Associations between ICU nursing care and functional outcomes in survivors of critical COVID-19: Longitudinal study

The evaluation of long-term functional disabilities and factors associated with decline following COVID-19-related critical illness in low- and middle-income countries remains underexplored in current literature. Addressing this gap is essential for healthcare professionals, particularly nurses, to develop targeted interventions aimed at reducing the risk of functional decline after critical illness during pandemics.

To analyze ICU nursing care factors associated with functional outcomes in survivors of critical illness due to COVID-19, six months after ICU discharge.

A prospective longitudinal study was conducted. Adults (≥18 years) discharged from the ICU after viral pneumonia, confirmed by RT-PCR for SARS-CoV-2, with a minimum ICU stay of 72 h, were included. Follow-up was conducted via telephone interviews at one, three, and six months to collect sociodemographic data and assess functional status using the Barthel Index. Data were analyzed using Generalized Estimating Equations.

The study included 400 participants (mean age: 52.41 ± 13.680 years; median ICU stay: 15.0 days, IQR: 8.0-26.0). Functional decline was observed in 43% of patients at one month, 28.4% at three months, and 20.4% at six months. Delirium and skin ulcers during ICU stay were modifiable factors associated with post-critical care functional disability.

Exploring targeted nursing interventions, such as delirium and pressure ulcer prevention, is essential to promote recovery and prevent long-term disability after critical illness.