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Association of Functional Characteristics and Physiotherapy with COVID-19 Mortality in Intensive Care Unit in Inpatients with Cardiovascular Diseases.

Chiara Andrade SilvaAgnaldo Jose LopesJannis Vasileios PapathanasiouLuis Felipe da Fonseca ReisArthur de Sá Ferreira
Published in: Medicina (Kaunas, Lithuania) (2022)
Background and Objectives: To estimate the association between admission functional outcomes and exposure to physiotherapy interventions with mortality rate in intensive care unit (ICU) inpatients with cardiovascular diseases and new coronavirus disease (COVID-19). Materials and Methods : Retrospective cohort including 100 ICU inpatients (mean (standard deviation), age 75 (16) years) split into COVID-19+ or COVID-19-. The association of in-ICU death with admission functional outcomes and physiotherapy interventions was investigated using univariable and multivariable regression models. Results: In total, 42 (42%) patients tested positive for COVID-19. In-ICU mortality rate was 37%, being higher for the COVID-19+ group (odds ratio, OR (95% CI): 3.15 (1.37-7.47), p = 0.008). In-ICU death was associated with lower admission ICU Mobility Scale score (0.81 (0.71-0.91), p = 0.001). Restricted mobility (24.90 (6.77-161.94), p < 0.001) and passive kinesiotherapy (30.67 (9.49-139.52), p < 0.001) were associated with in-ICU death, whereas active kinesiotherapy (0.13 (0.05-0.32), p < 0.001), standing (0.12 (0.05-0.30), p < 0.001), or walking (0.10 (0.03-0.27), p < 0.001) were associated with in-ICU discharge. Conclusions: In-ICU mortality was higher for inpatients with cardiovascular diseases who had COVID-19+, were exposed to invasive mechanical ventilation, or presented with low admission mobility scores. Restricted mobility or passive kinesiotherapy were associated with in-ICU death, whereas active mobilizations (kinesiotherapy, standing, or walking) were associated with in-ICU discharge in this population.
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