Rationale, Design, and Baseline Characteristics of the VALIANT (COVID-19 in Older Adults: A Longitudinal Assessment) Cohort

Abstract

BackgroundMost older adults hospitalized with COVID-19 survive their acute illness. The impact of COVID-19 hospitalization on patient-centered outcomes, such as physical function, cognitive function, and symptoms, is not well understood. We sought to address this knowledge gap by collecting longitudinal data about these issues from a cohort of older adult survivors of COVID-19 hospitalization.MethodsWe undertook a prospective study of community-living persons age ≥60 years who were hospitalized with COVID-19 from June 2020 to June 2021. A baseline interview was conducted during or up to two weeks after hospitalization. Follow-up interviews occurred at one, three, and six months post-discharge. In interviews, participants completed comprehensive assessments of physical and cognitive function, symptoms, and psychosocial factors. If a participant was too impaired to complete an interview, an abbreviated assessment was performed with a proxy. Additional information was collected from the electronic health record. Baseline characteristics of the cohort are reported here.ResultsAmong 341 participants, the mean age was 71.4 (SD 8.4) years, 51% were women, and 37% were of Black race or Hispanic ethnicity. Median length of hospitalization was 8 (IQR 6-12) days. All but 4% of participants required supplemental oxygen and 21% required a higher level of care in an intensive care unit or stepdown unit. Nearly half (47%) reported at least one disability in physical function, 45% demonstrated cognitive impairment, and 67% were pre-frail or frail. Participants reported a mean of 9 of 14 (SD 3) COVID-19-related symptoms.ConclusionsOlder adults hospitalized with COVID-19 demonstrated high rates of baseline physical and cognitive impairment as well as high symptom burden. Longitudinal findings from this cohort will advance our understanding of outcome trajectories of great importance to older survivors of COVID-19.