Dados do Trabalho

Título

Cognitive trajectories in critical COVID-19 survivors: a 1-year prospective cohort

Objetivo

To describe cognitive trajectories and associated risk factors in survivors of COVID-19 admissions to an intensive care unit (ICU).

Métodos

Prospective cohort study in COVID-19 patients admitted to ICU and discharged alive from the hospital. Participants were followed-up for one year and were evaluated for cognitive function at one, three, six, nine and twelve months after hospital discharge. Longitudinal cognitive tests were analyzed with linear mixed models and clusters of cognitive impairment were defined using sequential analysis.

Resultados

We studied 428 participants (mean age of 64 years, 57% males, and 61% required invasive mechanical ventilation). Cognitive impairment was observed in 26% (112/428 participants) during follow-up. Predictors of cognitive decline were older age (β=−0.02, 95%CI=−0.04 to 0), previous dementia diagnosis or memory complaints (β=−0.45, 95%CI=−0.84 to -0.05), delirium (β=−0.38, 95%CI=−0.67 to -0.08), and frailty before hospitalization (β=−0.19, 95%CI=−0.30 to -0.08). Three clusters of cognitive trajectories were identified: no cognitive impairment (77% of participants), initial short-term cognitive impairment (8.5%), and later persistent cognitive impairment (14.5%). Risk factors for transition to clusters with cognitive impairment were less years of education, invasive mechanical ventilation, older age, shorter symptoms duration before hospitalization, and frailty before hospitalization.

Conclusão

Cognitive impairment was frequently observed in survivors of critical COVID-19, and associated with sociodemographic and in-hospital risk factors.