Associations between COVID-19 severity, cognitive impairment, and quality of life in individuals in need of care: Results from the multicenter registry study BaCoM

Background: Older adults in need of care are at high risk for severe COVID-19 and cognitive impairment. Objective: This study investigates the association between COVID-19 severity, quality of life, and cognitive impairment in individuals requiring care. Methods: Data from 531 participants (68.4% female; n = 363; median age = 82.0 years, IQR = 13.0) of the Bavarian ambulatory COVID-19 Monitor (BaCoM)—all of whom were in need of care and had a prior SARS-CoV-2 infection—were analysed. We compared sociodemographic and health-related characteristics, cognitive performance, COVID-19 disease features, and quality of life between 80 individuals hospitalized for COVID-19 and 451 individuals who were infected but not hospitalized. Associations between cognitive impairment and COVID-19 severity were examined using binary logistic regressions with the MoCA Blind and Six-Item Screener as dependent variables. The association between quality of life and COVID-19 severity was analysed using multiple linear regression with the EQ VAS as the dependent variable. Results: Hospitalized individuals had significantly lower MoCA Blind scores than non-hospitalized peers (17.0 vs. 19.0, p=0.039), while SIS scores showed no difference. EQ VAS scores were similar between the groups, but hospitalized individuals had lower EQ-5D-5L Index scores (0.57 vs. 0.75, p=0.004). COVID-19 severity (hospitalization, symptom duration) was not associated with MoCA Blind <18 or with the EQ VAS. Conclusion: The study found lower MoCA-Blind scores and reduced quality of life in hospitalised individuals, but adjusted analyses showed no significant link between COVID-19 severity and cognition or quality of life.