Standardization use of the International Classification of Functioning, Disability and Health in the Determination of Health State in Patients with Post-Acute-COVID-19 Syndrome submitted to a cardiorespiratory rehabilitation program
International Classification of Functioning, Disability and Health; Post Acute COVID19 Syndrome; Rehabilitation; Disability Evaluation; Psychosocial Functioning.
Introduction: Post-Acute COVID-19 Syndrome (PASC) is characterized by the persistence of symptoms beyond the acute phase. Literature emphasizes the need for in-depth investigation to understand the demands in this population. The International Classification of Functioning, Disability, and Health (ICF) is a crucial tool to assess the functional impact of these sequelae, providing a comprehensive view of health components. However, ICF underuse persists due to a lack of standardization in its application. Objectives: To describe the functional profile of patients with PASC based on the ICF undergoing a cardiorespiratory rehabilitation program. To assess inter-rater agreement in linking evaluation instruments and complementary exams to ICF codes. To compare the effects before and after a cardiorespiratory rehabilitation program using ICF qualifiers. Materials and Methods: This retrospective study that used records from 52 patients undergoing rehabilitation. The study comprised three stages: 1) linking instruments and clinical measures to ICF codes by two evaluators independently; 2) Inter-rater agreement using Kappa coefficient and resolution of discrepancies between the raters; 3) Qualification of codes based on established qualification standards for each instrument or clinical measure and comparing qualifiers before and after rehabilitation. Results: The instrument with the lowest agreement was anxiety and depression (k=0.57). Forty ICF codes were linked to instruments and clinical measures. The fatigue instrument exhibited a higher degree of impairment, from severe to complete, in the linked codes. No statistically significant differences were observed in qualifiers before and after rehabilitation in codes b4552 (p=0.096), d920 (p=0.198), b1603 (p=0.251), b1264 (p=0.40), d2 (p=0.20), d163 (p=0.20), b1600 (p=0.20), b1601 (p=0.20), b1263 (p=0.14). Conclusion: Patients with PASC presents disabilities in respiratory, emotional, and aerobic functions, resulting in limitations in daily activities and restrictions in social participation. Cardiorespiratory rehabilitation shows improvements in certain aspects. Inter-rater agreement in linking instruments to the ICF suggests moderate to good agreement. Further studies are necessary to establish functional measurement as a practical indicator in healthcare services.