Older adults and those with chronic underlying health conditions are the most susceptibleto COVID-19 and its complications. Although there has been a rapid response to studyingthe effects of COVID-19 in the acute stages, little is known about recovery over thelonger-term. Older adults who survive the diseases are at risk of developing persistentmobility limitations due to extensive bed rest during hospitalization. For older patientsand those with underlying frailty recovering from COVID-19, this could rapidly lead tosignificant physical deconditioning and rapid declines in mobility. Understanding thetrajectory of functional recovery of older hospitalised patients with COVID-19 in theshort- and long-term is critical to improving patient outcomes and informing health andrehabilitative interventions for survivors.
The coronavirus disease of 2019 (COVID-19) is an international public health challenge
with far-reaching social, economic and health impacts. Older adults and those with
chronic underlying health conditions are the most susceptible to COVID-19 and its
complications. Of the 15,381 reported cases of COVID-19 in Ontario to date, approximately
22.2% (n=3,420) are aged 60-79 and 22.4% (n=3,443) are 80 and over. Although there has
been a rapid and coordinated response to studying the effects of COVID-19 in the acute
stages, little is known about recovery over the longer-term. Anecdotally, the
investigators are seeing severe declines in function, persistent symptoms, and new and
worsening chronic conditions among older survivors of COVID-19. It is known that older
adults who survive acute respiratory distress syndrome and associated diseases are at
risk of developing persistent mobility limitations due to extensive bed rest and/or long
stays in the intensive care unit (ICU) during hospitalization. Recent studies have shown
that many older patients spend only 4% of their hospital stay out of bed, and each day in
bed is associated with a 1-5% loss in muscle strength. For older patients and those with
underlying frailty recovering from COVID-19, this could rapidly lead to significant
physical deconditioning and rapid declines in mobility; with further losses in
physiological reserve and resilience. Understanding the trajectory of functional recovery
of older hospitalised patients with COVID-19 in the short- and long-term is critical to
improving patient outcomes and informing health and rehabilitative interventions for
survivors.
This study is an extension of the Coronavirus (COVID-19) Registry (COREG) platform (PI
Andrew Costa)- a unique Kitchener-Waterloo-Hamilton registry of suspected and confirmed
COVID-19 hospital admissions based on (and in collaboration with) the WHO International
Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The addition of a
prospective cohort study extension to COREG will allow the investigators to follow-older
hospitalised COVID-19 patients over the longer-term in order to gain an understanding of
the trajectory of functional recovery of the disease. Combining the primary data
collection with COREG will also allow the investigators to identify determinants of
long-term outcomes for at-risk older adults. These data are necessary to guide the
clinical care and optimal management of older patients who survive serious COVID-19
illness.
Inclusion Criteria:
- 18 years of age or older
- Currently hospitalised/recently discharged due to/since confirmed or suspected
COVID- 19 infection using the ISARIC definition.
Exclusion Criteria:
- Previously institutionalized
- Pre-morbid severe mobility limitation
McMaster University
Hamilton, Ontario, Canada
Marla K Beauchamp, PhD, Principal Investigator
McMaster University