Impact of COVID-19: urging a need for multi-domain assessment of COVID-19 inpatients

Abstract

Key summary points Aim To retrospectively analyse data obtained from the multi-domain assessment of hospitalized COVID-19 patients, to describe their health status at discharge, and to investigate whether subgroups of patients, more specific ICU patients and older adults (> 70 years), had more (or less) risk to experience specific impairments. Findings The results of the assessment show that physical, functional, cognitive, nutritional, and psychological impairments are highly prevalent in the group of COVID-19 patients, both in ICU and non-ICU patients, adults and older adults. Message The high prevalence of physical, cognitive, psychological, and functional impairments in hospitalized COVID-19 patients, both ICU and non-ICU patients, indicates that assessment of impairments is imperative.

Physical Function, Cognitive Function, and Daily Activities in Patients Hospitalized Due to COVID-19: A Descriptive Cross-Sectional Study in Sweden

“…The older patients were more cognitively impaired than the younger patients ( Table 2 ). This finding is in line with what might be expected in an elderly population and what was seen in a previous study of COVID-19 patients [ 30 ], as well as what has been described by the Pan American health organization [ 6 ]. Although the total study sample scored below the 26-point cutoff on the MoCA, no difference in the level of cognition was seen based on admission to the ICU.…”

“…The PCFS scores indicated that the patients themselves expressed difficulties managing daily activities, although they were able to take care of themselves. For both the ICU treated patients and the older group, the BI was in line with what has been previously shown in hospitalized COVID-19 patients, being somewhat dependent after hospitalization [ 17 , 18 , 22 , 30 ]. In particular, this suggests that older patients and ICU-treated patients require further follow-up after hospital discharge.…”

“…Although the total study sample scored below the 26-point cutoff on the MoCA, no difference in the level of cognition was seen based on admission to the ICU. Previous studies have described cognitive impairments in ICU-treated patients due to COVID-19 [ 17 , 30 , 38 ]. The differences between studies may be due to different time points of assessment during the hospital stay.…”

“…Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), which is a brief screening test for mild cognitive impairment, with a maximum score of 30 points, where scores below 26 points indicate cognitive impairment [ 29 ]. The MoCA has high reliability and validity in patients with mild cognitive impairment [ 29 ] and has been previously used to evaluate cognitive function in patients hospitalized due to COVID-19 [ 30 ] and patients recovering from COVID-19 [ 9 ]. To evaluate visual search, scanning, speed of processing, mental flexibility, and executive functions [ 31 ], trail making tests A and B (TMT A, TMT B) were used.…”

Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study

“…Our results may be useful in selecting appropriate candidates for rehabilitation during hospitalization from limited rehabilitation resources to treat and prevent functional decline and to provide the high-risk patient families or caregivers with sufficient time to arrange support after the discharge home (e.g., home help services and a reclining bed for easy transferring from a bed). These implications would be supported by a previous study, which showed that multi-domain assessment of COVID-19 inpatients, including functional, physical, and cognitive assessment, may be useful for evaluating their health status and for planning care, rehabilitation, and follow-up after discharge [17].…”