ULiège and CHU de Liège
" BACKGROUND The SARS-CoV2 or COVID-19 infection is unique in terms of its speed of spread, the importance of structural medical reorganization, the length of resuscitation stays sometimes required, the diversity of the affected population, especially young or fragile subjects, and the impacts on physical and mental health generated by this pandemic and the prolonged confinement of populations. Muscle damage related to immobility, inflammation, corticosteroids, hypoxemia associated with pulmonary and cardiac damage, and metabolic damage (undernutrition), all sometimes linked to the infection, suggests weak or major functional repercussions, already described in SARS patients. Thus, the patients most affected by COVID-19 require acute hospital management and sometimes complex rehabilitation management. Retrospective studies of the functional capacities of patients with SARS of viral origin show the persistence of functional impairment at a distance from the infection. However, no prospective studies have been carried out for this type of patient, who often have an impaired functional reserve compared to functional performance prior to this virulent infection. OBJECTIVES Prospectively identify functional limitations in patients with COVID-19 by follow-up up to 12 months from the start of rehabilitation/rehabilitation management after infection (main objective). Secondary objectives include : - To describe the prevalence of various long-term (12 months post infection) persistent functional impairments in patients infected with CoV2-SARS who required initial acute hospitalization followed by rehabilitation/rehabilitation care. - Describe the quality of life and long-term (12 months post-infection) psychological disorders in patients infected with CoV2-SARS who required initial acute hospitalization followed by rehabilitation/rehabilitation. METHODOLOGY This observational study aims to follow a sample of patients infected with SARS-CoV2 who required hospitalisation and then rehabilitation/rehabilitation care in the territories of REIMS, STRASBOURG, TROYES and LIEGE (monocentric for Belgium). For the CHU of Liège, 50 patients will be included (≥ 18 years old, French-speaking literate, medically stable) after having read the protocol and signed the consent form. Patients with cognitive disorders (Mini-Mental State Examination < 22) or under guardianship or curatorship will be excluded. Patients included will be followed for a period of 12 months with functional and respiratory measures organized in a battery of tests and performed at the time of inclusion, at 6 weeks, 3 months, 6 months and 12 months. The test battery is composed as follows: Retrospective medical data on patient characteristics prior to illness: age, sex, body weight, usual height, lifestyle, history and co-morbidities according to the Charlson score, retrospective functional measures (ACTIVLIM questionnaire, London Activities of Daily Living Respiratory Questionnaire, multidimensional profile of dyspnea, usual walking perimetry prior to SARS-CoV2 infection). Medical data on the acute phase: Date of the first day of hospitalisation, entry weight, phenotype of infectious disease, therapeutics used, biological data, medical imaging data, typologies of organic disease. Cognitive deficiencies: Montreal Cognitive Assessment, Muscular deficiencies: maximum strength of long fingers on the JAMAR dynamometer bent elbow, medical research council-sum score Functional capacity data monitored in post-infectious conditions: Chair-lift test in one minute, Time of 10 chair lifts, Timed Up and Go test (chair lift, walk 3 meters, back to chair), 6-minute walk test, Search for the maximum power on ergometers adapted to the patient's capacities and then endurance test at 80% of the maximum power (at a distance from the prophylactic isolation period). Barthel's Activities of Daily Living Scale Dyspnea: Modified Medical Resaerch Council Resting Scale, Dypnea12, London Respiratory Activities of Daily Living Questionnaire and Multidimensional Profile of Dyspnea. Pulmonary Impairments: Respiratory function testing, carbon monoxide diffusion capacity, plethysmography for walking patients Fatigue: Modified Fatigue Impact Scale and Fatigue Severity Scale Body pain: Brief pain inventory short form Mental Health: Hospital Anxiety and Depression scale Health-Related Quality of Life: WHO Quality of Life-BREF, St. George's Respiratory Questionnaire. This observational study, with prospective inclusion and multicentric (but monocentric for Belgium), will seek to explain the impact of SARS-CoV2 infection on the functional capacities of patients who have been hospitalized and require rehabilitation/rehabilitation care. The data collected will allow comparison with known data in the general population, as well as retrospective functional capacities of patients. These data seek to better identify the prevalences of different functional impairments in patients with COVID-19 over a one-year follow-up from hospitalization for SARS-CoV2 infection. "
Funding: Application for funds submitted to the FNRS
Jean-François Kaux, Professor
ULiège and CHU de Liège