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European Journal of Physical and Rehabilitation Medicine 2021 Feb 10

DOI: 10.23736/S1973-9087.21.06699-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Midterm functional sequelae and implications in rehabilitation after COVID19. A cross-sectional study

Alessio BARICICH 1, 2 , Margherita B. BORG 1, 2, Daria CUNEO 1, 2, Emanuela CADARIO 3, Danila AZZOLINA 3, Piero E. BALBO 4, Mattia BELLAN 3, 5, Patrizia ZEPPEGNO 3, 6, Mario PIRISI 3, 5, Carlo CISARI 1, 2, on behalf of the NO-MORE COVID Group 

1 Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy; 2 Physical Medicine and Rehabilitation Department, Maggiore della Carità University Hospital, Novara, Italy; 3 Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; 4 Pneumology Department, Maggiore della Carità University Hospital, Novara, Italy; 5 Internal Medicine Department, Maggiore della Carità University Hospital, Novara, Italy; 6 Psychiatry Department, Maggiore della Carità University Hospital, Novara, Italy


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BACKGROUND: To date, COVID-19 has been mainly investigated concerning the acute and subacute phase implications and management. Meanwhile, few studies focused on the mid-term sequelae, which still remain largely unknown.
AIM: To assess the physical performance of COVID-19 survivors at 3 to 6 months from Hospital discharge.
DESIGN: A cross-sectional study focused on mid-term functional outcomes evaluation in COVID-19 survivors.
SETTING: Outpatients who had been previously hospitalized due to COVID-19 from March to May 2020 at the University Hospital of Novara (Italy).
POPULATION: We enrolled 204 patients, of which 60% were men, with the mean age of 57.9 years.
METHODS: Patients firstly underwent the Short Physical Performance Battery test (SPPB), which is composed of a series of physical tests assessing the lower limb function and the functional status of the subjects. Subsequently, based on SPPB results, patients' cardiorespiratory fitness performance was further investigated. Patients with normal SPPB score (SPPB > 10) underwent the 2-Minute Walking test (2MWT) whereas, in order to safely test the cardiorespiratory function, in patients with abnormal SPPB score (SPPB ≤ 10) the 1-Minute-Sit-to-Stand Test (1MSTST) was performed. It should be noted that the 1MSTST can be safely performed even by subjects with compromised walking ability.
RESULTS: Overall, 66 patients (32% of our sample) showed an impaired physical performance at 3 to 6 months after hospital discharge. In particular, 29 patients presented an SPPB score ≤ 10, and the 1MSTST confirmed this status in the whole group (100%) compared to the reference values for age and sex. Besides, among patients with a normal SPPB score, 37 showed a lower sex- and age-matched 2MWT score. Finally, a significant association between Intensive Care Unit hospitalization or mechanical ventilation and physical impairment was observed together with a significant association between the walking ability (measured with SPPB and 2MWT) and the number of comorbidities.
CONCLUSIONS: A residual physical and functional impairment was observed in COVID-19 survivors at mid-term evaluation after hospitalization.
CLINICAL REHABILITATION IMPACT: Considering the current COVID-19 epidemiology, we might expect a tremendous burden of disability in the next future. Thus, an appropriate clinical rehabilitation pathway must be implemented.


KEY WORDS: Coronavirus; Rehabilitation; Outcome assessment; COVID-19; Disability evaluation; Outpatients; Physical and rehabilitation medicine

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