Functional status of mechanically ventilated COVID-19 survivors at ICU and hospital discharge

Benjamin Musheyev, Lara Borg, Rebeca Janowicz, Michael Matarlo, Hayle Boyle, Gurinder Singh, Victoria Ende, Ioannis Babatsikos, Wei Hou, Tim Q. Duong

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A significant number of COVID-19 patients have been treated using invasive mechanical ventilation (IMV). The ability to evaluate functional status of COVID-19 survivors early on at ICU and hospital discharge may enable identification of patients who may need medical and rehabilitation interventions. Methods: The modified “Mental Status”, ICU Mobility, and Barthel Index scores at ICU and hospital discharge were tabulated for 118 COVID-19 survivors treated with invasive mechanical ventilation (IMV). These functional scores were compared with pre-admission functional status, discharge durable medical equipment, discharge medical follow-up recommendation, duration on IMV, duration post-IMV, demographics, comorbidities, laboratory tests, and vital signs at ICU and hospital discharge. Results: The majority of COVID-19 IMV patients were not functionally independent at hospital discharge (22% discharged with cane or rolling walker, 49% discharged with durable medical equipment, and 14% admitted to a rehabilitation facility), although 94% of these patients were functionally independent prior to COVID-19 illness. Half of the patients were discharged with supplemental oxygen equipment. The most prevalent medical follow-up recommendations were cardiology, vascular medicine, pulmonology, endocrinology, and neurology with many patients receiving multiple medical follow-up recommendations. Functional status improved from ICU discharge to hospital discharge (p < 0.001). Worse functional status at hospital discharge was associated with longer IMV duration, older age, male sex, higher number of comorbidities, and the presence of pre-existing comorbidities including hypertension, diabetes, chronic obstructive pulmonary disease, and immunosuppression (p < 0.05, ANOVA). Conclusions: The majority of IMV COVID-19 survivors were not functionally independent at discharge and required significant follow-up medical care. The COVID-19 circumstance has placed constraints on access to in-hospital rehabilitation. These findings underscore the need for prospective studies to ascertain the short- and long-term sequela in COVID-19 survivors.

Original languageEnglish (US)
Article number31
JournalJournal of Intensive Care
Volume9
Issue number1
DOIs
StatePublished - Dec 2021

Keywords

  • Coronavirus disease 2019
  • COVID-19 sequela
  • Functional outcome
  • Invasive mechanical ventilation
  • Late effects of COVID-19 infection

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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