Post-COVID-19 Intensive Care Unit-Acquired Weakness Compromises Long-Term Functional Status.

Abstract

The objective of this study was to evaluate the impact of intensive care unit (ICU)-acquired weakness (ICUAW) on the functional independence of patients hospitalized for coronavirus disease 2019 (COVID-19) over 6months after ICU discharge. This was a prospective cohort study that included patients who were admitted to the ICU because of COVID-19 and who were monitored for 6months after discharge from the ICU via telephone. Patients were evaluated at 3 times (30days, 3months, and 6months after discharge from the ICU) for functional independence for personal care and mobility activities (Barthel Scale), independence for self-care (Katz Index), impact of COVID-19 on functional status (post-COVID-19 Functional Status Scale [PCFS]), and mobility level (ICU Mobility Scale). The existence of some degree of dependence was considered when the Barthel Scale score was <100 points, the Katz Index was ≥1, and the PCFS score was ≥1. A PCFS score of ≥3 indicated moderate or severe dependence. Patients with a Medical Research Council score of <48 at discharge from the ICU were diagnosed with ICUAW. Sixty-eight patients were included, with a mean age of 51 (SD = 13) years. The ICUAW rate at ICU discharge was 35%. In the evaluation with the PCFS, the values for the presence of any functional limitation at 30days, 3months, and 6months after ICU discharge were 89.7%, 57.4%, and 38.2%, respectively. The rate of persistence of functional limitations after 6months was higher in patients with ICUAW than in those without ICUAW (66.7% vs 22.8%; P = .000); the same was true for moderate or severe limitations (20.8% vs 4.5%; P = .035). Likewise, functional independence for personal care, mobility, and self-care activities was poorer in patients with ICUAW. In patients surviving an ICU stay due to COVID-19, decreased functional independence persists even 6months after discharge, and patients with ICUAW have worse outcomes. Patients who survive ICU stays due to COVID-19 continue to have greater functional dependence even 6months after ICU discharge.