ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2021 June;57(3):443-50

DOI: 10.23736/S1973-9087.20.06660-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

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

Claudio CURCI ¹, Francesco NEGRINI ² ✉, Martina FERRILLO ³, Roberto BERGONZI ⁴, Eleonora BONACCI ⁵, Danila M. CAMOZZI ¹, Claudia CERAVOLO ⁴, Silvia DE FRANCESCHI ⁴, Rodolfo GUARNIERI ⁵, Paolo MORO ⁴, Fabrizio PISANO ¹, Alessandro De SIRE ^{6, 7}

¹ Unit of Neurorehabilitation, Policlinico San Marco, Gruppo San Donato, Zingonia, Bergamo, Italy; ² IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; ³ Department of Surgical Sciences, University of Turin, Turin, Italy; ⁴ Unit of Orthopedic Rehabilitation, Policlinico San Marco, Gruppo San Donato, Zingonia, Bergamo, Italy; ⁵ Unit of Pulmonary Rehabilitation, Policlinico San Marco, Gruppo San Donato, Zingonia, Bergamo, Italy; ⁶ Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy; ⁷ Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy

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 10^th, 2020 to April 30^th, 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.

KEY WORDS: COVID-19; SARS-CoV-2; Coronavirus; Rehabilitation; Physical and rehabilitation medicine