{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T21:37:49Z","timestamp":1776980269286,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["T32AG000212"],"award-info":[{"award-number":["T32AG000212"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["303883\/2021\u20109"],"award-info":[{"award-number":["303883\/2021\u20109"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["22\/01769\u20105"],"award-info":[{"award-number":["22\/01769\u20105"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["23AARFD\u20101028868"],"award-info":[{"award-number":["23AARFD\u20101028868"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["24CBIDR\u20101185483"],"award-info":[{"award-number":["24CBIDR\u20101185483"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hospitalization frequently results in persistent symptoms among older adults, raising concerns about the long\u2010term impacts of acute events\u2014a problem amplified by COVID\u201019. We investigated the effects of persistent symptoms on functional decline and unplanned events over 1\u2009year in older patients recovering from COVID\u201019 hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort included patients aged \u2265\u200950\u2009years who survived COVID\u201019 hospitalization between March and December 2020 as part of the CO\u2010FRAIL study at Brazil's largest academic medical center. Persistent symptoms were defined as those reported at admission and continuously present at one\u2010, three\u2010, six\u2010, nine\u2010, and 12\u2010month post\u2010discharge, covering 16 symptoms. Outcomes included functional decline in basic activities of daily living (ADL), mobility activities, instrumental activities of daily living (IADL), number of falls, emergency department (ED) visits, and hospital readmissions. Associations between persistent symptoms and outcomes were examined using mixed\u2010effects negative binomial regression models adjusted for sociodemographic, clinical, hospitalization\u2010related factors, and post\u2010discharge rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1019 patients (mean age\u2009=\u200965\u2009\u00b1\u200910\u2009years; women\u2009=\u200945%; White\u2009=\u200962%), 324 (32%) experienced persistent symptoms throughout the year. Fatigue (28%), myalgia (19%), and dyspnea (13%) were the most common. Patients with \u2265\u20092 symptoms had an increased risk of functional decline in mobility activities (IRR\u2009=\u20092.11; 95% CI\u2009=\u20091.50\u20132.96), IADL (IRR\u2009=\u20092.00; 95% CI\u2009=\u20091.44\u20132.79), falls (IRR\u2009=\u20092.56; 95% CI\u2009=\u20091.14\u20135.75), and ED visits (IRR\u2009=\u20092.69; 95% CI\u2009=\u20091.27\u20135.70), but not readmissions. Among women, \u2265\u20091 persistent symptom was associated with a twofold increased risk of ADL decline. One year after discharge, patients with \u2265\u20092 persistent symptoms developed 1.27 more new disabilities (3.26 vs. 1.99 on a 15\u2010point functional scale) and had 31 more unplanned events per 100 person\u2010years (54.3 vs. 23.2) than those without symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Persistent symptoms after hospitalization are common and contribute to functional decline, falls, and ED visits in older COVID\u201019 survivors. These findings suggest that greater attention to symptom burden may support risk identification and improve post\u2010discharge care planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19490","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T06:35:00Z","timestamp":1746686100000},"page":"1722-1732","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Post\u2010Discharge\n                    <scp>COVID<\/scp>\n                    \u201019 Symptoms Predict 1\u2010Year Functional Decline, Falls, and Emergency Department Visits: A Cohort Study"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9415-709X","authenticated-orcid":false,"given":"Murilo Bacchini","family":"Dias","sequence":"first","affiliation":[{"name":"Laboratorio de Investiga\u00e7\u00e3o Medica em Envelhecimento (LIM\u201066), Servi\u00e7o de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiago J.","family":"Avelino\u2010Silva","sequence":"additional","affiliation":[{"name":"Laboratorio de Investiga\u00e7\u00e3o Medica em Envelhecimento (LIM\u201066), Servi\u00e7o de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo  Sao Paulo Brazil"},{"name":"Division of Geriatrics University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Ferriolli","sequence":"additional","affiliation":[{"name":"Laboratorio de Investiga\u00e7\u00e3o Medica em Envelhecimento (LIM\u201066), Servi\u00e7o de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leandro Utino","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Emergency Medicine Discipline Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo  Sao Paulo Brazil"},{"name":"Research Institute Hospital Sirio\u2010Libanes  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson","family":"Jacob\u2010Filho","sequence":"additional","affiliation":[{"name":"Laboratorio de Investiga\u00e7\u00e3o Medica em Envelhecimento (LIM\u201066), Servi\u00e7o de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5942-4778","authenticated-orcid":false,"given":"Claudia Kimie","family":"Suemoto","sequence":"additional","affiliation":[{"name":"Laboratorio de Investiga\u00e7\u00e3o Medica em Envelhecimento (LIM\u201066), Servi\u00e7o de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7467-1745","authenticated-orcid":false,"given":"M\u00e1rlon Juliano Romero","family":"Aliberti","sequence":"additional","affiliation":[{"name":"Laboratorio de Investiga\u00e7\u00e3o Medica em Envelhecimento (LIM\u201066), Servi\u00e7o de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo  Sao Paulo Brazil"},{"name":"Research Institute Hospital Sirio\u2010Libanes  Sao Paulo Brazil"},{"name":"Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the CO\u2010FRAIL Study Group for the COVID HCFMUSP Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"I. 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