Estado funcional e a associação com fatores sociodemográficos, clínicos e de saúde no pós-covid-19

Abstract

Introduction: The pandemic caused by COVID-19 left sequelae in survivors, however, how these interfere with the daily activities of individuals affected by the disease remains under investigation. Objective: To assess the functional status, as well as associated clinical and epidemiological outcomes, within 12 months after hospital discharge, of individuals hospitalized due to COVID-19 in a municipality in the north of Rio Grande do Sul. Methods: This is a quantitative, observational study, with a cross-sectional epidemiological design, of a descriptive and analytical nature, carried out from June/2022 to April/2023. Individuals aged 18 years and over who required hospitalization due to complications from COVID-19 from September/2021 to September/2022, residing in the city of Passo Fundo (RS), were considered eligible. Contact with those eligible was carried out based on the list of notified and confirmed cases of Severe Acute Respiratory Syndrome from the Influenza Surveillance System and made available by the Municipal Health Department. For data collection, a home visit was carried out to apply a standardized questionnaire and physical tests to obtain the variables of interest for the study, including: i) functionality through the post-COVID-19 functional status scale, ii) peripheral muscle strength through of the Medical Research Council Score (change in muscle strength: MRC < 60 points and presence of muscle weakness: MRC < 48 points) and iii) sociodemographic, clinical and health variables. Results of interest were change in muscle strength, presence of muscle weakness and functional limitation. Data analysis was performed using SPSS version 26.0 using descriptive and analytical statistics using Pearson's chi-square and Fisher's exact tests and gross and adjusted logistic regression models. The significance level adopted was p<0.05. Results: Of the 160 individuals interviewed, most individuals evaluated were women, white, with a mean age of 64 years. The data indicate that 67.5% of the participants had functional limitations, more than 50% had changes in muscle strength and 10% had muscle weakness. Individuals with a higher proportion of functional limitations were those with low education (p = 0.016), who did not perform an active occupational activity (p = 0.017), who reported having a diagnosis of sarcopenia (p = 0.035) and respiratory diseases (p = 0.001), those who needed oxygen therapy during hospitalization (p = 0.011) and physiotherapy after discharge (p = 0.037). There was an association between greater functional limitation and the diagnosis of respiratory diseases (p = 0.002). The individuals with the highest proportion of change in muscle strength were female (p=0.009), who did not perform an active occupational activity (p=0.003), who had sarcopenia (p= 0.005) and required orotracheal intubation (OTI) (p =0.032). The study associated the change in muscle strength with the female gender (p= 0.009), with the diagnosis of sarcopenia (p=0.036), with the habit of smoking (p=0.022) and with the need for OTI (p=0.009). Conclusion: Within 12 months of hospital discharge, 67.5% of the participants still had functional limitations, more than 50% had some type of impairment of muscle strength, and 10% had an indication of muscle weakness.