Background This study aimed to determine the frequency of functional decline and to identify the factors related to a greater risk of functional decline among hospitalized older patients with coronavirus disease 2019 (COVID-19). Methods We reviewed the medical records of patients aged over 65 years who were admitted to a tertiary care hospital for COVID-19 over 1 year from February 2020. We evaluated the proportion of functional decline, which was defined as a decrease in the Barthel Index score from before the onset of COVID-19 to discharge. Multivariable logistic regression analyses were performed to evaluate the associations between the demographic and clinical characteristics of patients at admission and a greater risk of functional decline. Two sensitivity analyses with different inclusion criteria were performed: one in patients without very severe functional decline before the onset of COVID-19 (i.e., limited to those with Barthel Index score ≥ 25), and the other with a composite outcome of functional decline and death at discharge. Results The study included 132 patients with COVID-19; of these, 72 (54.5%) developed functional decline. The severity of COVID-19 did not differ between patients with functional decline and those without ( P = 0.698). Factors associated with a greater risk of functional decline included female sex (adjusted odds ratio [aOR], 3.14; 95% confidence interval [CI], 1.25 to 7.94), Barthel Index score < 100 before the onset of COVID-19 (aOR, 13.73; 95% CI, 3.29 to 57.25), and elevation of plasma D-dimer level on admission (aOR, 3.19; 95% CI, 1.12 to 9.07). The sensitivity analyses yielded similar results to those of the main analysis. Conclusions Over half of the older patients who recovered from COVID-19 developed functional decline at discharge from a tertiary care hospital in Japan. Baseline activities of daily living impairment, female sex, and elevated plasma D-dimer levels at admission were associated with a greater risk of functional decline. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02597-w.
【저자키워드】 Coronavirus disease 2019, Hospitalization, disability, older patients, Activities of Daily Living, Functional decline, Barthel Index, 【초록키워드】 COVID-19, coronavirus disease, Hospitalized, Clinical characteristics, hospital, Sex, risk, outcome, discharge, activity, older patient, severity of COVID-19, female, Patient, death, Logistic regression, Japan, sensitivity analysis, plasma, Admission, Care, association, D-dimer level, Frequency, Analysis, medical record, Factor, adjusted odds ratio, supplementary material, 95% CI, 95% confidence interval, inclusion criteria, daily living, impairment, over, decrease, main analysis, Result, greater, defined, not differ, identify, performed, evaluate, proportion, evaluated, elevated, functional, determine, 【제목키워드】 coronavirus disease, Hospitalized, older patient, retrospective cohort study,