COVID-related difficulty and changes in health, social participation, and psychological well-being among people with traumatic spinal cord injury.

STUDY

DESIGN

Cohort study.

OBJECTIVE

To identify pre-COVID differences between those reporting COVID-related difficulty and those who did not during the pandemic, and examine their longitudinal changes in outcomes after the pandemic.

SETTING

Self-reported data were collected by a medical university in the United States.

PARTICIPANTS

There were 297 participants with traumatic SCI identified from a state population-based registry, who completed the assessment within the three months prior to the COVID-19 pandemic restrictions. Among them, 172 were successfully followed three times.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Four domains of outcome measures: (1) self-reported health outcomes, (2) healthcare utilization, (3) social participation, and (4) psychological well-being.

RESULTS

Those who reported COVID-related difficulties during the pandemic were those with poorer outcomes prior to the pandemic. We observed the curvilinear effects for those with difficulties during the pandemic, especially on the perspective of life satisfaction indicators, declining first after the pandemic and then improving at the time of the third follow-up post pandemic. For those who had not reported COVID-related difficulties, an indicator of general health showed an overall declining trend, while one mental health indicator and one health utilization indicator were noted curvilinear trend.

CONCLUSIONS

The absence of measurable pandemic effects underscore the resilience demonstrated by people with SCI. The findings underscore the importance of (1) measuring individual differences in resilience to unforeseen circumstances, (2) focusing resources on those with a history of poor outcomes, and (3) methodologically, measuring outcomes over time.