Functional outcome after inpatient rehabilitation in postintensive care unit COVID-19 patients: findings and clinical implications from a real-practice retrospective study

Eur J Phys Rehabil Med. 2021 Jun;57(3):443-450. doi: 10.23736/S1973-9087.20.06660-5. Epub 2021 Jan 4.

Abstract

Background: Coronavirus disease 2019 (COVID-19) pandemic is quickly spreading worldwide, with survivors that suffer functional impairments with a consequent key role of rehabilitation in this context. To date, there is a lack of findings on the role of rehabilitation in postacute COVID-19 patients.

Aim: Thus, we aimed at describing the role of a patient-tailored rehabilitation plan on functional outcome in hospitalized COVID-19 patients.

Design: Real-practice retrospective study.

Setting: Inpatients Rehabilitation Unit.

Population: Postacute COVID-19 patients.

Methods: Medical records of patients referred to an Italian COVID-19 Rehabilitation Unit from March 10th, 2020 to April 30th, 2020 were collected. All patients underwent a rehabilitative (30 minutes/set, 2 times/day), aimed to improve gas exchanges, reducing dyspnoea, and improving muscle function. At the admission (T0) and at the discharge (T1), we evaluated as outcome measures: Barthel Index (BI), modified Medical Research Council Dyspnea Scale, 6-Minute Walking Test (6-MWT) and Borg Rating of Perceived Exertion (RPE) scale. We also assessed: type of respiratory supports needed, pulmonary function, coagulation and inflammation markers and length of stay (LOS) in Rehabilitation Unit.

Results: We included 41 postacute COVID-19 patients (25 male and 19 female), mean aged 72.15±11.07 years. Their mean LOS in the Rehabilitation Unit was 31.97±9.06 days, as 39 successfully completed the rehabilitation treatment and 2 deceased. We found statistically significant improvement in BI (84.87±15.56 vs. 43.37±26.00; P<0.0001), 6-MWT (303.37±112.18 vs. 240.0±81.31 meters; P=0.028), Borg RPE scale (12.23±2.51 vs. 16.03±2.28; P<0.0001).

Conclusions: These findings suggest that postacute COVID-19 patients might beneficiate of a motor and respiratory rehabilitation treatment. However, further studies are advised to better understand long-term sequelae of the disease.

Clinical rehabilitation impact: This study provides evidence on the role of rehabilitation COVID-19 postacute inpatients through a patient-tailored treatment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / rehabilitation*
  • Female
  • Humans
  • Inpatients
  • Italy
  • Male
  • Middle Aged
  • Pandemics
  • Physical Therapy Modalities*
  • Pneumonia, Viral / rehabilitation*
  • Recovery of Function
  • Retrospective Studies
  • SARS-CoV-2
  • Walk Test