BMJ Open Respiratory Research (Dec 2023)
Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis
- ,
- Linzy Houchen-Wolloff,
- Sally Singh,
- Jennifer K Quint,
- Michael Marks,
- Nicholas Hart,
- Matthew Richardson,
- Ling-Pei Ho,
- Charlotte E Bolton,
- Rachael A Evans,
- Amit Kulkarni,
- Amisha Singapuri,
- Felicity Evison,
- Sarah Wallace,
- Betty Raman,
- Trudie Chalder,
- Claire Marie Nolan,
- William Man,
- Ewen Harrison,
- Nazir I Lone,
- Chris Brightling,
- Julie Whitney,
- James Chalmers,
- Enya Daynes,
- Neil J Greening,
- Annemarie Docherty,
- Gavin Donaldson,
- Janet Scott,
- Camilla Dawson,
- Tom Yates,
- Louise V Wain,
- Marco Sereno,
- Krisnah Poinasamy,
- Gemma Clunie,
- Hamish McAuley,
- Alex Robert Horsley,
- Melitta McNarry,
- Sallyanne Duncan,
- Olivia C Leavy,
- Elneima Omer,
- Aarti Shikotra,
- Ruth M Saunders,
- Victoria C Harris,
- Dan Gower Wootton,
- Jack Sargent,
- John Pimm,
- Lettie Bishop,
- Neil Sharma,
- Margaret Coffey
Affiliations
- Linzy Houchen-Wolloff
- Department of Pulmonary Rehabilitation, University Hospitals of Leicester, Leicester, UK
- Sally Singh
- Cardiac/Pulmonary Rehabilitation, University Hospitals of Leicester NHS Trust, Leicester, UK
- Jennifer K Quint
- School of Public Health, Imperial College, London, UK
- Michael Marks
- London School of Hygiene & Tropical Medicine, London, UK
- Nicholas Hart
- Lane Fox Respiratory Service, Guy`s & St Thomas` NHS Foundation Trust, London, UK
- Matthew Richardson
- Leicester Respiratory Biomedical Research Unit, National Institute for Health Research, Leicester, UK
- Ling-Pei Ho
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, Oxford, UK
- Charlotte E Bolton
- Respiratory Medicine, NIHR Nottingham Biomedical Research Centre Respiratory Theme, University of Nottingham, Nottingham, UK
- Rachael A Evans
- University of Leicester, Leicester, UK
- Amit Kulkarni
- Royal College of Speech and Language Therapists, London, UK
- Amisha Singapuri
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Felicity Evison
- Department of Informatics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Sarah Wallace
- Wythenshawe Hospital, Manchester, UK
- Betty Raman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxfordshire, UK
- Trudie Chalder
- 43 Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Claire Marie Nolan
- Royal Brompton and Harefield Hospitals, London, UK
- William Man
- Imperial College London, London, UK
- Ewen Harrison
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Nazir I Lone
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Chris Brightling
- Institute of Lung Health, University of Leicester, Leicester, UK
- Julie Whitney
- King`s College London Faculty of Life Sciences and Medicine, London, UK
- James Chalmers
- Tayside Respiratory Research Group, University of Dundee, Dundee, UK
- Enya Daynes
- CERS, NIHR Leicester Biomedical Research Centre, Leicester, UK
- Neil J Greening
- Respiratory Medicine, Institute for Lung Health, UK
- Annemarie Docherty
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Gavin Donaldson
- Imperial College London, London, UK
- Janet Scott
- University of Glasgow, Glasgow, UK
- Camilla Dawson
- Department of Speech and Language Therapy, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Tom Yates
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
- Louise V Wain
- Biomedical Research Centre—Respiratory, National Institute for Health Research, Leicester, UK
- Marco Sereno
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Krisnah Poinasamy
- Head of Research and Innovation Advocacy, Asthma UK, London, UK
- Gemma Clunie
- Department of Surgery and Cancer, Imperial College London, London, UK
- Hamish McAuley
- University of Leicester, Leicester, UK
- Alex Robert Horsley
- Respiratory Medicine, Manchester Adult Cystic Fibrosis Centre, Manchester, UK
- Melitta McNarry
- College of Engineering, Swansea University, Swansea, UK
- Sallyanne Duncan
- Wellcome-Wolfson Institute for Experimental Medicine, Queen`s University Belfast, Belfast, UK
- Olivia C Leavy
- Department of Health Sciences, University of Leicester, Leicester, UK
- Elneima Omer
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Aarti Shikotra
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Ruth M Saunders
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Victoria C Harris
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Dan Gower Wootton
- Respiratory Research, University Hospital Aintree, Liverpool, UK
- Jack Sargent
- University Hospitals of Leicester NHS Trust, Leicester, UK
- John Pimm
- Healthy Minds, The Buckinghamshire IAPT Service, Oxford Health NHS Foundation Trust, Oxford, UK
- Lettie Bishop
- Loughborough University, Loughborough, UK
- Neil Sharma
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Margaret Coffey
- Imperial College London, London, UK
- DOI
- https://doi.org/10.1136/bmjresp-2023-001647
- Journal volume & issue
-
Vol. 10,
no. 1
Abstract
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.
