{"doi":"10.1111/jgs.19534","title":"Reply to: Reevaluating Functional Recovery Post‐ <scp>COVID</scp> ‐19: A Call for Broader Considerations","abstract":"We appreciate the opportunity to respond to the commentary by Sathian and colleagues [1] regarding our recent publication [2]. We welcome the discussion that advances our understanding of post-COVID-19 functional trajectories in older adults. Our study aimed to delineate distinct functional trajectories in the 6 months following hospitalization. A second objective was to determine whether six factors—age, comorbidities, in-hospital delirium, frailty, pre-admission disability, and severity of illness—were associated with trajectory membership. We selected these factors a priori because they are well-established determinants of outcomes in geriatric populations. In analyses of this kind, it is essential that the explanatory variables (in our study, these six factors) temporally precede the outcome (the repeated functional measures used to fit the functional trajectories). To maintain temporal separation, it was therefore not possible to include post-discharge factors such as rehabilitation practices, psychological support, and community care resources as explanatory variables in the analysis. While these post-discharge factors are important, their role in recovery after a COVID-19 hospitalization should be the focus of a future study with a different design. We fully agree with the comment that social determinants of health (SDOH), such as socioeconomic status and healthcare access, play a role in recovery from COVID-19. Our cohort was diverse, with substantial representation of individuals from varied socioeconomic backgrounds, which strengthens the generalizability of our findings. While a full evaluation of SDOH was outside the scope of this study, additional analyses of the VALIANT cohort are underway to further elucidate the contribution of SDOH to other patient-centered outcomes after COVID-19 hospitalization. We hope that this forthcoming work, and future research from other investigators, will help inform the care of disadvantaged older adults who have survived a COVID-19 hospitalization. Preparation of the manuscript: Jim Q. Ho, Andrew B. Cohen, and Lauren E. Ferrante. Review and revision of the manuscript for important intellectual content: all authors. This work was supported by the Yale Claude D. Pepper Older Americans Independence Center (P30AG021342 and P30AG021342-18S1). Dr. Cohen and Dr. Ferrante were supported by Paul B. Beeson Emerging Leaders in Aging awards (K76AG059987 and K76AG057023, respectively) from the National Institute on Aging. Dr. Murphy was supported by the National Center for Advancing Translational Sciences at the National Institutes of Health (UL1TR002014). The funders of this work were not involved in the preparation of the paper. The authors declare no conflicts of interest. This publication is linked to a related article by Sathian et al. 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