PTOTCohortPhysical therapy2023

Patients With and Without COVID-19 in the Intensive Care Unit: Physical Status Outcome Comparisons 3 Months After Discharge.

Bastiaan Cijs, Karin Valkenet, Germijn Heijnen and 2 others

PMID 37079487

WHAT IT FOUND

Three months after leaving the intensive care unit, patients with and without COVID-19 had similar handgrip strength, physical functioning, and health status.

Both groups scored below healthy people. Men with COVID-19 reported better physical function than women.

Key findings

01No significant differences were found between the COVID-19 and non-COVID-19 groups for handgrip strength, physical functioning, or health status.

02Both groups had lower physical functioning and health status than healthy reference values three months after discharge.

03In the COVID-19 group, men showed significantly higher physical functioning than women, and more comorbidities were associated with lower physical functioning.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study had a small sample size for an observational design, and post hoc subgroup analyses by pandemic wave did not reach the minimum sample size required for reliable conclusions. Outcomes were measured only once, approximately three months after discharge, preventing analysis of the recovery trajectory or potential earlier differences between the groups. There was significant missing data for primary outcomes (37.7% for handgrip strength, 26.5% for physical functioning, 32.2% for health status), which was handled via multiple imputation. The study was conducted at a single academic hospital that treats high-complexity patients, limiting generalizability to community hospitals. Selection bias may exist because not all eligible ICU patients attended the aftercare clinic, and the non-COVID-19 group may differ from pre-pandemic cohorts due to postponed surgeries.

Declared interests

The text does not report specific funding sources or author conflicts of interest.

The easy way to misread this

Do not conclude that COVID-19 ICU survivors have identical physical impairments to non-COVID-19 survivors based on the null primary outcome alone. The study found no significant difference in the means, but the confidence intervals for handgrip strength were wide, and a post hoc analysis showed first-wave patients had significantly lower strength than controls. The lack of statistical significance does not prove equivalence, especially given the small sample size and missing data.

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