Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study

作者：Rachael A Evans, Hamish J. C. McAuley, Ewen Munro Harrison, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Omer Elneima, Annemarie Beth Docherty, Nazir Lone, Olivia C. Leavy, Luke Daines, John Kenneth Baillie, Jeremy Brown, Trudie Chalder, Anthony De Soyza, Nawar Diar Bakerly, Nicholas J. W. Easom, John R. Geddes, Neil J. Greening, Nicholas Hart, Liam Gabriel Heaney, Simon R. Heller, Luke Howard, John Robert Hurst, Joseph Jacob, Gisli R. Jenkins, Caroline J. Jolley, Steven Kerr, Onn Min Kon, Keir Edward Lewis, Janet M. Lord, Gerry Patrick McCann, Stefan Neubauer, Peter Openshaw, Dhruv Parekh, Paul Pfeffer, Najib Mahboob Rahman, Betty Raman, Matthew W. Richardson, Matthew J. Rowland, Malcolm Gracie Semple, Ajay M. Shah, Sally J. Singh, Aziz Sheikh, David Thomas, Mark R. Toshner, James Duncan Chalmers, Ling‐Pei Ho, Alex Robert Horsley, Michael Marks, Krisnah Poinasamy, Louise V. Wain, Christopher Edward Brightling, Kathryn Mary Abel, Huzaifa I. Adamali, Davies Adeloye, Olaoluwa M Adeyemi, Famous O. Adeyemi, Shazaad S. Y. Ahmad, Rizwan Ahmed, Mark Andrew Ainsworth, Bashar Al-Sheklly, Asma Khalid Alamoudi, M Aljaroof, Louise M. Allan, R Allen, A Alli, Doris Altmann, Debra Jane Anderson, Michele Andrews, Adrienn Angyal, Chrystalina A. Antoniades, G Arbane, Chérie Armour, Natalie Armstrong, Lará Armstrong, HORACE D. ARNOLD, David Arnold, Mark J. Ashworth, Andrew J. Ashworth, Hosanna Assefa-Kebede, Philip Alan Atkin, H. Atkins, Amy D. Atkins, Raminder Aul, Cristina Avram, Rob Baggott, David Baguley, John Kenneth Baillie, Shadiamon Bain, M Bakali, M Bakau, Eileen Baldry, David Baldwin, Clive G. Ballard, J. Bambrough, Ruth Emily Barker, Shaney Louise Barratt, Fiona Barrett, D Basire, N Basu, Rachel Louise Batterham, Helen Baxendale, Hannah Kelly Bayes, Martin J. Bayley, Michael B. J. Beadsworth, Paul Beirne, R. Bryan Bell, D Bell, Colin Berry, Sarah Betts, Kam Bhui, Lisa D. Bishop, J Blaikely, Claire Bloomfield, A Bloss, A Bolger, Charlotte E. Bolton, James Bonnington, Adam H Botkai, M Bourne, Carmel Bourne, E Bradley, Kate Bramham, L Brear, Gerome D. Breen, J Breeze, Andrew H. Briggs, E Bright, Christopher Edward Brightling, Simon Edward Brill, Khara Croswaite Brindle, L Broad, Matthew R. Broome, Jeremy Brown, M Brown, J Brown, J Brown, Rachel L. Brown, Victoria Tzortziou Brown, A Brown, M Brown, A Brown, Traolach Sean Brugha, Nigel John Brunskill, Maya H Buch, Anda Bularga, Edward Thomas Bullmore, Daniel Burn, G Burns, John Busby, A Buttress, Suzanne C. Byrne, Paula L. Cairns, P C Calder, Ellen Calvelo, Brittany Card, Loretta Carr, Gail Carson, P Carter, Jorunn Pauline Cavanagh, Trudie Chalder, James D. Chalmers, R C Chambers, Keith M. Channon, K Chapman, A Charalambou, Nazia Chaudhuri, Anna M. Checkley, J Chen, Luke Chetham, Edwin R. Chilvers, Hector Chinoy, K Chong-James, Noura J. Choudhury, Gourab Choudhury, Priyanka Roy Chowdhury, Phil Chowienczyk, C D C Christie, David Clark, Collin M. Clark, Jennifer Clarke, Peter D. Clift, Sara Clohisey, Z Coburn, Joby Cole, Christopher Michael Coleman, David Connell, Bronwen A. Connolly, L Connor, Aisha Cook, Brendan G. Cooper, Cherry Coupland, Tom Craig, Philippe Crisp, D Cristiano, Michael George Crooks, Adam Cross, I Cruz, Paul Cullinan, Luke Daines, M Dalton, Paul M Dark, Jo Dasgin, Abel P. David, C David, Matthew John Davies, Gwyneth A. Davies, Katherine Davies, Ffyon Davies, G A Davies, E Daynes, Thushan