This study examined 11 critically ill COVID-19 patients who developed critical illness polymyopathy. It found that patients who received protocol-based physiotherapy interventions like long sitting, chair mobilization, and walking had improved survival rates compared to those who did not receive these interventions. Specifically, 71% of survivors were able to ambulate independently with physiotherapy, while all non-survivors remained fully dependent. The study concludes that physiotherapy may help recovery from COVID-19 related critical illness polymyopathy, but larger studies are still needed.

1. ABSTRACT N0 -ABS0027
TITLE: CRTICAL ILLNESS POLYMYOPATHY IN COVID 19
PATIENTS.
AUTHORS: DR MOHAMMAD ABBAS, DR HARISH M M
NARAYANA HRUDAYALAYA HOSPITAL, BOMMASANDRA,
BENGALURU-560022

2. TITLE:CRTICAL ILLNESS POLYMYOPATHY IN COVID 19 PATIENTS.
INTRODUCTION:
COVID19disease aglobalpandemicwillberemembered for rapid onset respiratory failure
requiring Oxygen therapy, Prolonged Mechanical ventilation and Proning. It required
Prolonged duration of hospitalization, Inotropic supports, Antibiotics, Steroids,
Fluctuation in Sugar levels and prolonged use of muscle relaxants for mechanical
ventilation which is associated with increased incidence on Critical illness
polymyopathy.
Hence, we collected retrospective data of critically ill COVID-19 patients who
developed from critical illness myopathy and assessed the effect of various risk factors
and interventions like physiotherapy on the long-term outcome in these patients.

3. METHODOLOGY:
COVID19Positive
August2020–December2020
Criticalillnesspolymyopathyclinically
Anonymously, and all patient identifiers were removed to ensure confidentiality
DATA COLLECTION.
Demographic details, Vitals, dose of inotropes, Glasgow Coma Scale(GCS), SOFA scores
at arrival, Glucose levels, Arterial blood gas analysis, Complete blood count,
Electrolytes, and Use of antibiotics, Steroids, Hydroxychloroquine/chloroquine,
Antivirals were collected. Use of interventions, and Various physiotherapy
measures(re-education, long sitting on the bed, chair mobilization, walking, and gait
balance) in terms of outcomes.
TITLE:CRTICAL ILLNESS POLYMYOPATHY IN COVID 19 PATIENTS.

4. RESULTS.
RESULTS Survived (N= 7) Died (N= 4) P value
Age (yrs) 59 ± 1.41 63 ± 4.24 0.24
Male (%) 5 (71.4%) 3 (75%) 0.72
Female 2 (28.6%) 1(25%)
Weight, kg 80 ± 2.82 73±7.07 1
ICU stay* (No. of days) 41 (2) 26 (5) 0.57
Ventilator days 32.5 (11) 13 (1) 0.61
Ventilator Free days 9(15) 5(14.5) 0.67
P/F ratio† 179.57 ± 13.66 171 ± 39.04 0.60
PCO2, mmHg‡ 46.42 ± 7.43 48 ± 4.08 0.70
SOFA score§ 2.57 ± 0.97 2.75 ± 0.50 0.74
Neuromuscular relaxant Free
days 17(17) 13.5(23) 0.75
Corticosteroid use, days 15.1±3.3 20.2±5.6 0.08
Polymyxin use, days 7.8±5.3 7.5±3.5 0.90
Colchicine use, days 8.3±3.8 9.5±1.9 0.58
Random Blood Sugar, mg/dl 140.50 ± 7.78 188.50 ± 21.92 0.86
Lactate, mmol/L 1.57 ± 0.53 2.25 ± 0.50 0.06
CRP, mg/L||
92.50 ± 88.38 129 ± 152.73 0.50
LDH, Units/L** 641.50 ± 44.54 467.50 ± 567.80 0.24
Ferritin, ng/ml 565 ± 244.65 1042.50 ± 497.09 0.24
D-Dimer, ng/ml 2253 ± 654.78 2246 ± 2375.87 0.12
Survived (N= 7) Died (N= 4) P value
Re education, number
of days 16.29 ± 5.55 14.50 ± 4.12 0.59
Long Sitting, number of
days 10.43 ± 3.15 2.75 ± 3.09 0.007
Chair mobilization,
number of days 7.14 ± 1.95 2 ± 1.41 0.001
Standing, number of
days 3.43 ± 3.15 0 0.06
Survived
(N=7) Died (N=4) P value
Dependency, Total
(n,%) 1 (14.3%) 4 (100%) 0.02
Significant
(n,%) 5 (71.4%) 0
DISCUSSION:
One important finding in our case
series was the effect of protocol-based
physiotherapy interventions on
survival.
Physiotherapy

5. CONCLUSION:
In patients with COVID-19 related critical illness myopathy, use of protocol based
physiotherapy interventions leads to improved survival. Further studies with larger
population of cases are needed to draw a stronger conclusion.
REFERENCES: 1. Critical Illness Polyneuropathy and Myopathy in COVID-19 Patients: A Prospective Observational Intensive Care
Unit Cross-Sectional Cohort Study [Internet]. 2020 [cited 2021 Mar 18]. Available from: https://www.researchsquare.com.
2.Cabañes-Martínez L, Villadóniga M, González-Rodríguez L, Araque L, Díaz-Cid A, Ruz- Caracuel I, et al. Neuromuscular
involvement in COVID-19 critically ill patients. Clin Neurophysiol. 2020;131:2809–16.
TITLE:CRTICAL ILLNESS POLYMYOPATHY IN COVID 19 PATIENTS.
LIMITATIONS
Smaller sample size
Definitive diagnostic methods not used.