Full recovery from disorders of consciousness possible after severe COVID-19 infection
Click Here to Manage Email Alerts
SEATTLE — Full recovery and functional independence is possible in patients who experience a disorder of consciousness after severe COVID-19 infection, according to a presenter at the 2022 American Academy of Neurology annual meeting.
“The reason that this matters is because if you’ve been diagnosed [with minimally conscious state (MCS)], this puts you on a different recovery trajectory,” Lindsey Gurin, MD, clinical assistant professor of neurology, psychiatry and rehabilitation medicine at NYU Langone Health, told attendees.
Gurin and colleagues sought to examine long-term outcomes of disorders of consciousness following severe COVID-19 infection, as recovery to MCS, especially within 8 weeks of injury or illness from COVID-19, is largely unknown.
The prospective cohort study included 21 patients at NYU Langone with severe COVID-19 who required sedation and experienced impaired arousal or awareness when sedation was discontinued.
Once discharged from the hospital, patients were asked to participate in a telephone survey at 6 and 12 months after discharge. For patients completing those assessments, functional outcomes were reported via the Barthel Index, extended Glasgow Outcome Scale (E-GOS) and modified Rankin Scale (mRS); psychological outcomes were reported using Quality of Life in Neurological Disorders (Neuro-QOL) assessments on anxiety, depression, fatigue and sleep disturbance.
According to Gurin, six patients completed both assessments, two of whom were in a COVID-19-associated disorder of consciousness at 6 months and died by 12 months. One patient recovered consciousness at the 6-month interval but remained severely disabled, and one was moderately disabled. Two patients achieved functional independence at the 12-month assessment (Barthel Index 100; E-GOS 5-7; mRS 1-2).
In addition, researchers found that recovery to MCS within 8 weeks of illness onset was associated with survival at 12 months (6/8 vs. 2/9; P = .024), which is consistent with findings on non-COVID disorders of consciousness.
“Functional recovery is possible for patients who have disorders of consciousness,” Gurin said. “We want to try to avoid therapeutic nihilism. Some of these people can recover.”