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. 2024 Dec 19:19:29768675241305102.
doi: 10.1177/29768675241305102. eCollection 2024 Jan-Dec.

Predictors of Functional Impairment in Severe COVID-19 Patients Two Months After Discharge

Antoine El Kik, Hind Eid, Nabil Nassim, Karim Hoyek, Albert Riachy, Bassem Habr  1 , Ghassan Sleilaty  2 , Moussa Riachy  1
Affiliations

Predictors of Functional Impairment in Severe COVID-19 Patients Two Months After Discharge

Antoine El Kik et al. Ther Adv Pulm Crit Care Med. .

Abstract

Background: The Post-COVID-19 Functional Status (PCFS) scale is a validated tool used to measure the functional status of patients discharged from the hospital.

Objectives: To describe the functional limitations of hospitalized COVID-19 patients at the time of discharge and two months afterward, and to identify risk factors associated with functional impairment.

Design: Retrospective study.

Methods: A total of 540 patients were included in this monocentric study. The functional status assessment using the PCFS scale and ventilatory needs were recorded at discharge and two months later. Univariate and multivariate analyses were performed in order to identify the risk factors of a high PCFS score.

Results: Two months after discharge, the PCFS grade was 0 in 60,6% of the survivors, 1 in 24.5%, 2 in 6.9%, 3 in 2.8%, and 4 in 5.3%. The identified risk factors of a high PCFS scale were: age, arterial hypertension, diabetes mellitus, immunosuppression, cardiovascular disease, high need for oxygen and high News2 score at admission, a high percentage of ground glass at chest CT scan performed at admission or during follow-up, elevated leukocytes, neutrophils, LDH, D-dimers, procalcitonin, and serum creatinine levels. During the hospital stay, treatment with steroids, tocilizumab, longer duration of hospitalization, ICU admission and prolonged stay, and the occurrence of thromboembolic or hemorrhagic events were also significantly associated with a higher PCFS. Multivariate analysis identified that only age and a high News2 score at admission were independent risk factors of a low PCFS score.

Conclusion: Multiple risk factors for a higher PCFS score were identified, but only age and a high News2 score at admission were found to be independent risk factors.

Keywords: PCFS scale; Post-COVID-19; functional limitations.

Plain language summary

Study aiming to identify the risk factors for functional impairment in patients recovering from Severe COVID-19 infection.

Why was the study done?: COVID-19 survivors can experience persistent symptoms during the recovery phase, affecting their physical, cognitive, or mental health and limiting their ability to engage in regular physical activities. The study aims to identify the factors that best predict the functional impairment in these patients.

What did the researchers do?: The study included 540 patients. Their functional status was assessed at discharge and again two months later using a specific scale. Statistical analyses were conducted to identify the risk factors for functional impairment.

What did the researchers find?: Two months after hospitalization for COVID-19, 4 out of 10 patients still exhibited mild to severe functional impairment. The study identified several risk factors, with age and the severity of COVID-19 infection emerging as the most significant predictors of functional impairment after severe COVID-19.

What do the findings mean?: Clinicians and physicians taking care of COVID-19 hospitalized patients can use the identified risk factors to predict early on which patients may require rehabilitation or home help following their recovery.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Selection of study population.
Figure 2.
Figure 2.
PCFS score at discharge (M0) and 2 months later (M2).
See this image and copyright information in PMC

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