Functional capacity, activities of daily living and quality of life after 6 months of hospital discharge for COVID-19 treatment

Abstract

Introduction: The new coronavirus disease (COVID-19) is described as a severe disease mainly affecting the lower respiratory tract, triggering pneumonia and severe acute respiratory syndrome. COVID-19 can leave persistent functional sequelae in patients with longer hospital stays and use of ventilatory support, such as dyspnea, fatigue, myalgia, and muscle weakness. Objective: To evaluate the functional impacts on activities of daily living (ADL) and health-related quality-of-life (HRQoL) in post-hospitalization patients due to the evolution of COVID-19 six months after hospital discharge. Methods: 130 patients with COVID-19 (mean ± SD age 58.2 ± 11.1 years, 74% men) requiring hospitalization were evaluated by the six-minute walk test (6MWT), ADL-Glittre test (TGlittre), handgrip dynamometry, and Short-form (SF-36) questionnaire six months after hospital discharge. Results: Length of stay was 25.0 ± 1.0 days, and 62.3% of the sample required invasive mechanical ventilation and O2 for 13 ± 10.0 days and 23.2 ± 1.1 days, respectively. Six-month after discharge, greater functional limitation was observed in mechanically ventilated patients (88% [n=71] and 51% [n=25]; p =0.004). Participants also showed reduced 6MWT (median [IQR] 295[12,80] vs 267[7,20]m, p<0.001)m, p = 0.001) and TGlittre time (3,0[0,20] vs 4,9[0,60] min, p<0.001), handgrip strength (median [IQR] 26 [0.90] vs 18 [0.70] kg, p <0.001), lower overall HRQoL (median [IQR] 55 [15] vs 40 [12], p <0.001) and worse HRQoL in the physical function domain (median [IQR] 60 [15] vs. 40[10], p <0.001). Conclusion: Patients with COVID-19 who required hospitalization and invasive mechanical ventilation show low functional capacity and limitation in activities of daily living, which impact health-related quality-of-life six months after hospital discharge.