Physical recovery of COVID-19 pneumosepsis intensive care survivors compared with non-COVID pneumosepsis intensive care survivors during post-intensive care hospitalization: The RECOVID retrospective cohort study.
Covid19
ICU-acquired weakness
pneumonia
recovery
sepsis
Journal
JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
pubmed:
4
8
2021
medline:
28
5
2022
entrez:
3
8
2021
Statut:
ppublish
Résumé
Coronavirusdisease 2019 (COVID-19) pneumosepsis survivors are at a high risk of developing intensive care unit (ICU)-acquired weakness (ICUAW) because of high incidence of acute respiratory distress syndrome and the common need for prolonged invasive ventilation. It remains unknown whether regular postpneumosepsis physical rehabilitation strategies are suitable for this extraordinary patient category. We retrospectively compared the physical recovery of COVID-19 and non-COVID pneumosepsis ICU survivors during post-ICU hospitalization, defined as the difference in performance on the Medical Research Council Sum-Score (MRC-SS), Chelsea Critical Care Physical Assessment tool (CPAx), and percentage of predicted handgrip strength (POP-HGS). An analysis of covariance model was built using age, sex, Barthel index, body mass index, admission Acute Physiology And Chronic Health Evaluation II score, adequacy of protein delivery during ICU stay, and ward length of stay as covariates. Thirty-five COVID-19 ICU patients could be compared with 21 non-COVID pneumosepsis ICU survivors. All patients scored ≤48 on the MRC-SS at ICU discharge, indicating ICUAW. When controlling for covariates, COVID-19 patients performed worse on all physical assessments upon ICU discharge, but had improved more at hospital discharge on the MRC-SS (ɳ COVID-19 ICU survivors are vulnerable to ICUAW, but they show better tendency towards physical rehabilitation than non-COVID pneumosepsis ICU survivors during the post-ICU hospitalization period regarding MRC-SS and CPAx. COVID-19 ICU patients might benefit from early, more intensive physical therapy.
Sections du résumé
BACKGROUND
Coronavirusdisease 2019 (COVID-19) pneumosepsis survivors are at a high risk of developing intensive care unit (ICU)-acquired weakness (ICUAW) because of high incidence of acute respiratory distress syndrome and the common need for prolonged invasive ventilation. It remains unknown whether regular postpneumosepsis physical rehabilitation strategies are suitable for this extraordinary patient category.
METHODS
We retrospectively compared the physical recovery of COVID-19 and non-COVID pneumosepsis ICU survivors during post-ICU hospitalization, defined as the difference in performance on the Medical Research Council Sum-Score (MRC-SS), Chelsea Critical Care Physical Assessment tool (CPAx), and percentage of predicted handgrip strength (POP-HGS). An analysis of covariance model was built using age, sex, Barthel index, body mass index, admission Acute Physiology And Chronic Health Evaluation II score, adequacy of protein delivery during ICU stay, and ward length of stay as covariates.
RESULTS
Thirty-five COVID-19 ICU patients could be compared with 21 non-COVID pneumosepsis ICU survivors. All patients scored ≤48 on the MRC-SS at ICU discharge, indicating ICUAW. When controlling for covariates, COVID-19 patients performed worse on all physical assessments upon ICU discharge, but had improved more at hospital discharge on the MRC-SS (ɳ
CONCLUSION
COVID-19 ICU survivors are vulnerable to ICUAW, but they show better tendency towards physical rehabilitation than non-COVID pneumosepsis ICU survivors during the post-ICU hospitalization period regarding MRC-SS and CPAx. COVID-19 ICU patients might benefit from early, more intensive physical therapy.
Identifiants
pubmed: 34343362
doi: 10.1002/jpen.2242
pmc: PMC8420383
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
798-804Informations de copyright
© 2021 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.
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