Repercussões respiratórias, motoras e funcionais em pacientes que necessitaram de internação em unidade de terapia intensiva por covid-19

Abstract

Introduction: COVID-19 is a multisystem disease that affects the musculoskeletal system, with losses in muscle strength and functionality. Objective: To evaluate respiratory and peripheral muscle strength and functionality after hospital discharge in patients who required admission to an intensive care unit (ICU) for COVID-19. Methods: Cross-sectional study with 52 adults who were admitted to the COVID ICU of a university hospital in 2020. Sociodemographic and clinical data were obtained from electronic medical records. Respiratory muscle strength, peripheral muscle strength and functionality were evaluated 180 to 365 days after hospital discharge, using manovacuometry, dynamometry and Barthel and Katz indices and Karnofsky scale. Quantitative variables were expressed as mean and standard deviation and qualitative variables were presented as absolute and relative frequencies. Statistical analyzes were performed using linear regressions, Pearson's correlation matrix and mixed model, using the R 4.1.0 software with the aid of the lme4 and lmerTest packages. Results: Measures 70% lower than expected were identified for maximal inspiratory pressure in 6 patients (28.6%) and for maximal expiratory pressure in 7 (33.3%). The hand grip strength of the dominant hand was lower than predicted in 10 patients (47.6%). Five (23.81%) patients were unable to work, 3 (14.3%) reported difficulty walking outside the home and 2 (9.5%) reported inability to perform household chores. The increase in IMV time was related to the reduction in muscle strength. Conclusion: There were long-term respiratory, motor and functional impacts in patients who were admitted to the ICU for COVID-19 in terms of respiratory and peripheral muscle strength and functionality, especially in those who used IMV for a longer time. The results of this study are applicable in planning rehabilitation programs for this population.