I. de Silva, Anthony De Soyza, B Deakin, ANDREW ROBERT DEANS, Sylviane Defres, Amanda Dell, K Dempsey, John Dennis, Amy Dewar, R Dharmagunawardena, Nawar Diar Bakerly, Alexandra Dipper, Sarah E. Diver, S N Diwanji, M Dixon, Ratko Djukanović, Hannah Dobson, Charlotte Dobson, Susan L. Dobson, Annemarie Beth Docherty, Anthony S. Donaldson, Tao Dong, Natalie C. Dormand, Andrew Dougherty, Rowan Dowling, S Drain, Pearl Dulawan, Aidan Dunleavy, S Dunn, S Dunn, Nicholas J. W. Easom, Carlos Echevarria, Sarah Louise Edwards, Charlotte L. Edwardson, Brian P. Elliott, Angela Elliott, Yvette Ellis, Anneliese T. Elmer, Omer Elneima, Rachael A Evans, Jonathan Evans, Helen S Evans, David Evans, Rhodri Evans, Rachael A Evans, Teriann Evans, Laura Fabbri, S. Fairbairn, Andrea D. Fairman, Kathleen Fallon, David Faluyi, Clair Favager, Tim Felton, Joanne Finch, Simon J. Finney, Helen Louise Fisher, Simon N. Fletcher, R Flockton, David Foote, A Ford, Daniel M. Forton, Rebecca Francis, Sarah L Francis, C Francis, Adam John Frankel, Emily Fraser, Robert C. Free, Nigel Peter French, Jonathan P. Fuld, James J. Furniss, Lee Garner, N Gautam, J R Geddes, P M George, J George, Michael Gibbons, Lesley Gilmour, Fergus Vincent Gleeson, Jodie Glossop, S Glover, Nigel B. Goodman, Bibek Gooptu, Thomas Gorsuch, E. S. Gourlay, Paul Leonard Greenhaff, William Greenhalf, A Greenhalgh, Neil J. Greening, John Pierre Greenwood, Sharlene Anuska Greenwood, R. Gregory, D Grieve, Mahitha Gummadi, Ayush Gupta, Sambasivarao Gurram, E Guthrie, Kate Hadley, A Haggar, Kirsten Hainey, Pranabashis Haldar, I Hall, L Hall, Mark Halling‐Brown, R Hamil, Neil A. Hanley, Hayley E. Hardwick, Elaine Hardy, Beverley Hargadon, Kevin Joseph Harrington, V. Harris, E M Harrison, Phillippa Harrison, Nicholas Hart, Angela J. Harvey, M Harvey, Miranda Harvie, May Havinden-Williams, Jason Ezra Hawkes, Nancy Hawkings, Jill Haworth, A Hayday, L G Heaney, Jonathan Luke Heeney, Melissa Heightman, Simon R. Heller, Morag Henderson, L Hesselden, Toby Hillman, Aroon Dinesh Hingorani, Tarek Hiwot, Ling‐Pei Ho, A Hoare, M Hoare, P Hogarth, A Holbourn, Luke Holdsworth, D Holgate, Katrina Holmes, B Holroyd-Hind, Alex Robert Horsley, Akram A. Hosseini, Matthew H. Hotopf, Linzy Houchen, L Howard, L Howard, Alice Howell, E Hufton, Alun D. Hughes, Joel W. Hughes, R Hughes, Alister Humphries, Nathan T. M. Huneke, John Robert Hurst, Robert E. Hurst, Masud Husain, Tracy Hussell, Wadah Ibrahim, A Ient, L Ingram, Khalida Ismail, Thomas Jackson, Joseph Jacob, W Y James, Stephanie Janes, Hannah Jarvis, B Jayaraman, Gisli R. Jenkins, Peter Jezzard, K Jiwa, Steven Johnson, Candace L. Johnson, D Johnston, Caroline J. Jolley, Caroline J. Jolley, Ian A. Jones, Sheila Jones, D Jones, H. Jones, G Jones, Mark G. Jones, S Jose, T Kabir, Georgios Kaltsakas, Vicky Kamwa, Partha S. Kar, Z. Kausar, Sarah Kelly, S Kerr, A L Key, Fasihul A Khan, Kamlesh K. Khunti, C King, Bridget King, Pádraig Thomas Kitterick, Paul Klenerman, Lucy Knibbs, Stephen Richard Knight, Alexandra Knighton, Onn Min Kon, Samantha S.C. Kon, S S Kon, Ania Korszun, C Kotanidis, Ivan G. Koychev, P Kurupati, Jennifer M. Kwan, Charles Laing, H. Lamlum, Geraldine Landers, Claudia Langenberg, Daniel S Lasserson, Alison M. Lawrie, A Lea, Olivia C. Leavy, D Lee, E Lee, Kellie Leitch, Rebecca Lenagh, Keir Edward Lewis, Virginia J. Lewis, Keir Edward Lewis, Jonathan R. Lewis, N Lewis-Burke, Teresa Light, L Lightstone, L. Lim, S Linford, Anne