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Investigation of the Clinical Features and Long-Term Functional Status of Patients with a Diagnosis of Covid-19 Followed in the Intensive Care Unit

Year 2025, Volume: 12 Issue: 2, 67 - 73, 28.08.2025
https://doi.org/10.47572/muskutd.1564449

Abstract

The study aims to examine the clinical features and mortality-related factors of COVID-19 patients in critical condition and their long-term functional status in survivors. All COVID-19 patients admitted to our intensive care unit (ICU) between March 2020 and November 2020 were included in the study. In the ICU, mortality-related parameters were evaluated using univariate and multiple analyses. The long-term functional status of daily living activities (Katz ADL and Lawton IADL), nutrition (MNA-SF), frailty (FRAIL index), and life satisfaction tests were evaluated by assessing the final status at home after discharge in critically ill COVID-19 patients. A total of 203 COVID-19 patients were included in the study (55.2% male, median age 76 years, median ICU stay 7 days, APACHE II score median 19 points, and mortality rate 81.8%). Invasive mechanical ventilation use was found to be an independent risk factor for ICU mortality in multiple regression models. Twenty-two (22/203, 11.0%) patients were evaluated by telephoneregarding their functional status. Median follow-up times after discharge were 169 days (97-324). The Katz ADL, Lawton IADL, MNA-SF, FRAIL index, and Life Satisfaction Scale scores were worse than before COVID-19 infection. In this study, it has been shown that mortality rates may be high, and invasive mechanical ventilation support was an independent risk factor for mortality in patients hospitalized in the intensive care unit due to COVID-19, especially in the early stages of the pandemic. Furthermore, patients who could be discharged may experience a deterioration in their life activities, nutritional status, and physical performance for months compared to their condition before COVID-19 infection.

References

  • Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433.
  • Avci, Isil . Evaluation of functional status and quality of life of patients in the 1st and 6th months post-COVID in the light of radiological influence. Bratisl Lek Listy. 2024;125(9):580-6.
  • Salmam, I, Kadija P, Krista L et al. Physical impairments in individuals with Long COVID. Front Sports Act Living. 2025;7:1511942
  • Arik G, Varan HD, Yavuz BB, et al. Validation of Katz index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015;61(3):344-50.
  • Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the Lawton instrumental activities of daily living scale to Turkish: validity and reliability study. Ann Geriatr Med Res. 2020;24(1):35.
  • Sarikaya D, Halil M, Kuyumcu ME, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60.
  • Hymabaccus Muradi BAB. Yaşlılarda Kırılganlığı Ölçmeye Yönelik FRAİL Ölçeğinin Türkçe Geçerlik ve Güvenirlik Çalışması. 2017.
  • Karataş, Z, Kıvanç U, Özlem T. COVID-19 Salgın Sürecinde Türk Yetişkinler İçin Yaşam Doyumu, Yaşamdaki Anlam, Umut ve COVID-19 Korkusu Arasındaki İlişkiler. Psikolojide sınırlar. 2021;12: 633384.
  • Helviz, Yigal. Lack of Clinical Prognostic Power for Ventilated Critical COVID-19 Patients in the Intensive Care Unit. IMAJ. 2025;27(1): 34-41.
  • Taylor EH, Marson EJ, Elhadi M, et al. Factors associated with mortality in patients with COVID-19 admitted to intensive care: a systematic review and meta-analysis. Anaesthesia. 2021;76(9):1224-32.
  • Chang R, Elhusseiny KM, Yeh YC et al. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes-A systematic review and meta-analysis. PLoS One. 2021;16(2):e0246318.
  • Sathyamurthy P, Madhavan S, Pandurangan V. Prevalence, Pattern and Functional Outcome of Post COVID-19 Syndrome in Older Adults. Cureus. 2021;13(8):e17189.
  • Damanti, Sarah. Exploring the Association between Delirium and Malnutrition in COVID-19 Survivors: A Geriatric Perspective. Nutrients. 2023;15(22):4727
  • De Lorenzo R, Conte C, Lanzani C, et al. Residual clinical damage after COVID-19: A retrospective and prospective observational cohort study. PLoS One. 2020;15(10):e0239570.
  • Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing. 2018;47(2):193-200.
  • Jeong, Jong Hwan. Prevalence of new frailty at hospital discharge in severe COVID-19 survivors and its associated factors. Tuberc Respir Dis (Seoul). 2024;88(2):361.
  • Greco GI, Noale M, Trevisan C, et al. Increase in Frailty in Nursing Home Survivors of Coronavirus Disease 2019: Comparison With Noninfected Residents. J Am Med Dir Assoc. 2021;22(5):943-7.
  • Satici, B. Adaptation of the Fear of COVID-19 Scale: Its Association with Psychological Distress and Life Satisfaction in Turkey. Int J Ment Health Addict. 2021;19(6): 1980-8.
  • Rogowska AM, Kuśnierz C. Changes in Stress, Coping Styles, and Life Satisfaction between the First and Second Waves of the COVID-19 Pandemic: A Longitudinal Cross-Lagged Study in a Sample of University Students. J Clin Med. 2021;10(17):4025.

