Becker's Clinical Quality & Infection Control

24 PATIENT SAFETY & OUTCOMES 45% of COVID-19 patients leave hospital with functional decline, Michigan Medicine finds By Mackenzie Bean N early half of COVID-19 patients dis- charged from Ann Arbor-based Mich- igan Medicine last spring experienced functional decline, research found. For the study, published April 30 in the jour- nal PM&R, researchers analyzed the outcomes of 288 adult COVID-19 patients hospitalized between March 4, 2020, and May 1, 2020. Four study findings: 1. Forty-five percent of COVID-19 survivors experienced functional decline, and nearly 20 percent were discharged to a location other than their home. 2. About 81 percent of survivors with func- tional decline were referred for additional therapy aer their discharge. 3. Nearly 20 percent of survivors' functional decline was so significant they could no longer live independently aer leaving the hospital. 4. About 40 percent of patients never under- went a rehabilitation evaluation during their hospital stay, which means the number of patients with functional decline is likely an undercount, study authors said. "e major shis in functioning that we highlight are important, but less dramatic declines in physical and cognitive functioning are likely to be found in nearly all previously hospitalized COVID patients," senior author Anna Kratz, PhD, a clinical psychologist at Michigan Medicine, said in a news release. "Even subtle changes in functioning can derail a person's life trajectory. Future work needs to focus on improving our ability to identify and treat people across the full range of the functional decline spectrum." n The long-term pandemic toll few are talking about By Mackenzie Bean M any older adults have experienced physical and cognitive decline after sheltering in place for 15 months, a problem Kaiser Health News calls a "little-discussed, long-term toll of the pandemic" in a May 21 report. The scale of this impairment is unknown, as no major studies have been done on the topic. But physicians, physical therapists and health plan leaders cited this frailty among the nation's older adults as a rising concern. "Anyone who cares for older adults has seen a significant decline in function- ing as people have been less active,"Jonathan Bean, MD, director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System, told Kaiser Health News. The pandemic disrupted normal schedules for older adults, and many didn't eat well, hydrate properly or maintain their mobility. As a result, many have lost strength since the pandemic started, spurring new mobility and balance issues or worsening chronic health issues, clinicians told Kaiser Health News. "Immobility and debility are outcomes to this horrific pandemic that people aren't even talking about yet," said physician therapist Linda Teodosio, division rehabilitation manager at Bayada Home Health Care's office in Towson, Md. "What I'd love to see is a national effort, maybe by the CDC, focused on help- ing older people overcome these kinds of impairments." n 72% of COVID-19 survivors have persistent symptoms, study finds By Mackenzie Bean N early three-fourths of people who recover from COVID-19 have at least one lingering symptom, according to a study published May 26 in Jama Network Open. Researchers at Stanford (Calif.) School of Medicine conducted a systematic re- view of 45 studies on long-term COVID-19 symptoms published between Jan. 1, 2020, and March 11. The research included 9,751 participants, 83 percent of whom had been hospitalized. Researchers defined persistent symptoms as those lasting for at least 60 days after diagnosis, symptom onset or hospitaliza- tion, or at least 30 days after recovery or discharge. They found 72.5 percent of study participants reported at least one per- sistent symptom. In total, participants reported 84 different symptoms and clinical signs of COVID-19. The most common lingering symptoms included shortness of breath, fatigue and sleep disorders. There was a lot of variation in the studies' design and quality, which makes it difficult to compare results, but the review still shows persistent symptoms are common among COVID-19 survivors, according to senior author Steven Goodman, MD, PhD, a professor of epidemiology, population health and medicine at Stanford. "If something on the order of 70 percent of those coming out of moderate to serious COVID-19 are showing persisting symptoms, that is a huge number," Dr. Goodman said in a news release, raising concerns about the potential public health burden of so many patients requiring continued care. n

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