependence at 3 months.