R. Lingford-Hughes, Marc C.I. Lipman, Kamal Liyanage, Adam P. Lloyd, Sarah A E Logan, David A. Lomas, Nazir Lone, Ronda Loosley, Jodie Lord, Harpreet Lota, Alice J. Lucey, Guy MacGowan, Irene Macharia, Callum Mackay, L Macliver, S Madathil, G Madzamba, Nick Magee, Nathan Mairs, Nauman Majeed, Eugene O. Major, Michael H. Malim, Georgia Mallison, William D‐C Man, Sema Mandal, Kenneth Mangion, Parisa Mansoori, Stefan John Marciniak, M Mariveles, Michael Marks, Ben G. Marshall, Adrian R. Martineau, N Maskell, Darwin Matila, Lawrence M. Matthews, Jamil Mayet, Stephen Paul McAdoo, Hamish McAllister-Williams, P McArdle, Angela McArdle, D McAulay, Hamish J. C. McAuley, Daniel Francis McAuley, Kieran McCafferty, Gerry Patrick McCann, H McCauley, Paul McCourt, Lorcan P. McGarvey, Jade McGinness, A. McGovern, Heather McGuinness, Iain B. McInnes, Katherine McIvor, Emma McIvor, Anne Marie McMahon, Michael McMahon, Liam McMorrow, Thomas A. McNally, Melitta Anne McNarry, Alison McQueen, H McShane, Sharon Megson, James Meiring, Dan Menzies, A Michael, Benedict Daniel Michael, Lea Milligan, Nicholas L. Mills, James Mitchell, Awab Musaad Mohamed, Philip L. Molyneaux, W Monteiro, A Morley, Leigh Morrison, Richard Keith Morriss, A Morrow, Alison Moss, A J Moss, Paul A. H. Moss, Elizabeta B. Mukaetova‐Ladinska, Usama Munawar, Elodie Murali, Jennifer Murira, H Nassa, P Neill, Stefan Neubauer, David Ernest Newby, Helen Newell, A Newton Cox, Timothy R. Nicholson, D Nicoll, Claire M. Nolan, Maria Noonan, Petr Novotný, J Nunag, Joseph Nyaboko, L O'Brien, Nicole O'Dell, Graham Stuart Ogg, Oladoyin Olaosebikan, C Oliver, Z Omar, Peter Openshaw, R Osbourne, Marlies Ostermann, Christopher E. Overton, Julie Oxton, Edmund Pacpaco, Stella‐Maria Paddick, Padmasayee Papineni, Kerry Paradowski, Manish Pareek, Dhruv Parekh, Helen Parfrey, Carmine Maria Pariante, Sean Parker, Miles Parkes, J Parmar, R Parvin, S Patale, B. Patel, Suresh C. Patel, Manish Patel, B. Pathmanathan, M Pavlides, John E. Pearl, Daniel Gavin Peckham, Jessica Pendlebury, Yun Peng, Catherine M. Pennington, I Peralta, Emma Perkins, Tünde Pető, Nayia Petousi, J. Petrie, P Pfeffer, J Phipps, J Pimm, Karen Piper Hanley, Riinu Pius, Sven Plein, Tatiana Plekhanova, K Poinasamy, O Polgar, L Poll, Joanna C. Porter, Sofiya Portukhay, Neil Powell, L Price, D Price, Angeline Price, Christopher Price, A Prickett, Sheena Quaid, J Quigley, Jennifer Kathleen Quint, H Qureshi, Najib M. Rahman, M. I. Rahman, Markus Ralser, Betty Raman, A Ramos, Jade Rangeley, Tim Rees, Karen S. Regan, A Richards, M Richardson, Pilar Rivera‐Ortega, Elaine Robertson, J Rodgers, G Ross, J Rossdale, Anthony Rostron, Ash C. Routen, A Rowland, Matthew J. Rowland, J Rowland, Sarah Rowland‐Jones, Krishna Chandra Roy, Igor Rudan, R Russell, Emma Russell, Ramsey Sabit, Elizabeth Kathryn Sage, N Samani, R Samuel, Elizabeth Sapey, Dinesh Saralaya, Athanasios N. Saratzis, Jack Alistair Sargeant, T. Sass, Naveed A. Sattar, Karen Saunders, Ruth M. Saunders, W Saxon, A Sayer, Wilhelm Schwaeble, Janet T. Scott, Kristin L. Scott, Nicholas M. Selby, Malcolm Gracie Semple, M Sereno, Kanan J. Shah, Ajay M. Shah, Pallav L. Shah, Manish Kr. Sharma, Michael Sharpe, Claire C. Sharpe, Victoria E. Shaw, A Sheikh, K Shevket, A Shikotra, J Short, Salman Hameed Siddiqui, Louise Sigfrid, G Simons, Jennifer R. Simpson, Amisha Singapuri, S J Singh, Claire Singh, Sally J. Singh, J Skeemer, Isabelle Smith, John A. Smith, Lauren