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Functional Outcomes and Their Association With Physical Performance in Mechanically Ventilated Coronavirus Disease 2019 Survivors at 3 Months Following Hospital Discharge: A Cohort Study.
van Gassel, Rob J J; Bels, Julia; Remij, Loes; van Bussel, Bas C T; Posthuma, Rein; Gietema, Hester A; Verbunt, Jeanine; van der Horst, Iwan C C; Olde Damink, Steven W M; van Santen, Susanne; van de Poll, Marcel C G.
  • van Gassel RJJ; Department of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Bels J; Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Remij L; NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
  • van Bussel BCT; CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
  • Posthuma R; Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Gietema HA; CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands.
  • Verbunt J; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • van der Horst ICC; GROW School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
  • Olde Damink SWM; Department of rehabilitation, Maastricht University, Maastricht, The Netherlands.
  • van Santen S; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.
  • van de Poll MCG; Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany.
Crit Care Med ; 49(10): 1726-1738, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1221494
ABSTRACT

OBJECTIVES:

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.

DESIGN:

Preregistered prospective observational cohort study.

SETTING:

University hospital ICU. PATIENTS All mechanically ventilated coronavirus disease 2019 patients admitted to our ICU during the first European pandemic wave. MEASUREMENTS AND MAIN

RESULTS:

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.

CONCLUSIONS:

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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Survivors / Recovery of Function / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Crit Care Med Year: 2021 Document Type: Article Affiliation country: CCM.0000000000005089

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Survivors / Recovery of Function / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Crit Care Med Year: 2021 Document Type: Article Affiliation country: CCM.0000000000005089