Function and activity capacity at 1 year after the admission to intensive care unit for COVID-19.
Netha Hussain, Per-Olof Hansson, Carina M Samuelsson and 1 others
PMID 38899867WHAT IT FOUND
At 1 year after ICU admission for COVID-19, 78 participants were assessed: 24.4% had impaired right grip, 29.5% had slow walking, 21.8% had limited mobility, and 5.1% had impaired balance.
Key findings
01At 1-year follow-up, impaired hand grip strength was found in 19 (24.4%) participants for the right hand and 18 (23.1%) for the left hand, impaired walking speed in 23 (29.5%), impaired functional mobility in 17 (21.8%), and impaired postural control in 4 (5.1%).
02Longer stay in the intensive care unit and diabetes mellitus were found to be significant predictors of impaired walking speed, and diabetes mellitus was found to be a significant predictor of impaired functional mobility.
03Of the 78 participants, 43 (55.1%) had no impairments in any of the four clinical assessments, while 15 (19.2%), 8 (10.3%), 11 (14.1%), and 1 (1.3%) had impairments in one, two, three, or all four assessments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no control group, so the study cannot show whether the impairments were caused by COVID-19, ICU admission, other medical events, or a combination. Only 78 of 105 cohort members completed the clinical tests, and the authors state this may leave the study underpowered for weak predictors. Participants had to attend on-site physical assessments, so people who were too unwell or too disabled to attend may be missing. Body mass index was missing for 23 (29%) participants, so it could not be included in the regression analyses. The paper does not report rehabilitation received after ICU admission, so function at 1 year cannot be linked to prior therapy. The Berg Balance Scale and Timed Up & Go are often used to assess older people, but this study included people aged above 18 years. Only 4 (5.1%) had impaired postural control, so that outcome was not used in regression analysis. The study did not have valid data related to neurological diagnoses or symptoms, which limits interpretation of walking speed findings. As an observational study, it cannot establish causal relationships between predictors and outcomes.
Declared interests
The authors declared no potential conflicts of interest. Funding came from The Swedish government and the county councils, the ALF agreement, grant number ALFGBG-881811.
The easy way to misread this
Do not read diabetes or longer ICU stay as proven causes of slow walking or poor mobility. This was an observational study without a control group, so it can only report associations.