Capacidade funcional de indivíduos pós COVID19 crítica sob a perspectiva dos atores sociais

Abstract

The COVID-19 pandemic, caused by SARS-CoV-2, has generated persistent impacts on health, functionality, and social participation, particularly among critically ill patients. In Brazil, structural inequalities have exacerbated morbidity, mortality, and post-infection reintegration challenges. This exploratory and descriptive case study analyzed 13 survivors of critical COVID-19 treated at the Hospital de Clínicas de Itajubá (MG) between 2020 and 2025, all of whom underwent orotracheal intubation and invasive mechanical ventilation. The sample was predominantly male (69.23%), aged 51–60 years (38.46%), and married or in stable unions (61.53%). High prevalence of pre-existing comorbidities was observed, especially systemic arterial hypertension (30.77%) and diabetes mellitus (23.08%), along with post-infection psychiatric disorders (38.46%) and persistent sequelae (46.15%), mainly musculoskeletal, neurological, and respiratory. Average hospital stay was 18.82 days in the ward and 19.22 days in the ICU. SF-36 scores indicated positive perception in General Health (89.74) and Mental Health (79.15), while Emotional Role (40.38) and Social Functioning (56.00) were the most affected domains. Significant associations were found between pre-existing comorbidities and lower Physical Functioning scores (p = 0.020) and between monthly income and General Health (p = 0.046), with trends involving vaccination history and Mental Health (p = 0.050) and sequelae and Vitality (p = 0.075). Analysis based on the International Classification of Functioning, Disability and Health (ICF) demonstrated that post-critical COVID-19 disability results from the interaction of functional deficits, activity limitations, participation restrictions, and contextual factors such as education, occupation, and social support. Rehabilitation for this population should be multidisciplinary, continuous, and personalized, encompassing functional recovery, psychosocial support, mental health care, and reduction of healthcare access inequalities. These findings provide evidence to support public policies and rehabilitation programs aimed at promoting full functionality and social inclusion, highlighting the need for future studies with larger samples to further explore and validate observed associations.