Characterization of functionality in individuals with COVID-19

Abstract

Introduction: 2019 was marked by cases of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The disease caused by this infection was named Coronavirus Disease 2019 (COVID-19). In addition to compromising the respiratory system, neurological
and musculoskeletal disorders were also identified. These dysfunctions and the entire environmental and personal context can interfere with patients' functionality. Objective: To characterize the functionality of patients infected with SARS-CoV-2, hospitalized in a semiintensive unit. Methods: A cross-sectional study that recruited 60 individuals hospitalized in a Semi-Intensive Unit, aged between 18-80 years and with confirmed SARS-CoV-2 infection. Initially, sociodemographic and clinical data were collected, and later the following tests were performed: ICU Functional Status Scale (FSS-ICU) and Functional Reach Test (TAF). Gait parameters were evaluated with two triaxial accelerometers positioned on the trunk and the spinous process of L5. Laboratory tests and clinical data were used to assess the degree of inflammation (cHIS) and disease severity (Ordinal Scale of Clinical Improvement). The variables computed to assess the patients' functionality were: FSS-ICU score, time for performing postural transitions, distance from the TAF, step length, and speed. Spearman's correlation test was used to investigate possible relationships between cHIS and Ordinal Scale of Clinical Improvement scores with the evaluated parameters. The TAF distance and gait parameters were normalized by calculating the Z-score. Results: The most frequent respiratory and neurological signs and symptoms identified among patients were: pneumonia (48.3%) and fatigue/discomfort (61.6%). In the present study, 21% of patients had TAF range values below -2 Z-scores. For gait parameters, at least 96% of patients had values below -2 Z-scores. There was no correlation between cHIS and Ordinal
Scale of Clinical Improvement scores with transfer task execution time, gait parameters, FSS-UCI score, and distance from TAF. Conclusion: Patients hospitalized in the semiintensive unit due to COVID-19 infection, classified as having mild disease, may have
impaired functionality, especially in gait. The characterization of functionality can help physical therapists to face COVID-19, optimizing the evolution of patients and, thus, providing greater independence and quality of life.