{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:21:58Z","timestamp":1789050118938,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Survivors of severe COVID-19 (Coronavirus Disease 2019) frequently experience long-term functional impairment, a condition known as post-COVID syndrome. As these patients may eventually undergo surgical procedures, evaluating their functional capacity becomes essential for safe anesthetic management. The Duke Activity Status Index (DASI) is a validated, easy-to-administer tool that correlates with cardiopulmonary fitness and surgical risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate changes in functional capacity using DASI scores in patients who survived severe COVID-19, comparing pre- and post-infection performance, and to assess implications for perioperative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted including 31 patients with a history of severe COVID-19 requiring ICU (Intensive Care Unit) admission. DASI scores were collected before and after hospitalization due to COVID-19. Associations between DASI variation and clinical variables (e.g., presence of pleural effusion, duration of intubation, ICU stay) were also explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A marked decline in functional capacity was observed after COVID-19, with lower DASI scores post-infection. The presence of pleural effusion and ultrasound abnormalities were associated with more pronounced reductions in DASI scores. A strong correlation was found between duration of intubation and length of hospital stay, and between post-COVID DASI and percentage variation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe COVID-19 has a lasting impact on functional capacity as measured by DASI. These findings highlight the need for anesthesiologists to include functional assessments in the preoperative evaluation of patients with a history of severe COVID-19. Integrating DASI into routine pre-anesthetic workup may improve risk stratification and perioperative outcomes in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1623423","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T06:27:53Z","timestamp":1767335273000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional decline after severe COVID-19: duke activity status index for preoperative risk assessment"],"prefix":"10.3389","volume":"12","author":[{"given":"Luis Alberto Rodriguez","family":"Linares","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Cerillo","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1001\/jama.2020.12603","article-title":"Persistent symptoms in patients after acute COVID-19.","volume":"324","author":"Carf\u00ec","year":"2020","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome.","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.bpa.2020.10.002","article-title":"Anesthesia considerations in patients recovering from COVID-19.","volume":"35","author":"Cattano","year":"2021","journal-title":"Best Pract Res Clin Anaesthesiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1213\/ANE.000000000000599111","article-title":"Long-term outcomes in COVID-19 survivors following critical illness.","volume":"135","author":"Bui","year":"2022","journal-title":"Anesth Analg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1056\/NEJMoa1011802","article-title":"Functional disability 5 years after acute respiratory distress syndrome.","volume":"364","author":"Herridge","year":"2011","journal-title":"N Engl J Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1093\/eurheartj\/ehab724","article-title":"Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus.","volume":"43","author":"Raman","year":"2022","journal-title":"Eur Heart J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/0002-9149(89)90496-7","article-title":"A brief self-administered questionnaire to determine functional capacity (Duke Activity Status Index).","volume":"64","author":"Hlatky","year":"1989","journal-title":"Am J Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e29331","DOI":"10.1002\/jmv.29331","article-title":"Clinical and electrocardiographic correlates of myocardial dysfunction after COVID-19 in nonhospitalised patients in long-term follow-up. 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