A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications.
A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications.
复制标题
DOI：
10.1016/j.jns.2021.117486
复制
发表时间：
2021-07-15
影响因子：
4.4
通讯作者：
Galetta S
中科院分区：
文献类型：
--
作者：
Frontera JA;Yang D;Lewis A;Patel P;Medicherla C;Arena V;Fang T;Andino A;Snyder T;Madhavan M;Gratch D;Fuchs B;Dessy A;Canizares M;Jauregui R;Thomas B;Bauman K;Olivera A;Bhagat D;Sonson M;Park G;Stainman R;Sunwoo B;Talmasov D;Tamimi M;Zhu Y;Rosenthal J;Dygert L;Ristic M;Ishii H;Valdes E;Omari M;Gurin L;Huang J;Czeisler BM;Kahn DE;Zhou T;Lin J;Lord AS;Melmed K;Meropol S;Troxel AB;Petkova E;Wisniewski T;Balcer L;Morrison C;Yaghi S;Galetta S
对于使用新冠肺炎入院治疗的患者的长期结果知之甚少。我们对住院的新冠肺炎患者的6个月结果进行了前瞻性研究。在住院期间有新的神经系统并发症的患者存活下来，他们与同期住院的没有神经系统并发症的新冠肺炎幸存者的倾向得分相匹配。主要的6个月结果是对有或没有神经系统并发症的患者进行多变量序贯分析改良朗肯评分(MRS)。次要结果包括：日常生活能力(ADLS；Barthel指数)、电话蒙特利尔认知评估和焦虑、抑郁、疲劳和睡眠的神经生活质量电池。在606名有神经系统并发症的新冠肺炎患者中，有395人在住院期间存活，并与395名对照组匹配；N=1 196名神经系统疾病患者和N=1 186名对照组完成了随访。总体而言，346/382(91%)患者至少有一种异常结果：56%的患者ADL有限，50%的认知受损，47%的患者不能重返工作岗位，62%的患者在≥1神经生活质量量表上的得分低于平均水平(更差的焦虑46%，睡眠38%，疲劳36%，抑郁25%)。多因素分析显示，有神经系统并发症的患者6个月MRS(中位数4个月比3个月，调整后OR1.98，95%可信区间1.23~3.48，P=0.02)、不良反应(AOR 0.38，95%可信区间0.29~0.74，P=0.01)和重返工作岗位的可能性(41%比%，P=0.04)明显低于对照组。两组之间的认知和神经生活质量指标相似。超过90%的患者在因新冠肺炎入院6个月后出现功能结局、ADL、焦虑、抑郁和睡眠异常。在多变量分析中，在指数住院期间有神经系统并发症的患者6个月的功能结果明显差于无并发症的患者。
Little is known regarding long-term outcomes of patients hospitalized with COVID-19. We conducted a prospective study of 6-month outcomes of hospitalized COVID-19 patients. Patients with new neurological complications during hospitalization who survived were propensity score-matched to COVID-19 survivors without neurological complications hospitalized during the same period. The primary 6-month outcome was multivariable ordinal analysis of the modified Rankin Scale(mRS) comparing patients with or without neurological complications. Secondary outcomes included: activities of daily living (ADLs;Barthel Index), telephone Montreal Cognitive Assessment and Neuro-QoL batteries for anxiety, depression, fatigue and sleep. Of 606 COVID-19 patients with neurological complications, 395 survived hospitalization and were matched to 395 controls; N = 196 neurological patients and N = 186 controls completed follow-up. Overall, 346/382 (91%) patients had at least one abnormal outcome: 56% had limited ADLs, 50% impaired cognition, 47% could not return to work and 62% scored worse than average on ≥1 Neuro-QoL scale (worse anxiety 46%, sleep 38%, fatigue 36%, and depression 25%). In multivariable analysis, patients with neurological complications had worse 6-month mRS (median 4 vs. 3 among controls, adjusted OR 1.98, 95%CI 1.23–3.48, P = 0.02), worse ADLs (aOR 0.38, 95%CI 0.29–0.74, P = 0.01) and were less likely to return to work than controls (41% versus 64%, P = 0.04). Cognitive and Neuro-QOL metrics were similar between groups. Abnormalities in functional outcomes, ADLs, anxiety, depression and sleep occurred in over 90% of patients 6-months after hospitalization for COVID-19. In multivariable analysis, patients with neurological complications during index hospitalization had significantly worse 6-month functional outcomes than those without.
登录
查看更多内容
DOI：
10.1056/nejmoa1301372
发表时间：
2013-10-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pandharipande PP;Girard TD;Jackson JC;Morandi A;Thompson JL;Pun BT;Brummel NE;Hughes CG;Vasilevskis EE;Shintani AK;Moons KG;Geevarghese SK;Canonico A;Hopkins RO;Bernard GR;Dittus RS;Ely EW;BRAIN-ICU Study Investigators
通讯作者：
BRAIN-ICU Study Investigators
影响因子：
9.9
作者：
Scott, T. F.;Frohman, E. M.;Weinshenker, B. G.
通讯作者：
Weinshenker, B. G.
影响因子：
9.9
作者：
Romero-Sanchez, Carlos Manuel;Diaz-Maroto, Inmaculada;Segura, Tomas
通讯作者：
Segura, Tomas
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