Predictors of low physical function in patients with COVID-19 with acute respiratory failure admitted to a sub-acute unit

Paneroni, Mara, Vogiatzis, Ioannis, Bertacchini, Laura, Simonelli, Carla and Vitacca, Michele (2021) Predictors of low physical function in patients with COVID-19 with acute respiratory failure admitted to a sub-acute unit. Archives of Physical Medicine and Rehabilitation, 102 (6). pp. 1228-1231. ISSN 0003-9993

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Abstract

Objective:
To document the level of physical function in patients with COVID-19 recovering from Acute Respiratory Failure (ARF) and investigate which patient clinical characteristics could predict physical function assessed by the Short Physical Performance Battery (SPPB) test.
Design:
Cross-sectional study.
Setting:
Sub-acute unit of a Rehabilitation Institute.
Participants:
184 patients with COVID-19 (aged 18 years or older) who were admitted to a sub-acute unit to stabilize their condition and recover from acute respiratory failure due to COVID-19.
Interventions:
Not applicable.
Main Outcome Measure:
At admission patients underwent the SPPB test, represented by the sum of three functional tests: standing balance, 4-meter gait speed (4-MGS), and five-repetition sit-to-stand (5-STS) motion. Comparisons between two SPPB score groups were performed by an unpaired t-test; multivariate stepwise linear regression analysis was employed to detect predictors of the SPPB score considering several clinical parameters.
Results:
Participants were 74±12 years old, 52% were male and with more than two comorbidities in 43% of cases. SPPB score was 3.02±3.87 denoting patients’ profound physical dysfunction. Normal physical function was detected in only 12% of patients, whereas low, intermediate and severe impairment was found in 65%, 13% and 10% respectively. Age, both invasive and non-invasive ventilation use, and the presence of previous disability were significant predictors of SPPB. Patients without any comorbidities (8%) also exhibited low function (SPPB: 5.67±1.12).
Conclusions:
The majority of survivors after COVID-19 experienced ARF due to pneumonia and exhibited substantial physical dysfunction influenced by age, mechanical ventilation need and previous disability. Further studies are needed to evaluate the role of rehabilitation to promote recovery and community reintegration in this population.

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