Demographic and social determinants of cognitive dysfunction following hospitalization for COVID-19.
Demographic and social determinants of cognitive dysfunction following hospitalization for COVID-19.
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DOI：
10.1016/j.jns.2022.120146
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发表时间：
2022-07-15
影响因子：
4.4
通讯作者：
Frontera JA
中科院分区：
文献类型：
--
作者：
Valdes E;Fuchs B;Morrison C;Charvet L;Lewis A;Thawani S;Balcer L;Galetta SL;Wisniewski T;Frontera JA
在COVID-19住院后，有持续认知症状的报告。我们调查了因COVID-19住院6个月后人口统计学、健康社会决定因素（SDOH）与认知结果之间的关系。我们分析了一项来自住院COVID-19患者的多中心前瞻性研究的6个月随访数据。比较蒙特利尔电话认知评估（t-MOCA，得分<18/22）正常和异常患者的人口统计学和SDOH变量（年龄、种族/民族、教育程度、就业、健康保险状况、收入中位数、主要语言、生活安排和covid前残疾）。建立多变量logistic回归模型评价t-MoCA的预测因子。在382例随访6个月的患者中，215例（56%）完成了t-MoCA （n = 109/215[51%]结果正常，n = 106/215[49%]结果异常）。14/215（7%）患者既往有痴呆/认知障碍病史。t-MoCA异常的单变量显著预测因子包括年龄较大、受教育程度≤12年、失业、黑人种族和covid前认知障碍史（均p < 0.05）。在多变量分析中，在调整年龄、痴呆史、语言、神经系统并发症、收入和出院倾向后，受教育≤12年（调整后OR 5.21, 95%CI 2.25-12.09）、黑人（调整后OR 5.54, 95%CI 2.25-13.66）以及住院前基线功能状态和失业的相互作用（调整后aOR 3.98, 95%CI 1.23-12.92）与t-MoCA评分异常显著相关。受教育年限较短、黑人和失业并伴有基线残疾与COVID-19住院后6个月的t-MoCA评分异常相关。这些关联可能是由于未诊断的基线认知功能障碍、t-MoCA的内隐偏差、其他未测量的SDOH或SARS-CoV-2的生物学效应。
Persistent cognitive symptoms have been reported following COVID-19 hospitalization. We investigated the relationship between demographics, social determinants of health (SDOH) and cognitive outcomes 6-months after hospitalization for COVID-19. We analyzed 6-month follow-up data collected from a multi-center, prospective study of hospitalized COVID-19 patients. Demographic and SDOH variables (age, race/ethnicity, education, employment, health insurance status, median income, primary language, living arrangements, and pre-COVID disability) were compared between patients with normal versus abnormal telephone Montreal Cognitive Assessments (t-MOCA; scores<18/22). Multivariable logistic regression models were constructed to evaluate predictors of t-MoCA. Of 382 patients available for 6-month follow-up, 215 (56%) completed the t-MoCA (n = 109/215 [51%] had normal and n = 106/215 [49%] abnormal results). 14/215 (7%) patients had a prior history of dementia/cognitive impairment. Significant univariate predictors of abnormal t-MoCA included older age, ≤12 years of education, unemployment pre-COVID, Black race, and a pre-COVID history of cognitive impairment (all p < 0.05). In multivariable analyses, education ≤12 years (adjusted OR 5.21, 95%CI 2.25–12.09), Black race (aOR 5.54, 95%CI 2.25–13.66), and the interaction of baseline functional status and unemployment prior to hospitalization (aOR 3.98, 95%CI 1.23–12.92) were significantly associated with abnormal t-MoCA scores after adjusting for age, history of dementia, language, neurological complications, income and discharge disposition. Fewer years of education, Black race and unemployment with baseline disability were associated with abnormal t-MoCA scores 6-months post-hospitalization for COVID-19. These associations may be due to undiagnosed baseline cognitive dysfunction, implicit biases of the t-MoCA, other unmeasured SDOH or biological effects of SARS-CoV-2.
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影响因子：
3.8
作者：
Le Cook, Benjamin;Nhi-Ha Trinh;Progovac, Ana M.
通讯作者：
Progovac, Ana M.
影响因子：
3.5
作者：
Frontera JA;Melmed K;Fang T;Granger A;Lin J;Yaghi S;Zhou T;Lewis A;Kurz S;Kahn DE;de Havenon A;Huang J;Czeisler BM;Lord A;Meropol SB;Troxel AB;Wisniewski T;Balcer L;Galetta S
通讯作者：
Galetta S
影响因子：
15.1
作者：
Hampshire A;Trender W;Chamberlain SR;Jolly AE;Grant JE;Patrick F;Mazibuko N;Williams SC;Barnby JM;Hellyer P;Mehta MA
通讯作者：
Mehta MA
影响因子：
9.9
作者：
Cella, D.;Lai, J-S.;Moy, C.
通讯作者：
Moy, C.
影响因子：
9.9
作者：
Frontera, Jennifer A.;Sabadia, Sakinah;Galetta, Steven
通讯作者：
Galetta, Steven