Muscle weakness, functional capacities and recovery for COVID-19 ICU survivors

Clément Medrinal,Bouchra Lamia,Francis-Edouard Gravier,Tristan Bonnevie,Pauline Smondack,Denys Mayard,Yann Combret,Guillaume Prieur,Guillaume Fossat,Emmanuelle Desmalles

doi:10.1186/s12871-021-01274-0

Abstract

BackgroundFew studies have evaluated muscle strength in COVID-19 ICU survivors. We aimed to report the incidence of limb and respiratory muscle weakness in COVID-19 ICU survivors.MethodWe performed a cross sectional study in two ICU tertiary Hospital Settings. COVID-19 ICU survivors were screened and respiratory and limb muscle strength were measured at the time of extubation. An ICU mobility scale was performed at ICU discharge and walking capacity was self-evaluated by patients 30 days after weaning from mechanical ventilation.ResultsTwenty-three patients were included. Sixteen (69%) had limb muscle weakness and 6 (26%) had overlap limb and respiratory muscle weakness. Amount of physiotherapy was not associated with muscle strength. 44% of patients with limb weakness were unable to walk 100 m 30 days after weaning.ConclusionThe large majority of COVID-19 ICU survivors developed ICU acquired limb muscle weakness. 44% of patients with limb weakness still had severely limited function one-month post weaning.

Highlights

Few studies have evaluated muscle strength in COVID-19 ICU survivors
During the study period, 89 patients with confirmed COVID-19 were admitted to ICU in both centres, and 65 required invasive mechanical ventilation (MV)
Limb muscle weakness was significantly associated with the number of days spent in a prone position, the use of catecholamines, and the number of days under MV (Table 1), with the use of assist-control ventilation (10.6 ± 6.3 vs. 4.8 ± 3.6 days; p = 0.03)

Summary

Introduction

Few studies have evaluated muscle strength in COVID-19 ICU survivors. We aimed to report the incidence of limb and respiratory muscle weakness in COVID-19 ICU survivors. COVID-19 ICU survivors were screened and respiratory and limb muscle strength were measured at the time of extubation. An ICU mobility scale was performed at ICU discharge and walking capacity was self-evaluated by patients 30 days after weaning from mechanical ventilation. Conclusion: The large majority of COVID-19 ICU survivors developed ICU acquired limb muscle weakness. Evidence from studies carried out worldwide shows that patients who undergo invasive ventilation in ICU have a high risk of developing respiratory and limb muscle weakness (50% prevalence) [2]. The primary aim of this study was to report the prevalence of limb and respiratory muscle weakness in COVID-19 ICU survivors. The secondary aims were to analyse variables associated with muscle weakness

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