Physical recovery of COVID-19 pneumosepsis intensive care survivors compared with non-COVID pneumosepsis intensive care survivors during post-intensive care hospitalization: The RECOVID retrospective cohort study

Background: Coronavirusdisease 2019 (COVID-19) pneumosepsis survivors are at a high risk of developing intensive care unit (ICU)-acquired weakness (ICUAW) because of high incidence of acute respiratory distress syndrome and the common need for prolonged invasive ventilation. It remains unknown whether regular postpneumosepsis physical rehabilitation strategies are suitable for this extraordinary patient category. Methods: We retrospectively compared the physical recovery of COVID-19 and non-COVID pneumosepsis ICU survivors during post-ICU hospitalization, defined as the difference in performance on the Medical Research Council Sum-Score (MRC-SS), Chelsea Critical Care Physical Assessment tool (CPAx), and percentage of predicted handgrip strength (POP-HGS). An analysis of covariance model was built using age, sex, Barthel index, body mass index, admission Acute Physiology And Chronic Health Evaluation II score, adequacy of protein delivery during ICU stay, and ward length of stay as covariates. Results: Thirty-five COVID-19 ICU patients could be compared with 21 non-COVID pneumosepsis ICU survivors. All patients scored <= 48 on the MRC-SS at ICU discharge, indicating ICUAW. When controlling for covariates, COVID-19 patients performed worse on all physical assessments upon ICU discharge, but had improved more at hospital discharge on the MRC-SS (eta(2) = 0.214, P =.002) and CPAx (eta(2) = 0.153, P =.011). POP-HGS remained lower in COVID-19 patients throughout hospital stay. Conclusion: COVID-19 ICU survivors are vulnerable to ICUAW, but they show better tendency towards physical rehabilitation than non-COVID pneumosepsis ICU survivors during the post-ICU hospitalization period regarding MRC-SS and CPAx. COVID-19 ICU patients might benefit from early, more intensive physical therapy.

Automated summary

COVID-19 ICU survivors are vulnerable to ICU-acquired weakness, but show a better tendency towards physical rehabilitation compared to non-COVID pneumosepsis ICU survivors, particularly in terms of Medical Research Council Sum-Score (MRC-SS) and Chelsea Critical Care Physical Assessment tool (CPAx). COVID-19 ICU patients may benefit from early, more intensive physical therapy.