Little is known about the physical function outcomes in patients with severe COVID-19 patients who are admitted to Intensive Care Unit (ICU) for invasive mechanical ventilation. The purpose of this study is to evaluate the short-term impact on physical function before hospital discharge in subjects with severe COVID-19 who have survived ICU admission for invasive mechanical ventilation.
DESIGN: An observation cohort study conducted in a tertiary hospital. METHODS: Data will be collected from patients along the ICU-hospital discharge continuum, will be analysed and non-parametric tests will be used to explore association between variables. Outcome measures: Muscle strength, as a component of physical function, will be evaluated with the Medical Research Council sum score (MRC- SS) at discharge from ICU and at hospital discharge; the Functional Status Score for the ICU (FSS-ICU) will also be assessed at hospital discharge. Data on participants' demographics, ICU admission and hospital admission will also be collected. SIGNIFICANCE OF THE RESEARCH: Understanding how physical function is affected in patients with severe COVID-19 may help develop future prevention, therapeutic and follow-up strategies that improve quality of care and outcomes in this specific group of patients. Findings from this study may be useful to design future larger cohort studies and experimental trials.
Study Type
OBSERVATIONAL
Enrollment
71
Clinical Testing: muscle strength. Muscle strength, as a component of physical function, will be assessed with the Medical Research Council sum score (MRC- SS) at discharge from the ICU and at discharge from the hospital. Clinical testing: physical function. The Functional Status Score for the ICU (FSS-ICU) will be used to evaluate 5 functional tasks at discharge from hospital.
Medical ICU. Hospital Universitario Ramón y Cajal
Madrid, Spain
Surgical ICU. Hospital Universitario Ramón y Cajal
Madrid, Spain
Medical Research Council sum score (MRC- SS).
Physical examination will be performed to carry out manual muscle testing of strength in 6 different muscle groups of the upper limb and lower limb on both sides of the body.
Time frame: < 48 hours before ICU discharge
Medical Research Council sum score (MRC- SS).
Physical examination will be performed to carry out manual muscle testing of strength in 6 different muscle groups of the upper limb and lower limb on both sides of the body.
Time frame: < 24 hours before hospital discharge
The Functional Status Score for the ICU (FSS-ICU)
The Functional Status Score for the ICU (FSS-ICU) will be used to evaluate 5 functional tasks. Each task is evaluated using an 8-point ordinal scale ranging from 0 (not able to perform) to 7 (complete independence).The total FSS-ICU score ranges from 0 to 35, with higher scores indicating better physical functioning.
Time frame: < 24 hours before hospital discharge
Age
Age in years
Time frame: Through study completion, up to 6 months
Sex
Male vs Female
Time frame: Throughout study completion , up to 6 month
Body Mass Index
kg/m2
Time frame: Throughout study completion, up to 6 months
Baseline mobility
Baseline mobility
Time frame: First day the patient can cooperate with assessment according to the ' 5 Standard Questions' test.
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APACHE II score
Acute Physiology and Chronic Health Evaluation II score.The APACHE II score ranges from 0 to 71 points. Higher scores correspond to more severe disease and a higher risk of death.
Time frame: <24 hours after ICU admission
Length of stay in ICU
Number of days of stay in ICU
Time frame: Throughout the study completion, up to 6 months
Number of days on mechanical ventilation
Number of days on mechanical ventilation
Time frame: Throughout the study completion, up to 6 months
Polyneuropathy diagnosis
Clinical or EMG polyneuropathy diagnosis confirmation
Time frame: Throughout the study completion, up to 6 months
Number of days on Neuromuscular Blockers
Number of days on NMB during mechanical ventilation
Time frame: Throughout the study completion, up to 6 months
Episodes of prone positioning
Number of prone positioning episodes during ICU stay
Time frame: Throughout the study completion, up to 6 months
Length of stay in hospital
Total number of days admitted to hospital
Time frame: Throughout the study completion, up to 6 months
Continuation of care
Home with no follow-up physiotherapy, home with domiciliary or out-patient physiotherapy, rehabilitation facility, care home, transfer to another acute hospital.
Time frame: Throughout the study completion, up to 6 months