背景:严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)感染后,认知功能障碍很常见。然而,出院后危险因素与认知轨迹之间的关联尚未被研究.
方法:共有1105名成年人(平均年龄±SD64.9±9.9岁,44%的女性,63%的白人)患有严重冠状病毒病2019(COVID-19)在出院后1年进行了认知功能评估。认知测试的分数是统一的,并使用序贯分析定义认知障碍的聚类。
结果:随访观察三组认知轨迹:无认知障碍,初始短期认知障碍,和长期认知障碍。COVID-19后认知功能下降的预测因素是年龄较大(β=-0.013,95%CI=-0.023;-0.003),女性(β=-0.230,95%CI=-0.413;-0.047),既往痴呆诊断或实质性记忆不适(β=-0.606,95%CI=-0.877;-0.335),住院前虚弱(β=-0.191,95%CI=-0.264;-0.119),血小板计数较高(β=-0.101,95%CI=-0.185;-0.018),谵妄(β=-0.483,95%CI=-0.724;-0.244)。出院后预测因素包括再入院和虚弱。
结论:认知障碍是常见的,认知轨迹的模式取决于社会人口统计学,在医院,和住院后预测因子。
结论:2019年冠状病毒病(COVID-19)出院后的认知障碍与较高的年龄有关,少受教育,住院期间谵妄,出院后住院人数增加,以及住院前后的虚弱。COVID-19住院后12个月的频繁认知评估显示出三种可能的认知轨迹:无认知障碍,初始短期减值,和长期减值。这项研究强调了频繁的认知测试对确定COVID-19认知障碍模式的重要性,鉴于住院1年后发生认知障碍的频率很高。
Cognitive impairment is common after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, associations between post-hospital discharge risk factors and cognitive trajectories have not been explored.
A total of 1105 adults (mean age ± SD 64.9 ± 9.9 years, 44% women, 63% White) with severe coronavirus disease 2019 (COVID-19) were evaluated for cognitive function 1 year after hospital discharge. Scores from cognitive tests were harmonized, and clusters of cognitive impairment were defined using sequential analysis.
Three groups of cognitive trajectories were observed during the follow-up: no cognitive impairment, initial short-term cognitive impairment, and long-term cognitive impairment. Predictors of cognitive decline after COVID-19 were older age (β = -0.013, 95% CI = -0.023;-0.003), female sex (β = -0.230, 95% CI = -0.413;-0.047), previous dementia diagnosis or substantial memory complaints (β = -0.606, 95% CI = -0.877;-0.335), frailty before hospitalization (β = -0.191, 95% CI = -0.264;-0.119), higher platelet count (β = -0.101, 95% CI = -0.185;-0.018), and delirium (β = -0.483, 95% CI = -0.724;-0.244). Post-discharge predictors included hospital readmissions and frailty.
Cognitive impairment was common and the patterns of cognitive trajectories depended on sociodemographic, in-hospital, and post-hospitalization predictors.
Cognitive impairment after coronavirus disease 2019 (COVID-19) hospital discharge was associated with higher age, less education, delirium during hospitalization, a higher number of hospitalizations post discharge, and frailty before and after hospitalization. Frequent cognitive evaluations for 12-month post-COVID-19 hospitalization showed three possible cognitive trajectories: no cognitive impairment, initial short-term impairment, and long-term impairment. This study highlights the importance of frequent cognitive testing to determine patterns of COVID-19 cognitive impairment, given the high frequency of incident cognitive impairment 1 year after hospitalization.