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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 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.


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

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