Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis

Abstract

Objective: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved.

Methods: A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization.

Results: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=-0.28, p=0.04), Short Physical Performance Battery score (r=-0.28, p=0.03), and forced vital capacity (r=-0.29, p=0.03).

Conclusion: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.

Figure 1. Cluster analysis of COVID-19 survivors with the K-Means algorithm.

Figure 2. Box plot of tests by Cluster with indication of means (in red circles) and p-values for the Student’s t-test. SPPB, short physical performance battery; BMI, body mass index; D, dominant; ND, no dominant; TUG, Timed Up and Go; TUG-COG, Timed Up and Go Cognitive; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity.