Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis
Abstract
Objective: Identify prevalence of self-reported swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19.
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.
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Date
2023-07-26
Type
Article
Subject
ARDS, COVID-19, critical care, pneumonia
Collections
Citation
Dawson, C., Clunie, G., Evison, F., Duncan, S., Whitney, J., Houchen-Wolloff, L., Bolton, C. E., Leavy, O. C., Richardson, M., Omer, E., McAuley, H., Shikotra, A., Singapuri, A., Sereno, M., Saunders, R. M., Harris, V. C., Greening, N. J., Nolan, C. M., Wootton, D. G., Daynes, E., … Wallace, S. (2023). Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis. BMJ open respiratory research, 10(1), e001647. https://doi.org/10.1136/bmjresp-2023-001647