Espirometria, funcionalidade, capacidade funcional e qualidade de vida de pacientes com covid-19 acompanhados por um serviço de home care

Abstract

COVID 19 Coronavirus Disease 2019 is an infectious disease caused by the SARS CoV 2 virus Severe acute respiratory syndrome coronavirus 2), a global pandemic. A subset of patients r ecovers from the acute phase of the disease. However, they have prolonged symptoms of the disease. Post COVID 19 syndrome is the presence of signs and symptoms consistent for more than 12 weeks after infection and not attributable to alternative diagnoses. Around 30% of patients hospitalized with COVID 19 develop Post COVID 19 Syndrome and have systemic, respiratory, neuropsychiatric, and musculoskeletal manifestations . After ten months of diagnosis, this study aimed to evaluate the persistent symptoms, spi rometry examination , functionality, functional capacity, and quality of life of individuals affected by COVID 19. Th is retrospective cohort study was carried out with patients diagnosed with severe COVID 19 admitted to home care from January to June 2021. Patients with a minimum age of 18 years, a medical diagnosis of COVID 19, and who required oxygen support throughout the disease treatment were included. Patients who needed to be transferred to the hospital without physical and psychological conditions to perform the tests and answer the questionnaires were excluded. Participants were assessed for the presence of persistent symptoms, spirometry examination (FVC, FEV 1 , FVC/FEV 1 , and PEF), functionality (Post COVID 19 Functional Status Scale PCFS ), functio nal capacity (1 minute sit to stand test TSL1 ), and quality of life (Short Form 36 Health Survey SF 36 The participants were divided into two groups, the adult group (age between 18 and 60 years) and the elderly group (age equal to or greater than 60 years). Statistical analyses were performed using the SPSS Statistics for Windows program (version 26.0). The Shapiro Wilk test was used in order to evaluate the data distribution. Numerical variables with normal distribution were expressed as mean (stand ard deviation) and compared using Student's t test. Numerical variables without normal distribution were expressed as median (interquartile range) and compared by Mann Whitney and Wilcoxon U tests. Categorical variables were expressed as a number (percenta ge) and compared using the chi square test. Data correlations were performed using Pearson's correlation and Spearmann's correlation. The significance level adopted was p<0.05. A total of 22 patients were included, 12 in the adult group and 10 in the elder ly group. The persistent symptom most commonly found among patients was fatigue (77.2%), being significantly higher in the adult group (p=0.005), followed by reduced exercise capacity (68.1%), memory loss (59%), difficulty concentrating (40.9%), anxiety (4 0.9%), body pain (36.3%), cough (22.7%) and dyspnea (18.1%). FVC was reduced in 13.6% of participants, but with no significant difference between groups. The predicted values of FVC, FEV 1 , and PEF were lower in the elderly group but with no significant dif ference between groups. Around 40% of patients did not have functional limitations, 36.3% had ineligible functional limitations, and 22.7% had mild functional limitations according to the PCFS scale, with no significant difference between groups. The mean number of TSL1 repetitions was significantly lower in the elderly group (p=0.024), and 86.4% of the participants were below the 25th percentile of the predicted value. The scores of all SF 36 domains, except for physical functioning, were lower in the adul t group but with no significant difference. In the elderly group, a significant positive correlation was found between FVC values % predicted and the social functioning domain (r=0.65; p=0.04). Ten months after the diagnosis, persistent diagnosis, persistent symptoms, symptoms, reductireduction of FVC on spirometryon of FVC on spirometry, some degree of , some degree of functional impairment, impaired functional capacity, and repercussions on the functional impairment, impaired functional capacity, and repercussions on the participants' quality of life, especially in the group of adults, are observed.participants' quality of life, especially in the group of adults, are observed.