key: cord-0926988-jfx8trze authors: Sousa, Laura; Dias, Lúcia; Santos, Lurdes; Silva-Pinto, André title: Functional status of recovered critical COVID-19 patients: an assessment of a convalescent cohort date: 2022-02-25 journal: Med Intensiva DOI: 10.1016/j.medin.2022.02.006 sha: b66ab8b662e2bcc2496855f401e847b70fc038c1 doc_id: 926988 cord_uid: jfx8trze nan December 2020 were assessed three months after COVID-19 cure. All patients provided written informed consent. This study was approved by the local Ethics Committee. The sequelae of each patient were assessed clinically (through a validated questionnaire) and functionally (through pulmonary function tests). The functional respiratory assessment was performed with a corporeal plestimography and CO diffusion capacity test and evaluated by a pneumologist. Clinical assessment was performed by a medical doctor investigator in the study. Apart from the clinical evaluation, Portuguese Severe Respiratory Insufficiency (SRI-PT) was applied. We applied the SRI-PT because it is validated to the Portuguese population (3) survivors three months after recovery found an association between elevated serum D-Dimer and decreased diffusion capacity in follow-up respiratory function tests (6) , which can explain our results. The SRI-PT results showed that the domains most affected were attendant symptoms and sleep, social relationships, psychosocial well-being, anxiety, and physical function, which is concordant with previous studies. (7, 8) The total scale SRI-PT was superior in men, which is also consistent with data from other studies. (7) Older patients, the patients who had comorbidities in general, the patients who had dyslipidaemia, and those with higher body mass index had also lower SRI-PT scores indicating an inferior quality of life. These findings matched our expectations and the results of other studies (8) . They are not specific to COVID-19 patients because they would also be expected in non-infected patients. The COVID-19 mostly affects the respiratory system, but is increasingly recognized as a systemic disease, with neurologic sequelae, most frequently in those with severe illness. Therefore, a pulmonary (9) and cognitive rehabilitation (10) program is very important in these patients. It is necessary to rule out long-term pulmonary and cognitive sequelae and provide rehabilitation to minimize the potential negative effects on physical and psychosocial functioning and, finally, quality of life of survivors. The results of our study support that the patients with severe disease need post-discharge care. Longer follow-up studies in a larger population are necessary to understand and manage longterm sequelae in patients who suffered from COVID-19. There is still a lack of standardized guidelines regarding the management of post-COVID-19 patients implying that each hospital adapts its resources according to its needs. We believe that the recommendations and suggestions of this work can help to further develop and implement functional and clinical protocols for follow-up on post-COVID-19 patients with respiratory impairment. This study had no funding. The authors declare that they have no conflicts of interest. COVID-19 and its sequelae: a platform for optimal patient care, discovery and training CT Lung Abnormalities after COVID-19 at 3 Months and 1 Year after Hospital Discharge Validation of the Portuguese Severe Respiratory Insufficiency Questionnaire for home mechanically ventilated patients Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study Prevalence and predictors of Post-Acute COVID-19 Syndrome (PACS) after hospital discharge: A cohort study with 4 months median follow-up Effectiveness of pulmonary rehabilitation in COVID-19 respiratory failure patients post-ICU Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia Data are n (%), n/N (%), or median (IQR-interquartile range).Abbreviations: BMI-body mass index; SOA-sleep obstructive apnea; COPD-Chronic obstructive pulmonary disease; IMV-invasive mechanical ventilation; NVI-non-invasive ventilation; HFNOhigh-flow nasal cannula for oxygen therapy; ID-ICU-Infectious diseases-intensive care unit.