ABSTRACT
BACKGROUND AND OBJECTIVES: Hospitalization by Covid-19 can cause persistent functional consequences after hospital discharge due to direct and indirect effects of SARS-COV-2 in several organs and systems of the body added to post-intensive care syndrome and prolonged bed rest. These impacts can lead to dependency in activities of daily living, mainly in older people due to aging process and functional decline. This study aimed to compare the effects of hospitalization by Covid-19 on functional capacity of adults and older people and to identify its associated factors. METHODS: Cross-sectional observational study of 159 survivors of hospitalization by Covid-19 after 1 month from discharge at Hospital das Clínicas of the University of São Paulo, divided into groups: adults (aged < 60 years) and older people (aged ≥ 60 years). Those who did not accept to participate, without availability or without ability to understand the questionnaires were excluded. Functional capacity was assessed by the Barthel Index and patients were classified according to their scores. Data analysis was performed in JASP Statistics program and the sample was compared between the age groups. Wilcoxon test was applied to compare before and after periods, Mann-Whitney test was used for between groups comparison. We adopted alpha = 0.05. RESULTS: The total Barthel Index median score was lower 1 month after hospital discharge than in the pre-Covid-19 period. Older people had worse functional status than adults before and also showed greater impairment after hospital discharge. Both groups showed lower Barthel Index classification than before, and older people presented more functional dependence than adults in both periods. Age, sarcopenia and frailty were associated factors. DISCUSSION: Hospitalization by Covid-19 impacts functional capacity after 1 month from discharge, especially in older people. Age, sarcopenia and frailty are associated factors. These results suggest need for care and rehabilitation of Covid-19 survivors.
ABSTRACT
To evaluate the impact of covid-19 on frailty, sarcopenia and patient functionality after hospital discharge. This is a prospective cohort study. The patients will monitor after hospital discharge by COVID-19 for one year with evaluations at one, four, six and twelve months after hospital discharge. This study was carried out in a reference Hospital for the treatment of COVID19 in São Paulo / Brazil. This study evaluated 68 patients, both genders, 18 years old or more that needed to receive treatment for COVID-19 in the hospital. This is a prospective cohort study with only apply assessment instruments in different periods. Patients were contacted by telephone and answered a questionnaire regarding sociodemographic data and the scale Barthel index, SARC-F and Clinical Frailty Scale (CFS) in relation to their condition before COVID-19, after 1 month and 4 months of hospital discharge. 68 patients, mean age of 60.2 (±11.3) years, 35 (51.4%) males, were evaluated. Before COVID-19, 8 (11.7%) patients used an auxiliary gait device, 4 (5.8%) were wheelchair users, 44 (64.7%) were independent (Barthel index=100) and 24 (35.2%) had impairment in at least one daily living activity (Barthel index <95). Barthel index score (p <.001), Sarc-F (p <.001) and CFS (p <.001) worse after 1 month of the hospital discharge. In addition, after 1 month of the hospital discharge, there was a worsening of Barthel index (p < 0.001), Sarc-F (p < 0.001), and CFS (p < 0.001). Finally, after 4 months of hospital discharge Sarc-F and CFS did not improve compared to the period before covid-19. It is concluded that after hospitalization for COVID-19 there is a decrease in functionality and worsening of the conditions of sarcopenia and frailty. Despite functionality returning to baseline after 4 months, sarcopenia and frailty remained deficient when compared to the pre-hospitalization period. Therefore, a long-term follow-up is necessary for evaluation and rehabilitation after hospitalization by COVID-19 There is no conflict of interest on the part of the authors.