Avaliação do desempenho funcional, fadiga e disfunção do músculo quadríceps em pacientes hospitalizados pela Covid- 19 no momento da alta hospitalar

Abstract

Rationale and Objective: This study objective to verify whether there is an association between functional performance, quadriceps muscle strength and endurance, and fatigue with the length of hospitalization, duration of IMV and use of neuromuscular blockers in COVID-19 survivors at hospital discharge. Methods and Measurements: This is a cross-sectional study including 34 COVID-19 survivors at hospital discharge (58±14 years and 56% men). On the day of hospital discharge, patients were assessed for: (1) functional performance, using the Short Physical Performance Battery (SPPB); (2) fatigue reported using the Checklist Individual Strength (CIS) scale; (3) isometric quadriceps strength and endurance using a manual dynamometry. Main Results: SPPB was equivalent to 54±29% for age, however for patients who used IMV, this performance was worse. Regarding isometric quadriceps muscle strength, the results found were equivalent to 65±25% predicted with isometric quadriceps endurance of 54(14-180) seconds. The patients scored 38±10 points, characterized as severe fatigue. Correlations were verified between SPPB and IMV (r=-0.67;p<0.001), using neuromuscular blockers (r = -0.67; p< 0.001), with length of hospital hospitalization (r = -0.48; p=0.004), strength (r = 0.41; p=0.015) and endurance isometric quadriceps (r=0.51; p=0.002). In the multivariate regression model, the longer the duration of IMV, the lower the functional performance (adjusted R2=0.34; p= 0.01). Conclusion: Therefore, patients who survived COVID-19, especially those who required invasive ventilatory support, showed greater impairment in functional performance, reported severe fatigue, and reduced isometric muscle strength at the time of hospital discharge.