C. Smith, Anne Smith, M Soares, David Southern, Mark Spears, Lisa G. Spencer, Fabio Speranza, Louise J. Stadon, Stefan Cristian Stanel, MICHAEL C. STEINER, David J. Stensel, M Stern, Iain D. Stewart, James A. Stockley, R Stone, A. Storrie, Kim Storton, Jeffrey S. A. Stringer, C. Subbe, Cathie L. M. Sudlow, Zainab Suleiman, Charlotte Summers, Christina Summersgill, D Sutherland, Dominic Lee Sykes, Robert Sykes, Nick P. Talbot, Ai Lyn Tan, Christopher A Taylor, Alex H. Taylor, A Te, H Tedd, C J Tee, Helen Tench, S. Terry, S. Thackray-Nocera, Favas Thaivalappil, DAVID R. THICKETT, David Thomas, D C Thomas, Andrew Thomas, A. A. Roger Thompson, T Thompson, T Thornton, Ryan S. Thwaites, Martin D. Tobin, G F Toingson, Catherine Tong, Mark R. Toshner, Rhian M. Touyz, K A Tripp, E. Tunnicliffe, Emma L. Turner, Lance C. W. Turtle, Helena A. Turton, R Ugwuoke, Rachel Upthegrove, Jonathan Valabhji, Kasturi Vellore, Erin A. Wade, L V Wain, L O Wajero, Sinead Walder, S Walker, Emma CB Wall, T Wallis, Sharon Lynn Walmsley, S Walsh, Jessica A. Walsh, Lea C. Watson, Judith M. Watson, Lea C. Watson, Eleanor Watson, Carly Welch, Hugh G. Welch, B Welsh, Simon C. Wessely, Sam West, Helen T. Wheeler, Victor Whitehead, Julie C. Whitney, S Whittaker, Ben Whittam, Jim M. Wild, M Wilkins, Dean Wilkinson, Nefyn Howard Williams, Bryan Williams, Justin H. G. Williams, S A Williams-Howard, Michelle Kay Willicombe, Guillermo Byrd Willis, D Wilson, Isabella Wilson, Nicola Window, Miles D. Witham, R Wolf-Roberts, Felix Woodhead, Jeffrey A. Woods, Dan Wootton, J Worsley, D Wraith, Lianne Wright, Clinton B. Wright, S Wright, C Xie, S Yasmin, Thomas E. Yates, Kay Por Yip, Bob Young, Scott Young, Alison Luk Young, Ahmed Yousuf, Ahmed Yousuf, A. Zawia, Boya Zhao, Odette N. Zongo · 发表于：The Lancet Respiratory Medicine · 年份：2021 · DOI：10.1016/s2213-2600(21)00383-0 · 被引用次数：670 · 研究领域：Long-Term Effects of COVID-19、Intensive Care Unit Cognitive Disorders、COVID-19 and Mental Health

BACKGROUND: The impact of COVID-19 on physical and mental health and employment after hospitalisation with acute disease is not well understood. The aim of this study was to determine the effects of COVID-19-related hospitalisation on health and employment, to identify factors associated with recovery, and to describe recovery phenotypes. METHODS: The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a multicentre, long-term follow-up study of adults (aged ≥18 years) discharged from hospital in the UK with a clinical diagnosis of COVID-19, involving an assessment between 2 and 7 months after discharge, including detailed recording of symptoms, and physiological and biochemical testing. Multivariable logistic regression was done for the primary outcome of patient-perceived recovery, with age, sex, ethnicity, body-mass index, comorbidities, and severity of acute illness as covariates. A post-hoc cluster analysis of outcomes for breathlessness, fatigue, mental health, cognitive impairment, and physical performance was done using the clustering large applications k-medoids approach. The study is registered on the ISRCTN Registry (ISRCTN10980107). FINDINGS: We report findings for 1077 patients discharged from hospital between March 5 and Nov 30, 2020, who underwent assessment at a median of 5·9 months (IQR 4·9-6·5) after discharge. Participants had a mean age of 58 years (SD 13); 384 (36%) were female, 710 (69%) were of white ethnicity, 288 (27%) had received mechanical ventila...