Yoğun Bakım Ünitesinde Takip Edilen Covid-19 Tanılı Hastaların Klinik Özelliklerinin ve Taburculuk Sonrası Uzun Dönem Fonksiyonel Durumlarının İncelenmesi

Year 2025, Volume: 12 Issue: 2, 67 - 73, 28.08.2025
https://doi.org/10.47572/muskutd.1564449

Abstract

Çalışma, kritik durumdaki COVID-19 hastalarının klinik özelliklerini, mortalite ile ilişkili faktörlerini ve hayatta kalanlarda uzun vadeli fonksiyonel durumlarını incelemeyi amaçlamaktadır. Mart 2020 ile Kasım 2020 tarihleri arasında yoğun bakım ünitemize başvuran tüm COVID-19 hastaları çalışmaya dahil edilmiştir. Mortalite ile ilişkili faktörler, tekli ve çoklu analizlerle incelenmiştir. Günlük yaşam aktiviteleri (Katz ADL ve Lawton IADL), beslenme (MNA-SF), kırılganlık (FRAIL indeksi) ve yaşam memnuniyeti testleri ile değerlendirilen uzun süreli fonksiyonel durumlar, hayatta kalan kritik COVID-19 hastalarında, taburculuk sonrası evdeki son durumları değerlendirilerek incelenmiştir. Çalışmaya toplam 203 COVID-19 hastası dahil edilmiştir (%55.2 erkek, medyan yaş 76 yıl, medyan yoğun bakım kalış süresi 7 gün, APACHE II skoru medyan 19 puan, mortalite oranı %81,8). İnvaziv mekanik ventilasyon gereksiniminin mortalite ile bağımsız ilişkili bir faktör olabileceği, çoklu regresyon analizlerinde gösterilmiştir. Yirmi iki (22/203, %11,0) hasta, telefon görüşmesi ile fonksiyonel durumlarına göre değerlendirilmiştir. Taburculuk sonrası ortanca takip süreleri 169 (97-324) gündü. Katz ADL, Lawton IADL, MNA-SF, FRAIL indeksi ve Yaşam Memnuniyeti Ölçeği puanlarının COVID-19 enfeksiyonundan önceki zamana kıyasla daha kötü olduğu tespit edilmiştir. Bu çalışmada, COVID-19 nedeniyle yoğun bakım ünitesine yatan hastalarda özellikle pandeminin ilk dönemlerinde mortalite oranlarının yüksek olabileceği, invaziv mekanik ventilasyon desteğinin mortalite için bağımsız bir ilişkili faktör olabileceği ve taburcu olabilen hastalarda COVID-19 enfeksiyonu öncesindeki durumlarına kıyasla yaşam aktiviteleri, beslenme durumları ve fiziksel performansları açısından aylarca sürebilen kötüleşme yaşanabileceği gösterilmiştir.

References

  • Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433.
  • Avci, Isil . Evaluation of functional status and quality of life of patients in the 1st and 6th months post-COVID in the light of radiological influence. Bratisl Lek Listy. 2024;125(9):580-6.
  • Salmam, I, Kadija P, Krista L et al. Physical impairments in individuals with Long COVID. Front Sports Act Living. 2025;7:1511942
  • Arik G, Varan HD, Yavuz BB, et al. Validation of Katz index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015;61(3):344-50.
  • Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the Lawton instrumental activities of daily living scale to Turkish: validity and reliability study. Ann Geriatr Med Res. 2020;24(1):35.
  • Sarikaya D, Halil M, Kuyumcu ME, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60.
  • Hymabaccus Muradi BAB. Yaşlılarda Kırılganlığı Ölçmeye Yönelik FRAİL Ölçeğinin Türkçe Geçerlik ve Güvenirlik Çalışması. 2017.
  • Karataş, Z, Kıvanç U, Özlem T. COVID-19 Salgın Sürecinde Türk Yetişkinler İçin Yaşam Doyumu, Yaşamdaki Anlam, Umut ve COVID-19 Korkusu Arasındaki İlişkiler. Psikolojide sınırlar. 2021;12: 633384.
  • Helviz, Yigal. Lack of Clinical Prognostic Power for Ventilated Critical COVID-19 Patients in the Intensive Care Unit. IMAJ. 2025;27(1): 34-41.
  • Taylor EH, Marson EJ, Elhadi M, et al. Factors associated with mortality in patients with COVID-19 admitted to intensive care: a systematic review and meta-analysis. Anaesthesia. 2021;76(9):1224-32.
  • Chang R, Elhusseiny KM, Yeh YC et al. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes-A systematic review and meta-analysis. PLoS One. 2021;16(2):e0246318.
  • Sathyamurthy P, Madhavan S, Pandurangan V. Prevalence, Pattern and Functional Outcome of Post COVID-19 Syndrome in Older Adults. Cureus. 2021;13(8):e17189.
  • Damanti, Sarah. Exploring the Association between Delirium and Malnutrition in COVID-19 Survivors: A Geriatric Perspective. Nutrients. 2023;15(22):4727
  • De Lorenzo R, Conte C, Lanzani C, et al. Residual clinical damage after COVID-19: A retrospective and prospective observational cohort study. PLoS One. 2020;15(10):e0239570.
  • Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing. 2018;47(2):193-200.
  • Jeong, Jong Hwan. Prevalence of new frailty at hospital discharge in severe COVID-19 survivors and its associated factors. Tuberc Respir Dis (Seoul). 2024;88(2):361.
  • Greco GI, Noale M, Trevisan C, et al. Increase in Frailty in Nursing Home Survivors of Coronavirus Disease 2019: Comparison With Noninfected Residents. J Am Med Dir Assoc. 2021;22(5):943-7.
  • Satici, B. Adaptation of the Fear of COVID-19 Scale: Its Association with Psychological Distress and Life Satisfaction in Turkey. Int J Ment Health Addict. 2021;19(6): 1980-8.
  • Rogowska AM, Kuśnierz C. Changes in Stress, Coping Styles, and Life Satisfaction between the First and Second Waves of the COVID-19 Pandemic: A Longitudinal Cross-Lagged Study in a Sample of University Students. J Clin Med. 2021;10(17):4025.
There are 19 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Article
Authors

