Functional Status of Mechanically Ventilated COVID-19 Survivors at ICU and Hospital Discharge

BACKGROUND: A significant number of COVID-19 patients have been treated using invasive mechanical ventilation (IMV) The ability to evaluate functional status of COVID-19 survivors early on at ICU and hospital discharge may enable identification of patients who may need medical and rehabilitation interventions METHODS: The modified "Mental Status", ICU Mobility, and Barthel Index scores at ICU and hospital discharge were tabulated for 118 COVID-19 survivors treated with invasive mechanical ventilation (IMV) These functional scores were compared with pre-admission functional status, discharge durable medical equipment, discharge medical follow-up recommendation, duration on IMV, duration post-IMV, demographics, comorbidities, laboratory tests, and vital signs at ICU and hospital discharge RESULTS: The majority of COVID-19 IMV patients were not functionally independent at hospital discharge (22% discharged with cane or rolling walker, 49% discharged with durable medical equipment, and 14% admitted to a rehabilitation facility), although 94% of these patients were functionally independent prior to COVID-19 illness Half of the patients were discharged with supplemental oxygen equipment The most prevalent medical follow-up recommendations were cardiology, vascular medicine, pulmonology, endocrinology, and neurology with many patients receiving multiple medical follow-up recommendations Functional status improved from ICU discharge to hospital discharge (p < 0 001) Worse functional status at hospital discharge was associated with longer IMV duration, older age, male sex, higher number of comorbidities, and the presence of pre-existing comorbidities including hypertension, diabetes, chronic obstructive pulmonary disease, and immunosuppression (p < 0 05, ANOVA) CONCLUSIONS: The majority of IMV COVID-19 survivors were not functionally independent at discharge and required significant follow-up medical care The COVID-19 circumstance has placed constraints on access to in-hospital rehabilitation These findings underscore the need for prospective studies to ascertain the short- and long-term sequela in COVID-19 survivors