Functional Outcomes and Their Association With Physical Performance in Mechanically Ventilated Coronavirus Disease 2019 Survivors at 3 Months Following Hospital Discharge: A Cohort Study.
Aged
COVID-19
/ complications
Cohort Studies
Female
Follow-Up Studies
Humans
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Outcome Assessment, Health Care
/ methods
Physical Functional Performance
Prospective Studies
Recovery of Function
/ physiology
Respiration, Artificial
/ adverse effects
Survivors
/ psychology
Time Factors
Journal
Critical care medicine
ISSN: 1530-0293
Titre abrégé: Crit Care Med
Pays: United States
ID NLM: 0355501
Informations de publication
Date de publication:
01 10 2021
01 10 2021
Historique:
pubmed:
11
5
2021
medline:
29
9
2021
entrez:
10
5
2021
Statut:
ppublish
Résumé
We performed a comprehensive health assessment in mechanically ventilated coronavirus disease 2019 survivors to assess the impact of respiratory and skeletal muscle injury sustained during ICU stay on physical performance at 3 months following hospital discharge. Preregistered prospective observational cohort study. University hospital ICU. All mechanically ventilated coronavirus disease 2019 patients admitted to our ICU during the first European pandemic wave. At 3 months after hospital discharge, 46 survivors underwent a comprehensive physical assessment (6-min walking distance, Medical Research Council sum score and handgrip strength), a full pulmonary function test, and a chest CT scan which was used to analyze skeletal muscle architecture. In addition, patient-reported outcomes measures were collected. Physical performance assessed by 6-minute walking distance was below 80% of predicted in 48% of patients. Patients with impaired physical performance had more muscle weakness (Medical Research Council sum score 53 [51-56] vs 59 [56-60]; p < 0.001), lower lung diffusing capacity (54% [44-66%] vs 68% of predicted [61-72% of predicted]; p = 0.002), and higher intermuscular adipose tissue area (p = 0.037). Reduced lung diffusing capacity and increased intermuscular adipose tissue were independently associated with physical performance. Physical disability is common at 3 months in severe coronavirus disease 2019 survivors. Lung diffusing capacity and intermuscular adipose tissue assessed on CT were independently associated with walking distance, suggesting a key role for pulmonary function and muscle quality in functional disability.
Identifiants
pubmed: 33967204
doi: 10.1097/CCM.0000000000005089
pii: 00003246-202110000-00012
pmc: PMC8439632
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1726-1738Informations de copyright
Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Déclaration de conflit d'intérêts
Dr. Posthuma received funding from Medtalk Health. The remaining authors have disclosed that they do not have any potential conflicts of interest.
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