Calculating Route: Functional Trajectories and Long-Term Outcomes in Survivors of Severe COVID-19.
J Nutr Health Aging
; 27(12): 1168-1173, 2023.
Article
em En
| MEDLINE
| ID: mdl-38151867
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atividades Cotidianas
/
COVID-19
Limite:
Humans
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
J Nutr Health Aging
Assunto da revista:
CIENCIAS DA NUTRICAO
/
GERIATRIA
Ano de publicação:
2023
Tipo de documento:
Article
País de publicação:
França