Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, UMC Utrecht Brain Center, Utrecht, the Netherlands.
Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Phys Ther. 2023 Jul 1;103(7). doi: 10.1093/ptj/pzad039.
Many patients with coronavirus disease 2019 (COVID-19) infections were admitted to an intensive care unit (ICU). Physical impairments are common after ICU stays and are associated with clinical and patient characteristics. To date, it is unknown if physical functioning and health status are comparable between patients in the ICU with COVID-19 and patients in the ICU without COVID-19 3 months after ICU discharge. The primary objective of this study was to compare handgrip strength, physical functioning, and health status between patients in the ICU with COVID-19 and patients in the ICU without COVID-19 3 months after ICU discharge. The second objective was to identify factors associated with physical functioning and health status in patients in the ICU with COVID-19.
In this observational, retrospective chart review study, handgrip strength (handheld dynamometer), physical functioning (Patient-Reported Outcomes Measurement Information System Physical Function), and health status (EuroQol 5 Dimension 5 Level) were compared between patients in the ICU with COVID-19 and patients in the ICU without COVID-19 using linear regression. Multilinear regression analyses were used to investigate whether age, sex, body mass index, comorbidities in medical history (Charlson Comorbidity Index), and premorbid function illness (Identification of Seniors At Risk-Hospitalized Patients) were associated with these parameters in patients in the ICU with COVID-19.
In total, 183 patients (N = 92 with COVID-19) were included. No significant between-group differences were found in handgrip strength, physical functioning, and health status 3 months after ICU discharge. The multilinear regression analyses showed a significant association between sex and physical functioning in the COVID-19 group, with better physical functioning in men compared with women.
Current findings suggest that handgrip strength, physical functioning, and health status are comparable for patients who were in the ICU with COVID-19 and patients who were in the ICU without COVID-19 3 months after ICU discharge.
Aftercare in primary or secondary care in the physical domain of postintensive care syndrome after ICU discharge in patients with COVID-19 and in patients without COVID-19 who had an ICU length of stay >48 hours is recommended.
Patients who were in the ICU with and without COVID-19 had a lower physical status and health status than healthy people, thus requiring personalized physical rehabilitation. Outpatient aftercare is recommended for patients with an ICU length of stay >48 hours, and functional assessment is recommended 3 months after hospital discharge.
许多患有 2019 年冠状病毒病（COVID-19）感染的患者被收入重症监护病房（ICU）。ICU 住院后，身体功能障碍很常见，且与临床和患者特征有关。迄今为止，尚不清楚 COVID-19 患者和无 COVID-19 患者在 ICU 出院后 3 个月时，其体力活动能力和健康状况是否可比。本研究的主要目的是比较 ICU 中患有 COVID-19 的患者和 ICU 中无 COVID-19 的患者在 ICU 出院后 3 个月时的握力、身体功能和健康状况。次要目的是确定与 COVID-19 患者 ICU 中体力活动能力和健康状况相关的因素。
在这项观察性、回顾性图表审查研究中，使用线性回归比较了 ICU 中患有 COVID-19 的患者和 ICU 中无 COVID-19 的患者的握力（手持式测力计）、身体功能（患者报告的结果测量信息系统身体功能）和健康状况（EuroQol 5 维度 5 级）。多线性回归分析用于调查 COVID-19 患者中年龄、性别、体重指数、既往病史中的合并症（Charlson 合并症指数）和发病前功能障碍（识别高危住院患者）是否与这些参数相关。
共纳入 183 例患者（N=92 例 COVID-19 患者）。ICU 出院后 3 个月时，两组患者在握力、身体功能和健康状况方面无显著差异。多线性回归分析显示 COVID-19 组中性别与身体功能之间存在显著关联，男性的身体功能优于女性。
目前的研究结果表明，ICU 中患有 COVID-19 的患者和 ICU 中无 COVID-19 的患者在 ICU 出院后 3 个月时，握力、身体功能和健康状况相当。
建议在 COVID-19 患者和 ICU 入住时间>48 小时的无 COVID-19 患者出院后的 ICU 后综合征的身体领域中，在初级或二级护理中进行后续护理。
与健康人相比，患有 COVID-19 和 ICU 入住时间>48 小时的无 COVID-19 的 ICU 患者的身体和健康状况较差，因此需要进行个性化的身体康复。建议对 ICU 入住时间>48 小时的患者进行门诊随访，并在出院后 3 个月进行功能评估。
