Oxygen Desaturation and Persistence of Symptoms During Activities of Daily Living in Patients Following Hospital Discharge for COVID-19

• Published in: Respiratory care Vol. 68; no. 3; pp. 346 - 355
• Main Authors: Petilli Zopelari, Lívia M, Viana, Daiane R, Carvalho da Silva, Marcela M, Facio, Carina A, Arcuri, Juliano F, Pires Di Lorenzo, Valéria A
• Format: Journal Article
• Language: English
• Published: United States Daedalus Enterprises, Inc 01-03-2023; Daedalus Enterprises Inc
• Subjects: Activities of Daily Living; Admission and discharge; COVID-19 - complications; Cross-Sectional Studies; Dyspnea - etiology; Fatigue; Health aspects; Hospitals; Humans; Original Research; Oxygen; Patient Discharge; Pulmonary Disease, Chronic Obstructive - complications; Brazil; Activities of Daily Living; COVID-19; Dyspnea; Hypoxemia; Telehealth; Physiotherapy; Fatigue
• DOI: 10.4187/respcare.09980
• EISSN: 1943-3654
• ISSN: 0020-1324

COVID-19 can cause respiratory and multisystemic impairments, which lead to impaired activities of daily living (ADL). Telemonitoring after discharge from the hospital may help identify the persistence of such limitations during ADLs simulations. The aim of this study was to compare S
, fatigue, and dyspnea through telemonitoring during a battery of 4 ADLs in patients following hospital discharge for COVID-19.
An observational cross-sectional study was conducted by using teleconferencing for patients 30 d after hospital discharge for COVID-19. The subjects were assessed and performed a simulated ADL battery (ie, walking, bathing and dressing, floor sweeping, and folding towels). S
, fatigue, and dyspnea were monitored immediately after the end of each ADL; also, the subjects were asked to show the pulse oximeter on camera and grade their symptoms by using the Borg scale score (0-10).
Sixty-six subjects were evaluated, all of whom were normoxic at rest. No significant difference in S
was found among the ADLs. A portion of the subjects experienced desaturation on at least 1 ADL, which allowed subject grouping into the desaturated group, with highest portion of subjects who desaturated found during the walking task (18%), and the non-desaturated group. The subjects who desaturated were found to have more cardiovascular diseases (
= .031) and diabetes mellitus (
= .005) compared with those who did not desaturate. Both groups experienced mild symptoms; however, a percentage of the subjects with desaturation presented moderate-to-intense symptoms, with higher fatigue scores during walking, bathing and dressing, and floor sweeping. Increased dyspnea was also found during walking and during bathing and dressing in the subjects with desaturation.
S
was similar among the ADLs but walking triggered desaturation in a larger number of subjects. The subjects presented with mild-to-intense fatigue and dyspnea during ADLs 30 d after discharge after hospitalization for COVID-19 regardless of desaturation status, which demonstrated that the persistence of symptoms is independent of hypoxemia during exercise.