Correlação entre o perfil demográfico e clínico de indivíduos com Covid-19 e os desfechos funcionais na alta hospitalar: um estudo transversal

Abstract

Correlation between the demographic and clinical profile of individuals with COVID-19 and functional outcomes in hospital discharge. Materials and methods: Cross-sectional study carried out in a public hospital in Ceará from April 2020 to September 2021. The study sample included one hundred and two (102) participants with a confirmed diagnosis of COVID-19 who were hospitalized for covid-19. Demographic, clinical and laboratory variables were collected directly from the patients' electronic medical records, and at the time of hospital discharge a functional independence questionnaire was applied: katz index; and two physical tests: 1-minute sit and stand test (TSL1M) and timed up and go (TUG). Results: About the study participants, 63.7% were male. The mean age was 51±16 years and the Body Mass Index (BMI) was 26.88±4.27kg/m-2. Among the participants, 61.8% had some comorbidity, with the cardiovascular and metabolic dyad being the most prevalent (17.6%). The average length of stay of the individuals was 12±11 days, however, only 19.6% required intensive care. Among those who went to the intensive care unit (ICU), 18.6% used invasive mechanical ventilation (IMV), and of these, 15.7% used a neuromuscular blocker. As for the TSL1M, it was noticed that older age and impairment in pulmonary tomography (CT) ≥ 50% are predictive variables for worse functional performance of the individual when it comes to lower limb strength and resistance (p=0.000; p=0.005, respectively). Regarding the performance in the TUG, it was evidenced that the greater the age, the more days of hospitalization and the greater the number of comorbidities have some impact on worse outcomes related to mobility and balance of the individual, evidenced by a longer time spent to perform of the test (p=0.000; p=0.007; p=0.024, respectively). In relation the degree of functional independence for self-care activities after hospital discharge, it was shown that patients with more advanced age have a 1.08 greater chance of being classified as less functional individuals, OR (95% CI) of 1.08 (1 .03 – 1.13), when compared to younger individuals. As for the degree of pulmonary impairment, it was possible to verify that those individuals who have a degree of pulmonary impairment on CT ≥ 50% are 13.55 times more likely to be less functional, OR (95% CI) of 13.55 (2.03 – 90.24). Conclusion: The age, length of stay, number of comorbidities, degree of inflammation and CT impairment were predictors of worse functional performance of the individual in relation to lower limb strength and resistance, mobility, and balance. And individuals who are older and have a higher degree of pulmonary impairment on CT are more likely to be less functional, that is, less independent in their self-care in hospital discharge than younger individuals with less pulmonary impairment.