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Physical recovery of COVID‐19 pneumosepsis intensive care survivors compared with non‐COVID pneumosepsis intensive care survivors during post–intensive care hospitalization: The RECOVID retrospective cohort study
Author(s) -
Moonen Hanneke Pierre Franciscus Xaverius,
Strookappe Bert,
Zanten Arthur Raymond Hubert
Publication year - 2022
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.2242
Subject(s) - medicine , intensive care unit , intensive care , emergency medicine , covid-19 , severity of illness , mechanical ventilation , retrospective cohort study , incidence (geometry) , physical therapy , body mass index , cohort study , rehabilitation , intensive care medicine , disease , physics , infectious disease (medical specialty) , optics
Background Coronavirusdisease 2019 (COVID‐19) pneumosepsis survivors are at a high risk of developing intensive care unit (ICU)–acquired weakness (ICUAW) because of high incidence of acute respiratory distress syndrome and the common need for prolonged invasive ventilation. It remains unknown whether regular postpneumosepsis physical rehabilitation strategies are suitable for this extraordinary patient category. Methods We retrospectively compared the physical recovery of COVID‐19 and non‐COVID pneumosepsis ICU survivors during post‐ICU hospitalization, defined as the difference in performance on the Medical Research Council Sum‐Score (MRC‐SS), Chelsea Critical Care Physical Assessment tool (CPAx), and percentage of predicted handgrip strength (POP‐HGS). An analysis of covariance model was built using age, sex, Barthel index, body mass index, admission Acute Physiology And Chronic Health Evaluation II score, adequacy of protein delivery during ICU stay, and ward length of stay as covariates. Results Thirty‐five COVID‐19 ICU patients could be compared with 21 non‐COVID pneumosepsis ICU survivors. All patients scored ≤48 on the MRC‐SS at ICU discharge, indicating ICUAW. When controlling for covariates, COVID‐19 patients performed worse on all physical assessments upon ICU discharge, but had improved more at hospital discharge on the MRC‐SS (ɳ 2 = 0.214, P =.002) and CPAx (ɳ 2 = 0.153, P =.011). POP‐HGS remained lower in COVID‐19 patients throughout hospital stay. Conclusion COVID‐19 ICU survivors are vulnerable to ICUAW, but they show better tendency towards physical rehabilitation than non‐COVID pneumosepsis ICU survivors during the post‐ICU hospitalization period regarding MRC‐SS and CPAx. COVID‐19 ICU patients might benefit from early, more intensive physical therapy.