Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients
Objectives: To investigate the longitudinal evolution of physical and cognitive problems after hospital discharge in survivors of severe COVID-19; to describe the co-occurrence of these health problems domains in the following year after discharge; and evaluate if results are different taking into a...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | The Journal of Nutrition, Health and Aging |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1279770725000715 |
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| author | Leandro U. Taniguchi Natalia G. Gonçalves Naomi V. Ferreira Laiss Bertola Thiago J. Avelino-Silva Murilo B. Dias Ludhmila A. Hajjar Wilson Jacob-Filho Claudia K. Suemoto Márlon J.R. Aliberti |
| author_facet | Leandro U. Taniguchi Natalia G. Gonçalves Naomi V. Ferreira Laiss Bertola Thiago J. Avelino-Silva Murilo B. Dias Ludhmila A. Hajjar Wilson Jacob-Filho Claudia K. Suemoto Márlon J.R. Aliberti |
| author_sort | Leandro U. Taniguchi |
| collection | DOAJ |
| description | Objectives: To investigate the longitudinal evolution of physical and cognitive problems after hospital discharge in survivors of severe COVID-19; to describe the co-occurrence of these health problems domains in the following year after discharge; and evaluate if results are different taking into account the use of invasive mechanical ventilation. Design: Prospective cohort study. Setting: A large academic medical center in Brazil. Participants: Patients aged ≥50 years who survived hospitalization for COVID-19 requiring critical care. Measurements: We evaluated participants’ status before hospital admission and one, three, six, nine, and twelve months after hospital discharge using validated questionnaires to measure frailty, persistent physical symptoms, and cognitive function. Clusters of physical and cognitive problems were defined using sequential analysis. Concordance was studied between different problems and trajectories, and after stratifying for use of invasive mechanical ventilation during ICU stay. Results: We included 428 participants (median age was 63 years, 57% were male, 14% were frail before COVID-19, and 61% required mechanical ventilation). Physical and/or cognitive problems were experienced in 83% of responders at least once during follow-up, and half reported any problem even after one year. Most participants experienced health problems in a single health domain, with co-occurrence less than 9% in every assessment (Cramer’s V bias-corrected less than 0.1 in any assessment). Sequential analysis identified three clusters each of cognitive and physical trajectories, with different evolution and no concordance. Stratifying the sample based on the use of mechanical ventilation did not change the results. Conclusions: Severe COVID-19 survivors frequently experience physical and/or cognitive problems, yet these conditions and their trajectories are discordant. Multidimensional evaluations post-ICU discharge can aid in delivering tailored rehabilitation programs. |
| format | Article |
| id | doaj-art-cd9f8f50d75c48499a154900cc3535c2 |
| institution | Kabale University |
| issn | 1760-4788 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Journal of Nutrition, Health and Aging |
| spelling | doaj-art-cd9f8f50d75c48499a154900cc3535c22025-08-20T03:44:27ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-06-0129610054710.1016/j.jnha.2025.100547Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patientsLeandro U. Taniguchi0Natalia G. Gonçalves1Naomi V. Ferreira2Laiss Bertola3Thiago J. Avelino-Silva4Murilo B. Dias5Ludhmila A. Hajjar6Wilson Jacob-Filho7Claudia K. Suemoto8Márlon J.R. Aliberti9Intensive Care and Emergency Medicine, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Hospital Sírio Libanês, São Paulo, Brazil; Brazilian Research in Intensive Care Network (BRICnet), São Paulo, Brazil; Corresponding author.Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil; Faculdade Israelita de Ciencias da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, BrazilIntensive Care and Emergency Medicine, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, BrazilLaboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, BrazilHospital Sírio Libanês, São Paulo, Brazil; Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, BrazilObjectives: To investigate the longitudinal evolution of physical and cognitive problems after hospital discharge in survivors of severe COVID-19; to describe the co-occurrence of these health problems domains in the following year after discharge; and evaluate if results are different taking into account the use of invasive mechanical ventilation. Design: Prospective cohort study. Setting: A large academic medical center in Brazil. Participants: Patients aged ≥50 years who survived hospitalization for COVID-19 requiring critical care. Measurements: We evaluated participants’ status before hospital admission and one, three, six, nine, and twelve months after hospital discharge using validated questionnaires to measure frailty, persistent physical symptoms, and cognitive function. Clusters of physical and cognitive problems were defined using sequential analysis. Concordance was studied between different problems and trajectories, and after stratifying for use of invasive mechanical ventilation during ICU stay. Results: We included 428 participants (median age was 63 years, 57% were male, 14% were frail before COVID-19, and 61% required mechanical ventilation). Physical and/or cognitive problems were experienced in 83% of responders at least once during follow-up, and half reported any problem even after one year. Most participants experienced health problems in a single health domain, with co-occurrence less than 9% in every assessment (Cramer’s V bias-corrected less than 0.1 in any assessment). Sequential analysis identified three clusters each of cognitive and physical trajectories, with different evolution and no concordance. Stratifying the sample based on the use of mechanical ventilation did not change the results. Conclusions: Severe COVID-19 survivors frequently experience physical and/or cognitive problems, yet these conditions and their trajectories are discordant. Multidimensional evaluations post-ICU discharge can aid in delivering tailored rehabilitation programs.http://www.sciencedirect.com/science/article/pii/S1279770725000715Post-acute COVID-19 syndromeEpidemiologySurvivorsCritical illnessMechanical ventilation |
| spellingShingle | Leandro U. Taniguchi Natalia G. Gonçalves Naomi V. Ferreira Laiss Bertola Thiago J. Avelino-Silva Murilo B. Dias Ludhmila A. Hajjar Wilson Jacob-Filho Claudia K. Suemoto Márlon J.R. Aliberti Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients The Journal of Nutrition, Health and Aging Post-acute COVID-19 syndrome Epidemiology Survivors Critical illness Mechanical ventilation |
| title | Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients |
| title_full | Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients |
| title_fullStr | Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients |
| title_full_unstemmed | Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients |
| title_short | Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients |
| title_sort | discordance between physical and cognitive health problems over one year after critical care insights from severe covid 19 patients |
| topic | Post-acute COVID-19 syndrome Epidemiology Survivors Critical illness Mechanical ventilation |
| url | http://www.sciencedirect.com/science/article/pii/S1279770725000715 |
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