Critical Illness Polyneuropathy and Functional Outcome in Subjects with Covid-19: Report on Four Patients and a Scoping Review of the Literature.
Domenico Intiso, Antonello Marco Centra, Antonio Giordano and 3 others
PMID 34935988WHAT IT FOUND
Most critically ill COVID-19 patients with ICU-acquired weakness did not fully recover.
In the reviewed literature, only 3 of 35 survivors regained full function. The 4 patients in this report had variable outcomes, with only one fully recovering at discharge.
Key findings
01In the reviewed literature, full recovery was rare among COVID-19 survivors with ICU-acquired weakness, with only 3 of 35 patients achieving it.
02The 4 patients in this case series showed variable functional outcomes, with only one reaching full recovery at discharge and three retaining some disability.
03Patients with critical illness polyneuropathy (CIP) had a poorer prognosis than those with myopathy (CIM), as the only full recoveries in the literature were in the CIM group.
STILL TO COME
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What it does not show
The case series includes only 4 patients from a single centre, so results are not generalizable. The reviewed literature was highly heterogeneous, with most studies being case reports or small case series rather than controlled trials. Functional outcomes were not consistently measured across the reviewed studies, making comparisons difficult. The contribution of rehabilitation to recovery cannot be separated from natural history, as there was no control group.
Declared interests
No conflicts of interest or funding sources were explicitly declared in the provided text.
The easy way to misread this
Do not assume that intensive rehabilitation guarantees full recovery. In this study, only 1 of 4 patients recovered fully by discharge, and in the wider literature, only 8.5% of survivors achieved full recovery. Prognosis varies by subtype, with polyneuropathy (CIP) associated with poorer outcomes than myopathy (CIM).