Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis
Camilla Dawson, Gemma Clunie, Felicity Evison, Sallyanne Duncan, Julie Whitney, Linzy Houchen‐Wolloff, Charlotte E. Bolton, Olivia C. Leavy, Matthew Richardson, Elneima Omer, Hamish McAuley, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Ruth Saunders, Victoria Harris, Neil Greening, Claire M. Nolan, Dan Wootton, Enya Daynes, Gavin C. Donaldson, Jack Sargent, J. T. Scott, John Pimm, Lettie Bishop, Melitta A. McNarry, Nicholas Hart, Rachael A Evans, Sally Singh, Tom Yates, Trudie Chalder, William D‐C Man, Ewen M. Harrison, Annemarie B Docherty, Nazir Lone, Jennifer K Quint, James D. Chalmers, Ling‐Pei Ho, Alex Horsley, Michael Marks, Krisnah Poinasamy, Betty Raman, Louise V. Wain, Chris Brightling, PHOSP-COVID collaborative Group, Neil Sharma, Margaret Coffey, Amit Kulkarni, Sarah Wallace
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.