Life AfTER covid-19 (LATER-19): a protocol for a prospective, longitudinal, cohort study of symptoms, physical function and psychological outcomes in the context of a pandemic

Abstract

Introduction

(COVID-19) disease can present with respiratory tract infection and influenza-like symptoms. Although increased symptoms during physical exertion and impairments in lung function have been recently reported as some of the negative effects of COVID-19, no study has defined the recovery trajectories during and following the acute phase of the disease from a symptomatic, physical or psychological perspective. The proposed study will aim primarily to provide a multidimensional analysis of the 12-month recovery of symptoms, physical function, health-related quality of life (HRQoL), and psychological function in adults following a diagnosis of COVID-19.

Methods

This report describes the method for a prospective, longitudinal, single-area multi-centre cohort study. Possible international extension is envisaged. Eligibility criteria are patients > 18 years old with a confirmed diagnosis of COVID-19, who provide informed consent. Exclusion criteria include those with pre-existing neuromuscular disorders likely to affect the measures of physical function, diagnosed pre-existing mental illness and significant cognitive impairment likely to affect responses to self-report measures. The study assessment protocol is in two parts. Part A will be undertaken by inpatients, who will undergo added clinical and symptom assessments every 48 hours during the admission. At discharge, participants will be eligible for Part B, incorporating assessments at four time points: on discharge and 3, 6, and 12 months from hospital admission. Assessments will include: symptoms (fatigue and shortness of breath), physical function (functional capacity and peripheral muscle force), HRQoL and psychological (feelings of anxiety and depression, and posttraumatic stress) function. Associations of patient and clinical characteristics predictors with longitudinal in-hospital clinical and symptomatic outcomes will be examined using generalised linear mixed models (GLMM) with random subject effects. Corresponding associations of patient characteristic, clinical pathway and rehabilitation pathway predictors with recovery trajectories will also be examined.