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Differences in functional outcome of COVID-19 and non-COVID-19 patients with critical illness polyneuropathy/
Michael Klein1, Bernadette Einhäupl2, Eva Grill1,3
1Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
Background:
Up to 80% of intensive care unit (ICU) patients suffer from neuromuscular disorders like critical illness polyneuropathy/myopathy (CIP/CIM), requiring further rehabilitation.
Objective:
This study investigates differences in the clinical course between Coronavirus Disease 2019 (COVID-19) and non-COVID-19 patients with CIP/CIM undergoing post-acute neurological rehabilitation (PANR) and the impact of COVID-19 on rehabilitation outcomes.
Methods:
A multicenter observational study was conducted in nine German PANR facilities. The clinical course and outcome were compared between COVID-19 and non-COVID-19 patients at rehabilitation admission and discharge. Functional outcomes were measured with the modified Ranking Scale (mRS) and the Barthel Index (BI). Functional independence was defined as either mRS Score < 3 or BI > 75 at discharge, discharged home without nursing support with a BI > 65, or discharged to further rehabilitation (phase D). To analyze outcome predictors, Cox regression was used.
Results:
A total of 323 patients (COVID-19 n = 166) after an ICU stay were enrolled, and outcome measures were available for 298. 56 of them achieved functional independence at discharge. COVID-19 patients had better functional scores at admission and discharge and a shorter length of stay as the non-COVID group. Pre-existing diabetes was significantly negatively associated with functioning at discharge.
Conclusions:
This analysis provides the first evidence for differences and predictors of the clinical course and outcome for COVID-19 and non-COVID-19 patients with CIP/CIM in the phase of post-acute rehabilitation. Our results offer valuable impulses for rehabilitation strategies for these patients. https://drks.de/search/de , German Clinical Trials Register, ID DRKS00022845, registered on September 1, 2020.
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