Independência funcional após internação por coronavírus disease: uma análise segundo a classificação internacional de funcionalidade, incapacidade e saúde

Abstract

Introduction: The Coronavirus Disease (COVID-19) emerged in 2019, being declared a pandemic in March 2020 by the World Health Organization. It is a multisystemic disease, which mainly affects the respiratory tract, and can lead to hospitalization, as well as death. After hospitalization, impairment of functional independence is expected, and it is important to identify the determining factors of such impairment. Objective: To assess functional independence after hospitalization due to COVID-19, according to the domains of the International Classification of Functioning, Disability and Health (ICF), identifying the potential determinants of the functionality of these individuals. Methodology: Observational cross-sectional study, in which 96 individuals aged over 18 years, diagnosed and hospitalized for COVID-19 in the State of Rio Grande do Norte, were evaluated. The evaluation was carried out by videoconference, collecting personal, sociodemographic and clinical data. In this aspect, the aerobic capacity was evaluated by the Duke Activity Status Index (DASI) questionnaire; feeling short of breath was measured using the London Chest Activity of Daily Living (LCADL) questionnaire; upper limb function, based on the QuickDASH questionnaire; functional independence, measured by the Functional Independence Measure (FIM: motor part); the strength of the lower limbs, from the Sitting and Standing Test of 5 repetitions (TSL5). According to the ICF domains, the DASI, LCADL and TSL5 instruments were classified as Body function; within the Activity domain, the “walking at home” responses from the evaluation form and the QuickDASH instrument were listed; regarding the Participation domain, the answers referring to the ability to return to work were classified; in the domain of Personal factors, the variables of education, race and income were listed; finally, in the field of environmental factors, we used the variable “living independently”. Results: Of the 96 individuals evaluated, 49 (51.04%) were female; the mean age was 52.17 (± 12.93) years and the length of hospital stay was 14.13 ± 12.3 days. The DASI score was 24.90 (±18.08), LCADL: 16.90 (±9.83), QuickDASH: 23.05 (±9.7), FIM: 86.25 (±8. 42), 5-repetition sit-to-stand test: 32% performed the test time >16.7 seconds. Conclusion: We suggest that the ICF Function domains, with the outcomes Upper limb function, Aerobic capacity and Lower limb function, and the Activity domain, with the outcomes Walking, Upper limb function and Self-care, are potential determinants to assess functional independence after hospitalization for COVID-19.