Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents risk to develop muscle weakness associated with prolonged period of mechanical ventilation support and hospital stay.
Intensive care unit (ICU) acquired muscle weakness affects both respiratory and peripheral muscles and can contribute to worsen clinical and functional outcomes. In this way, ultrasonography muscle evaluation could help to identify early alterations guiding the therapeutic planning and allowing to monitor the interventions performed. Therefore, the investigators intend to follow up mechanically ventilated patients with confirmed diagnosis of COVID-19 during ICU stay to quantify the diaphragm, parasternal intercostal, abdominals and femoral quadriceps muscles thickness assessed by ultrasonography. Additionally, functional capacity, frailty and level of physical activity will be evaluated and followed for pre-admission condition and 30, 90 and 180 days after hospital discharge .
Study Type
OBSERVATIONAL
Enrollment
138
Muscle ultrasound evaluation will be performed in patients admitted with COVID-19 requiring invasive mechanical ventilation. The measurements of thickness and thickening fraction will occur for diaphragm, abdominal - rectus abdominis, internal oblique, external oblique and transverse abdomen - and parasternal intercostal muscles. Serial measurements of the thickness and echogenicity of the quadriceps femoris muscle will also be performed.
Hospital Israelita Albert Einstein
São Paulo, Brazil
RECRUITINGMuscle thickness
Change in the thickness of the diaphragm and quadriceps femoris muscles.
Time frame: Day 1, 5, and within 24 hours after ICU discharge.
Respiratory muscle thickness
Change in the thickness of the intercostal and abdominal wall muscles.
Time frame: At the end of data collection, within 24 hours after ICU discharge.
Muscle thickness and functional outcomes
Verify the correlation between quadriceps femoris muscle thickness change and echogenicity with functional outcomes (Barthe Index, International Physical Activities Questionnaire, and the Clinical Frailty Score).
Time frame: At the end of data collection, within 24 hours after ICU discharge.
Grip strength and clinical outcomes
Verify the correlation between grip strength (measured by the Dynamometer Grip Strength) and clinical outcomes (Barthe Index, International Physical Activities Questionnaire, and the Clinical Frailty Score).
Time frame: At the end of data collection, within 24 hours after ICU discharge.
Mobility level correlation with clinical and functional outcomes
Verify the correlation between mobility level (measured by the Perme Intensive Care Unit Mobility Score) with clinical and functional outcomes (Barthe Index, International Physical Activities Questionnaire, and the Clinical Frailty Score).
Time frame: At the end of data collection, within 24 hours after ICU discharge.
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