Physical, cognitive and mental health impacts of COVID-19 following hospitalisation – a multi-centre prospective cohort study



PHOSP-COVID Collaborative Group, ORCID: 0000-0002-1667-868X, Evans, Rachael Andrea, McAuley, Hamish, Harrison, Ewen, Shikotra, Aarti, Singapuri, Amisha, Sereno, Marco, Elneima, Omer, Docherty, Annemarie ORCID: 0000-0003-2707-2779, Lone, Nazir ORCID: 0000-0002-1503-5535
et al (show 38 more authors) (2021) Physical, cognitive and mental health impacts of COVID-19 following hospitalisation – a multi-centre prospective cohort study.

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Abstract

<h4>Background</h4> The impact of COVID-19 on physical and mental health, and employment following hospitalisation is poorly understood. <h4>Methods</h4> PHOSP-COVID is a multi-centre, UK, observational study of adults discharged from hospital with a clinical diagnosis of COVID-19 involving an assessment between two- and seven-months later including detailed symptom, physiological and biochemical testing. Multivariable logistic regression was performed for patient-perceived recovery with age, sex, ethnicity, body mass index (BMI), co-morbidities, and severity of acute illness as co-variates. Cluster analysis was performed using outcomes for breathlessness, fatigue, mental health, cognition and physical function. <h4>Findings</h4> We report findings of 1077 patients discharged in 2020, from the assessment undertaken a median 5 [IQR4 to 6] months later: 36% female, mean age 58 [SD 13] years, 69% white ethnicity, 27% mechanical ventilation, and 50% had at least two co-morbidities. At follow-up only 29% felt fully recovered, 20% had a new disability, and 19% experienced a health-related change in occupation. Factors associated with failure to recover were female, middle-age, white ethnicity, two or more co-morbidities, and more severe acute illness. The magnitude of the persistent health burden was substantial and weakly related to acute severity. Four clusters were identified with different severities of mental and physical health impairment: 1) Very severe (17%), 2) Severe (21%), 3) Moderate with cognitive impairment (17%), 4) Mild (46%), with 3%, 7%, 36% and 43% feeling fully recovered, respectively. Persistent systemic inflammation determined by C-reactive protein was related to cluster severity, but not acute illness severity. <h4>Interpretation</h4> We identified factors related to recovery from a hospital admission with COVID-19 and four different phenotypes relating to the severity of physical, mental, and cognitive health five months later. The implications for clinical care include the potential to stratify care and the need for a pro-active approach with wide-access to COVID-19 holistic clinical services. Funding: UKRI and NIHR

Item Type: Article
Uncontrolled Keywords: PHOSP-COVID Collaborative Group
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 11 May 2021 07:03
Last Modified: 29 Sep 2021 17:11
DOI: 10.1101/2021.03.22.21254057
Open Access URL: https://www.medrxiv.org/content/10.1101/2021.03.22...
URI: https://livrepository.liverpool.ac.uk/id/eprint/3122263