Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis.
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Dawson Camilla, Clunie Gemma, Evison Felicity, Duncan Sallyanne, Whitney Julie, Houchen-Wolloff Linzy, Bolton Charlotte E, Leavy Olivia C, Richardson Matthew, Omer Elneima, McAuley Hamish, Shikotra Aarti, Singapuri Amisha, Sereno Marco, Saunders Ruth M, Harris Victoria C, Greening Neil J, Nolan Claire Marie, Wootton Dan Gower, Daynes Enya, Donaldson Gavin, Sargent Jack, Scott Janet, Pimm John, Bishop Lettie, McNarry Melitta, Hart Nicholas, Evans Rachael A, Singh Sally, Yates Tom, Chalder Trudie, Man William, Harrison Ewen, Docherty Annemarie, Lone Nazir I, Quint Jennifer K, Chalmers James, Ho Ling-Pei, Horsley Alex Robert, Marks Michael, Poinasamy Krisnah, Raman Betty, Wain Louise V, Brightling Chris, PHOSP-COVID collaborative Group, Sharma Neil, Coffey Margaret, Kulkarni Amit, Wallace Sarah
Аннотация
DESIGN: Multicentre prospective observational cohort study using questionnaire data at visit 1 (2-7 months post discharge) and visit 2 (10-14 months post discharge) from hospitalised patients in the UK. Lasso logistic regression analysis was undertaken to identify associations.
SETTING: 64 UK acute hospital Trusts.
PARTICIPANTS: Adults aged >18 years, discharged from an admissions unit or ward at a UK hospital with COVID-19.
MAIN OUTCOME MEASURES: Self-reported swallow, communication, voice and cognitive compromise.
RESULTS: Compromised swallowing post intensive care unit (post-ICU) admission was reported in 20% (188/955); 60% with swallow problems received invasive mechanical ventilation and were more likely to have undergone proning (p=0.039). Voice problems were reported in 34% (319/946) post-ICU admission who were more likely to have received invasive (p<0.001) or non-invasive ventilation (p=0.001) and to have been proned (p<0.001). Communication compromise was reported in 23% (527/2275) univariable analysis identified associations with younger age (p<0.001), female sex (p<0.001), social deprivation (p<0.001) and being a healthcare worker (p=0.010). Cognitive issues were reported by 70% (1598/2275), consistent at both visits, at visit 1 respondents were more likely to have higher baseline comorbidities and at visit 2 were associated with greater social deprivation (p<0.001).
CONCLUSION: Swallow, communication, voice and cognitive problems were prevalent post hospitalisation for COVID-19, alongside whole system compromise including reduced mobility and overall health scores. Research and testing of rehabilitation interventions are required at pace to explore these issues.