Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis

• Published in: BMJ open respiratory research Vol. 10; no. 1; p. e001647
• Main Authors: Dawson, Camilla, Clunie, Gemma, Evison, Felicity, Duncan, Sallyanne, Whitney, Julie, Houchen-Wolloff, Linzy, Bolton, Charlotte E, Leavy, Olivia C, Richardson, Matthew, Omer, Elneima, McAuley, Hamish, Shikotra, Aarti, Singapuri, Amisha, Sereno, Marco, Saunders, Ruth M, Harris, Victoria C, Greening, Neil J, Nolan, Claire Marie, Wootton, Dan Gower, Daynes, Enya, Donaldson, Gavin, Sargent, Jack, Scott, Janet, Pimm, John, Bishop, Lettie, McNarry, Melitta, Hart, Nicholas, Evans, Rachael A, Singh, Sally, Yates, Tom, Chalder, Trudie, Man, William, Harrison, Ewen, Docherty, Annemarie, Lone, Nazir I, Quint, Jennifer K, Chalmers, James, Ho, Ling-Pei, Horsley, Alex Robert, Marks, Michael, Poinasamy, Krisnah, Raman, Betty, Wain, Louise V, Brightling, Chris, Sharma, Neil, Coffey, Margaret, Kulkarni, Amit, Wallace, Sarah
• Format: Journal Article
• Language: English
• Published: England British Thoracic Society 01.07.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: ARDS; Cognition & reasoning; Communication; COVID-19; critical care; Dyspnea; Hospitalization; Hospitals; Intensive care; Language; Larynx; Medical research; Memory; Patients; pneumonia; Post traumatic stress disorder; Questionnaires; Respiration; Respiratory Infection; Self report; Swallowing; Variables; Ventilators; United Kingdom > UK; COVID-19; critical care; pneumonia; ARDS
• ISSN: 2052-4439; 2052-4439
• DOI: 10.1136/bmjresp-2023-001647

ObjectiveIdentify prevalence of self-reported swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19.DesignMulticentre 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.Setting64 UK acute hospital Trusts.ParticipantsAdults aged >18 years, discharged from an admissions unit or ward at a UK hospital with COVID-19.Main outcome measuresSelf-reported swallow, communication, voice and cognitive compromise.ResultsCompromised 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).ConclusionSwallow, 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.