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

Journal article

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

Authors: Dawson, C; Clunie, G; Evison, F; Duncan, S; Whitney, J

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BMJ Publishing Group
• Journal: BMJ Open Respiratory Research
• Volume: 10
• Issue: 1
• Pages: e001647-e001647
• Publication date: 2023-07-26
• Acceptance date: 2023-06-30
• DOI: 10.1136/bmjresp-2023-001647
• EISSN: 2052-4439
• ISSN: 2052-4439
• Language: English
• Keywords: Emergency medicine; Cognition; Coronavirus disease 2019 (COVID-19); Intensive care unit; Swallowing; Prospective cohort study; Logistic regression; Internal medicine; Compromise; Medicine; Pediatrics; Disease; Surgery; Psychiatry