Emrah Harman 0000-0002-1554-0419

Dursun Elmas 0000-0002-3452-529X

Muhammet Cemal Kızılarslanoğlu 0000-0002-7632-6811

Sedef Harman 0000-0002-7787-5855

Publication Date August 28, 2025
Submission Date October 10, 2024
Acceptance Date July 17, 2025
Published in Issue Year 2025 Volume: 12 Issue: 2

Cite

APA Harman, E., Elmas, D., Kızılarslanoğlu, M. C., Harman, S. (2025). Investigation of the Clinical Features and Long-Term Functional Status of Patients with a Diagnosis of Covid-19 Followed in the Intensive Care Unit. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 12(2), 67-73. https://doi.org/10.47572/muskutd.1564449
AMA Harman E, Elmas D, Kızılarslanoğlu MC, Harman S. Investigation of the Clinical Features and Long-Term Functional Status of Patients with a Diagnosis of Covid-19 Followed in the Intensive Care Unit. MMJ. August 2025;12(2):67-73. doi:10.47572/muskutd.1564449
Chicago Harman, Emrah, Dursun Elmas, Muhammet Cemal Kızılarslanoğlu, and Sedef Harman. “Investigation of the Clinical Features and Long-Term Functional Status of Patients With a Diagnosis of Covid-19 Followed in the Intensive Care Unit”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 12, no. 2 (August 2025): 67-73. https://doi.org/10.47572/muskutd.1564449.
EndNote Harman E, Elmas D, Kızılarslanoğlu MC, Harman S (August 1, 2025) Investigation of the Clinical Features and Long-Term Functional Status of Patients with a Diagnosis of Covid-19 Followed in the Intensive Care Unit. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 12 2 67–73.
IEEE E. Harman, D. Elmas, M. C. Kızılarslanoğlu, and S. Harman, “Investigation of the Clinical Features and Long-Term Functional Status of Patients with a Diagnosis of Covid-19 Followed in the Intensive Care Unit”, MMJ, vol. 12, no. 2, pp. 67–73, 2025, doi: 10.47572/muskutd.1564449.
ISNAD Harman, Emrah et al. “Investigation of the Clinical Features and Long-Term Functional Status of Patients With a Diagnosis of Covid-19 Followed in the Intensive Care Unit”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 12/2 (August2025), 67-73. https://doi.org/10.47572/muskutd.1564449.
JAMA Harman E, Elmas D, Kızılarslanoğlu MC, Harman S. Investigation of the Clinical Features and Long-Term Functional Status of Patients with a Diagnosis of Covid-19 Followed in the Intensive Care Unit. MMJ. 2025;12:67–73.
MLA Harman, Emrah et al. “Investigation of the Clinical Features and Long-Term Functional Status of Patients With a Diagnosis of Covid-19 Followed in the Intensive Care Unit”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 12, no. 2, 2025, pp. 67-73, doi:10.47572/muskutd.1564449.
Vancouver Harman E, Elmas D, Kızılarslanoğlu MC, Harman S. Investigation of the Clinical Features and Long-Term Functional Status of Patients with a Diagnosis of Covid-19 Followed in the Intensive Care Unit. MMJ. 2025;12(2):67-73.