FUNCTIONAL INDEPENDENCE, EXERCISE CAPACITY AND EXERTIONAL DESATURATION AFTER NON-CRITICAL COVID-19 IN NON VACCINED PATIENTS: SHORT AND MEDIUM-TERM IMPACTS

Abstract

Background

Studies point to the persistence of symptoms in patients with non-critical COVID-19 after hospitalization, pointing to impairments in functionality, exercise capacity and effort desaturation, which characterize the need for continuity of management and treatment after acute illness.

Objectives

To evaluate functional independence, exercise capacity, and effort desaturation after non-critical COVID-19 after hospital discharge.

Methods

A cross-sectional study included adult individuals with a noncritical COVID-19 diagnosis who were hospitalized for at least 24 hours between 30 and 180 days after hospital discharge. Participants were classified into 3 groups: G1M - one month after hospital discharge, G3M - three months after hospital discharge, and G6M - six months after charge. A digital form with clinical and sociodemographic questionnaire, modified MRC scale, Barthel Index, and London Chest Activity of Daily Living Scale was applied, in addition to the 6-minute Walk Test in G3M and G6M. The significance value was p<0.05.

Results

We included 64 individuals (G1M=18, G3M=25, G6M=21). There was a significant difference in Barthel Index between G1M and G6M (p=0.007). G3M walked 420m vs 442m of G6M (p=0.25). 48% of participants in G3M and 52% in G6M walked a distance less than 80% of predicted; 28% of G3M participants had >=4% drop in SpO2, vs 19.05% in G6M (p=0.478). There was a high prevalence of persistent symptoms, with a significant association between dyspnea (p=0.001), cough (p=0.038) and angina (p=0.001) and decreased functional independence.

Conclusion

After non-critical COVID-19, decreased functional independence was observed, with significant improvement 6 months after hospital discharge, in addition to decreased exercise capacity, the occurrence of desaturation on exertion, and high prevalence of persistent symptoms with no improvement 6 months after hospitalization.

Implications

Patients with persistent symptoms after COVID-19 should be evaluated and treated in pulmonary rehabilitation clinics. The changes caused by non-critical COVID-19 remain in the short and medium term, as in critical COVID-19.