Immediate Functional Outcomes of Survivors with Critically-ill COVID-19

Tay, Matthew Rong Jie; Ong, Poo Lee; Puah, Ser Hon; Tham, Shuen-Loong

Research Objectives To describe the functional outcomes of patients with critically ill coronavirus disease 2019 (COVID-19) after transfer out of intensive care unit (ICU). Design Retrospective observational cohort study. Setting National designated center for patients with COVID-19. Participants 51 consecutive critically ill COVID-19 patients admitted to the ICU. Interventions Patients were referred for physical therapy after transferring out from ICU if they had functional impairments. Main Outcome Measures Functional outcomes were measured primarily with the Functional Ambulation Category (FAC), and divided into 2 categories: dependent ambulators (FAC 0-3) and independent ambulators (FAC 4-5). Secondary outcomes measured included ADL dependence of patients and the need for supplemental oxygen. Results All patients were premorbidly independent in walking and in basic ADLs, and did not require supplementary oxygen. Upon transfer out of ICU, there were 24 patients (47.1%) who were dependent walkers (defined as FAC of 0-3) with 22 patients (43.1%) who were dependent in 1 or more basic ADLs. However, upon discharge, a majority achieved independence in ambulation and basic ADLs (92.2% and 90.2% respectively). All 41 patients (80.4%) who required continuous supplementary oxygen upon transferring out of ICU did not require supplementary oxygen on discharge. On multivariate analysis, we found that a Charlson Comorbidity Index of 1 or more (odds ratio 14.02, 95% CI 1.15-171.28, P=0.039) and a longer length of ICU stay (odds ratio 1.50, 95% CI 1.04-2.16, P=0.029) were associated with dependent ambulation upon discharge from ICU. Conclusions Critically ill COVID-19 survivors have a high level of impairment following discharge from ICU. Such patients should be screened for impairment and managed appropriately by rehabilitation professionals, so as to achieve good functional outcomes on discharge. Author(s) Disclosures None to disclose.