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

Eur Geriatr Med. 2021 Aug;12(4):741-748. doi: 10.1007/s41999-021-00486-4. Epub 2021 Mar 30.

Abstract

Objective: 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.

Methods: Retrospective case series in the University Hospitals Leuven, Belgium of confirmed COVID-19 patients 'after surviving an ICU-stay', 'aged ≥ 70 years', or 'aged < 70 years with a length of hospitalization > 7 days'. Exclusion criteria were 'unwilling to cooperate', 'medically unstable', or 'palliative care policy'. Following tests were used: 'Five Times Sit To Stand Test', 'hand grip dynamometry', 'Barthel index', 'Swallowing screening', 'Montreal Cognitive Assessment', 'Hospital Anxiety and Depression Scale', and 'Nutritional Risk Screening 2002'.

Results: One or more tests were obtained in 135/163 patients (83.3%). Physical impairments were present in 43.2-82.8% of the patients. Median BI was 10/20 indicating limited self-dependency. Swallow impairments were present in 3/53 (5.7%) and 24/76 (31.6%) had risk of malnutrition. Impaired memory was seen in 26/43 (60.5%) and 22/47 (46.8%) had elevated anxiety/depression scores. Older adults had more physical, functional, and cognitive impairments. ICU patients had a lower hand grip force.

Conclusion(s): 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. These results imply that rehabilitation and follow-up is essential for these patients. This paper proposes a short, workable assessment composed with known outcome measures to assess different domains of COVID-19 patients.

Keywords: Assessment; COVID-19; Cognitive impairment; Impairment; Nutritional impairment; Physical impairment; Post-infection; Rehabilitation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Belgium
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / therapy
  • Cognitive Dysfunction / complications*
  • Critical Illness*
  • Female
  • Hand Strength
  • Humans
  • Inpatients
  • Male
  • Malnutrition / complications*
  • Nutrition Assessment
  • Recovery of Function
  • Retrospective Studies
  • SARS-CoV-2
  • Treatment Outcome

Supplementary concepts

  • postintensive care syndrome