EVOLUÇÃO CLÍNICA E FUNCIONAL DE INDIVÍDUOS ADULTOS E IDOSOS COM COVID-19 ADMITIDOS EM UNIDADE DE TERAPIA INTENSIVA

Abstract

Introduction: There is evidence that individuals with the disease related to the new coronavirus SARS-CoV-2 (COVID-19) who require admission to the Intensive Care Unit (ICU) have functional decline. However, it remains unclear whether the functional evolution of these subjects is similar to that of people with acute pulmonary infection due to other agents under intensive care. Objective: To assess the clinical and functional profile of individuals with COVID-19-associated pneumonia admitted to the ICU and compare with individuals with non-COVID-19 pneumonia. Method: Retrospective longitudinal observational study, carried out from August 2020 to March 2021. Individuals admitted to the ICU with a history of pneumonia were included, being allocated into two groups: COVID and non-COVID. Variables related to the clinical and sociodemographic profile were evaluated, in addition to functional capacity and muscle strength at the moments of the initial assessment of the ICU, discharge from the ICU and hospital discharge. Results: 150 individuals with COVID-19 and 66 in the non-COVID-19 group were included. The groups were homogeneous in terms of age, presence of comorbidities, disease severity index (APACHE II), rate of mechanical ventilation use, and ICU length of stay. On the other hand, the mortality rate was higher in the COVID group. Furthermore, using a multivariate logistic regression model, it was found that SARS-CoV-2 infection, sex, disease severity index, duration of mechanical ventilation, and length of hospital stay were independent predictors of mortality. Regarding the functional evolution during hospitalization, both groups showed significant improvement, but the COVID group showed better functional capacity at the time of hospital discharge. In our correlation analysis of survivors, in both groups, we found that the time to first sitting showed a positive and strong correlation with the length of stay in the ICU and a moderate positive correlation with the time of IMV. Conclusion: Although individuals with COVID-19 have a higher mortality rate during the period of ICU stay, survivors have better functional capacity at hospital discharge.