PHYSICAL, COGNITIVE AND PSYCHOLOGICAL OUTCOMES IN ADULTS AND ELDERLY AFTER HOSPITAL DISCHARGE POST SEVERE COVID-19

C. Machado de Campos1, É.C. Gouveia e Silva1, E. Mendes da Silva1, C. Gil de Godoy1, D. Brancolini de Oliveira1, A.C. Gambeta1, J. Magalhães Silva1, M. Didone Santos1, C.R. Fernandes de Carvalho1, A.C. Basso1, C. Fu1, C. Tanaka1, C. Toufen Junior2, L. Cassimiro da Nóbrega3, L. Oliveira3, G. Correa2, C.R. Ribeiro Carvalho2, J.E. Pompeu1
1School of Medicine, University of São Paulo, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Sao Paulo, Brazil, 2Heart Institute (InCor), University of São Paulo, Pneumology Division, Cardiopulmonary Department, Sao Paulo, Brazil, 3Heart Institute (InCor), University of São Paulo, Cardiopulmonary Department, Sao Paulo, Brazil

Background: COVID-19 is an infectious disease that affects several structures and functions of the body. Severe cases requiring long hospital stays can suffer more intense functional impairment due primary consequences of COVID-19 plus the adverse effects of immobility and mechanical ventilation. However, few studies described the impact of COVID-19 on physical, cognitive and psychological function in patients with severe COVID-19 after hospital discharge.      

Purpose: To assess the prevalence of physical, cognitive and psychological impairment in patients affected by severe COVID-19, after hospital discharge.

Methods: Preliminary results of a cohort study that will follow up 400 adults and older people post severe COVID-19 during a period of one year. Participants were recruited after 30-45 days of hospital discharge from a high complexity hospital in Brazil. We assessed respiratory function (spirometry), functional status (Post-COVID-19 Functional Status Scale and Barthel Index), frailty (Clinical Frailty Scale), sarcopenia (SARC-F), muscle fatigue (Functional Assessment of Chronic Illness Therapy Fatigue Scale), cognition (10-point cognitive screener) and anxiety and depression symptoms (Hospital Anxiety and Depression Scale). The outcomes were presented in percentage. We used the Jasp 0.13.1 software.

Results: Fifty patients were evaluated, 26 adults and 24 elderly. The results showed that 60% of the patients developed restrictive pulmonary disorder, 34% sarcopenia, 94% frailty, and 90% muscle fatigue, 24% cognitive impairment and 44% symptoms of anxiety and depression.

Conclusion(s): Patients affected by severe COVID-19 presented high prevalence of physical, cognitive and psychological impairment after hospital discharge.      

Implications: The partial results demonstrated that patients affected by COVID-19 after discharge from hospital have the need for physical, cognitive and psychological rehabilitation. These results contribute to the development and planning of a multidisciplinary rehabilitation to minimize pulmonary, functional, cognitive and psychological consequences of COVID-19.

Funding, acknowledgements: Special acknowledgment to Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) for financial support (process number 2018/19618-8).

Keywords: COVID-19, functional prognosis, rehabilitation

Topic: COVID-19

Did this work require ethics approval? Yes
Institution: Medical School of the University of São Paulo
Committee: Hospital das Clinicas of São Paulo
Ethics number: Certificate of Presentation for Ethical Appreciation 34115720.5.0000.0068.


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