Repercussões neurológicas, respiratórias e musculoesqueléticas em sobreviventes da COVID-19 tratados em UTIs da cidade de Pelotas/RS

Abstract

This thesis aimed to describe the characteristics of COVID-19 survivors treated in the ICU, regarding their level of physical activity, lifestyle habits, and health status 9 to 12 months after hospital discharge. A previous study was conducted to determine the rate of discontinuation of mechanical ventilation in COVID-19 patients treated in intensive care units of three hospitals. The medical records of 270 COVID-19 patients were reviewed to collect information on intubation and extubation dates, mechanical ventilation parameters used, as well as health data prior to hospitaliazation. The length of stay in the ICU and on MV, ICU mortality, use of positive end-expiratory pressure (PEEP) ≥ 10CmH2O, prone positioning, and hemodialysis were calculated. Data were found for 258 patients, most of whom were male (56.20%), with a mean age of 62.31 ± 14.51 years. Hospitalizations lasted an average of 13.30 ± 10.12 days, and MV was maintained for an average of 11.28 ± 8.91 days. The mortality rate was 84.11%, and 16.28% had successful MV discontinuation. The intention of this thesis project was to reach a population representative of that observed in the first study. Two of the hospitals provided lists with contacts of patients treated in ICUs dedicated to COVID19 and the eligible patients screened for participation in the study. Eligibility criteria were age ≥ 18 years, having had a confirmed diagnosis of COVID-19, having been treated in an ICU for the disease, and having been discharged from the hospital up to 12 months before the start of data collection. After attempts to contact eligible patients, sixteen people agreed to participate in the study, 8 of each sex, with a mean age of 58.38 (± 16.89). During the study period, 15 had very mild to moderate functional limitations, 8 reported symptoms such as pain and fatigue, and four had non-dementia cognitive impairment according to their level of education. Four participants (25%) practiced physical activity for at least 150 minutes per week. The grip strength (HGS) of all women and 50% of the men was lower than expected. In the 1STST, participants fell within percentiles ranging from below 2.5 to 25, and PEF was also lower than predicted for 50% both male and female participants. The conclusion is that after the institution of invasive ventilatory support, a small proportion of patients with COVID-19 survive without pressure support the mortality rate is high and survivors have a low level of PA and may remain with functional and cognitive deficits for prolonged periods.