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European Journal of Physical and Rehabilitation Medicine 2020 August;56(4):515-24

DOI: 10.23736/S1973-9087.20.06317-0


language: English

COVID-19 pandemic. What should Physical and Rehabilitation Medicine specialists do? A clinician’s perspective

Stefano CARDA 1 , Marco INVERNIZZI 2, Ganesh BAVIKATTE 3, Djamel BENSMAÏL 4, Francesca BIANCHI 5, Thierry DELTOMBE 6, Nathalie DRAULANS 7, Alberto ESQUENAZI 8, Gerard E. FRANCISCO 9, Raphaël GROSS 10, Luis J. JACINTO 11, Susana MORALEDA PÉREZ 12, Michael W. O’DELL 13, Rajiv REEBYE 14, Monica VERDUZCO-GUTIERREZ 15, Jörg WISSEL 16, Franco MOLTENI 17

1 Service of Neuropsychology and Neurorehabilitation, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Lausanne, Switzerland; 2 Department of Health Sciences, University of Eastern Piedmont, Novara, Italy; 3 Neurorehabilitation Medicine, The Walton Centre NHS Foundation Trust, Liverpool, UK; 4 Department of Physical and Rehabilitation Medicine, R. Pointcaré Hospital, AP-HP Université Paris-Saclay, Team INSERM 1179, UFR de Santé Simone Veil, Université de Versailles Saint-Quentin, Versailles, France; 5 Unit of Neurophysiology, IRCCS San Raffaele Hospital, Milan, Italy; 6 Service of Physical Medicine and Rehabilitation, CHU UCL Namur site Godinne, Yvoir, Belgium; 7 Libra Revalidatie and Audiologie, Eindhoven, the Netherlands; 8 Department of Physical Medicine and Rehabilitation, MossRehab Gait and Motion Analysis Lab, Elkins Park, PA, USA; 9 Department of Physical Medicine and Rehabilitation, UTHealth McGovern Medical School, and TIRR Memorial Hermann Hospital, Houston, TX, USA; 10 Service de MPR Neurologique, CHU Nantes Hôpital Saint Jacques, Nantes cedex / EA 43334 laboratoire Motricité, Interactions, Performance - UFR STAPS Nantes, Nantes, France; 11 Service of Rehabilitation for Adults 3, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal; 12 Department of Physical Medicine and Rehabilitation, La Paz University Hospital, Madrid, Spain; 13 New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA; 14 Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada; 15 UT Health Science Center San Antonio, Department of Rehabilitation Medicine, San Antonio, TX, USA; 16 Unit of Neurological Rehabilitation and Physical Therapy, Department of Neurology with Stroke Unit, Vivantes Hospital Spandau, Berlin, Germany; 17 Valduce Hospital, Villa Beretta Rehabilitation Center, Costamasnaga, Lecco, Italy

COVID-19 pandemic is rapidly spreading all over the world, creating the risk for a healthcare collapse. While acute care and intensive care units are the main pillars of the early response to the disease, rehabilitative medicine should play an important part in allowing COVID-19 survivors to reduce disability and optimize the function of acute hospital setting. The aim of this study was to share the experience and the international perspective of different rehabilitation centers, treating COVID-19 survivors. A group of Physical Medicine and Rehabilitation specialists from eleven different countries in Europe and North America have shared their clinical experience in dealing with COVID-19 survivors and how they have managed the re-organization of rehabilitation services. In our experience the most important sequelae of severe and critical forms of COVID-19 are: 1) respiratory; 2) cognitive, central and peripheral nervous system; 3) deconditioning; 4) critical illness related myopathy and neuropathy; 5) dysphagia; 6) joint stiffness and pain; 7) psychiatric. We analyze all these consequences and propose some practical treatment options, based on current evidence and clinical experience, as well as several suggestions for management of rehabilitation services and patients with suspected or confirmed infection by SARS-CoV-2. COVID-19 survivors have some specific rehabilitation needs. Experience from other centers may help colleagues in organizing their services and providing better care to their patients.

KEY WORDS: COVID-19; Rehabilitation; Complications; Organization and administration

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