Predictors of Low Physical Function in Patients With COVID-19 With Acute Respiratory Failure Admitted to a Subacute Unit

Highlights

• To document the level of physical function in elderly patients with COVID-19 recovering from acute respiratory failure (ARF) and investigate which patient clinical characteristics could predict physical function.

• At admission, these patients underwent the Short Physical Performance Battery (SPPB) test, represented by the sum of 3 functional tests, standing balance, 4-meter gait speed (4-MGS), and 5-repetition sit-to-stand (5-STS) motion, and normal physical function was detected in only 12% of them.

• Different degree of impairment (low, intermediate, and severe) was found in 65%, 13%, and 10% of these patients, respectively.

• The majority of survivors after COVID-19 experienced ARF owing to pneumonia and exhibited substantial physical dysfunction influenced by age, mechanical ventilation need, and previous disability. Rehabilitation based on the SPPB test may promote recovery and community reintegration.

Abstract

Objective

To document the level of physical function in patients with coronavirus disease 2019 (COVID-19) recovering from acute respiratory failure and investigate which patient clinical characteristics could predict physical function assessed by the Short Physical Performance Battery (SPPB) test.

Design

Cross-sectional study.

Setting

Subacute unit of a Rehabilitation Institute.

Participants

Patients with COVID-19 (N=184; aged 18 years or older) who were admitted to a subacute unit to stabilize their condition and recover from acute respiratory failure due to COVID-19.

Interventions

Not applicable.

Main Outcome Measures

At admission patients underwent the SPPB test, represented by the sum of 3 functional tests, standing balance, 4-meter gait speed, and 5-repetition sit-to-stand motion. Comparisons between 2 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 men and with more than 2 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 noninvasive 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 acute respiratory failure 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.