Psychological and Cognitive Functioning Among Patients Receiving Outpatient Rehabilitation for Post-COVID Sequelae: An Observational Study

Objectives: To describe the characteristics of individuals receiving outpatient rehabilitation for post-acute sequelae of SARS-CoV-2 infection (PASC). Further, to examine factors associated with variation in their psychological and cognitive functioning and health-related quality of life. Design: Observational study. Setting: Outpatient COVID-19 recovery clinic at a large, tertiary, urban health system in the US. Participants: COVID-19 survivors with persistent sequelae (N=324). Interventions:: Not applicable. Main Outcome Measures: Multivariable logistic and linear regression models were used to examine factors associated with COVID survivors' experience of severe anxiety, severe depression, post-traumatic stress disorder (PTSD), cognitive impairment, and self-reported health-related quality of life. Results: About 38% of survivors seeking care for their persistent COVID symptoms suffered from severe anxiety, 31.8% from severe depression, 43% experiencing moderate to severe PTSD symptomology, and 17.5% had cognitive impairment. Their health-related quality of life was substan-tially lower than that of the general population (-26%) and of persons with other chronic conditions. Poor and African American/Black individuals experienced worse psychological and cognitive sequelae after COVID19 infection, even after controlling for age, sex, initial severity of the acute infection, and time since diagnosis. Conclusions: Evidence of consistent disparities in outcomes by the patients' race and socioeconomic status, even among those with access to post -acute COVID rehabilitation care, are concerning and have significant implications for PASC policy and program development. Archives of Physical Medicine and Rehabilitation 2023;104:11-7 (c) 2022 by the American Congress of Rehabilitation Medicine.

Automated summary

This observational study aims to describe the characteristics of individuals receiving outpatient rehabilitation for post-acute sequelae of SARS-CoV-2 infection (PASC) and examine factors associated with their psychological and cognitive functioning and health-related quality of life. The results show that a significant proportion of COVID-19 survivors seeking care for persistent symptoms experience severe anxiety, severe depression, PTSD, and cognitive impairment. Their health-related quality of life is substantially lower than the general population and persons with other chronic conditions. Disparities in outcomes by race and socioeconomic status are evident, even among those with access to post-acute COVID rehabilitation care.