Rationale, Design, and Characteristics of the VALIANT (COVID‐19 in Older Adults: ALongitudinal Assessment) Cohort

Abstract

Background Most older adults hospitalized with COVID‐19 survive their acute illness. The impact of COVID‐19 hospitalization on patient‐centered outcomes, including physical function, cognition, and symptoms, is not well understood. To address this knowledge gap, we collected longitudinal data about these issues from a cohort of older survivors of COVID‐19 hospitalization. Methods We undertook a prospective study of community‐living persons age ≥ 60 years who were hospitalized with COVID‐19 from June 2020–June 2021. A baseline interview was conducted during or up to 2 weeks after hospitalization. Follow‐up interviews occurred at one, three, and six months post‐discharge. Participants completed comprehensive assessments of physical and cognitive function, symptoms, and psychosocial factors. An abbreviated assessment could be performed with a proxy. Additional information was collected from the electronic health record. Results Among 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 20% required care in an intensive care unit or stepdown unit. At enrollment, nearly half (47%) reported at least one preexisting 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. At the six‐month follow‐up interview, more than a third of participants experienced a decline from their pre‐hospitalization function, nearly 20% had cognitive impairment, and burdensome symptoms remained highly prevalent. Conclusions We enrolled a diverse cohort of older adults hospitalized with COVID‐19 and followed them after discharge. Functional decline was common, and there were high rates of persistent cognitive impairment and symptoms. Future analyses of these data will advance our understanding of patient‐centered outcomes among older COVID‐19 survivors.

Coronavirus disease 2019 and its impact on the cognition of older adults: Unraveling the role of inflammation

“…Older individuals, along with other age groups, are particularly susceptible to adverse outcomes following COVID-19 infection. Research has shown that advanced age is a significant risk factor for severe COVID-19 outcomes [ 20 ] and studies have emphasized the potential for cognitive decline in older adults [ 22 , 23 ]. While studies have highlighted the impact of inflammation on cognitive function in older adults [ 24 ], few studies have investigated the link between cognitive function and inflammation in elderly individuals who have recovered from COVID-19 [ 25 ].…”

Post‐acute sequelae of SARS‐CoV‐2 (PASC) in nursing home residents: A retrospective cohort study

“…PASC can have a unique presentation in older adults with studies indicating worsening of geriatric syndromes after infection 7,8 . Studies have found higher risk of cognitive decline, sarcopenia, and worsened mobility in older survivors of COVID‐19 7–10 . Thus far, research has focused on community‐dwelling adults 9 even though NH residents were disproportionately affected by the pandemic 11,12 …”

“…7,8 Studies have found higher risk of cognitive decline, sarcopenia, and worsened mobility in older survivors of COVID-19. [7][8][9][10] Thus far, research has focused on community-dwelling adults 9 even though NH residents were disproportionately affected by the pandemic. 11,12 Interventions to treat PASC symptoms is an emerging area of research.…”