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European Journal of Physical and Rehabilitation Medicine 2020 May 19

DOI: 10.23736/S1973-9087.20.06317-0


lingua: Inglese

COVID-19 pandemic. What should PRM 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, 11, Luis J. JACINTO 12, Susana MORALEDA PÉREZ 13, Michael W. O’DELL 14, Rajiv REEBYE 15, Monica VERDUZCO-GUTIERREZ 16, Jörg WISSEL 17, Franco MOLTENI 18

1 Department of Clinical Neurosciences, Service of Neuropsychology and Neurorehabilitation, 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 Physical and Rehabilitation Medicine Department, R. Pointcaré Hospital, AP-HP Université Paris- Saclay, Team INSERM 1179, UFR de Santé Simone Veil, Université de Versailles Saint-Quentin, Versailles, France; 5 Neurophysiology Unit, IRCCS San Raffaele Scientific Institut,e Milan, Italy; 6 Service de Médecine Physique & Réadaptation, CHU UCL Namur Site Godinne, Yvoir, Belgium; 7 Libra Revalidatie & Audiologie, Eindhoven, the Netherlands; 8 Department of Physical Medicine & Rehabilitation, MossRehab Gait and Motion Analysis Lab, Elkins Park, PA, USA; 9 Department of Physical Medicine & 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, France; 11 EA 43334 Laboratoire Motricité, Interactions, Performance, UFR STAPS Nantes, France; 12 Serviço de Reabilitação de Adultos 3, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal; 13 Physical Medicine & Rehabilitation Department, La Paz University Hospital, Madrid, Spain; 14 New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA; 15 Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, BC, Canada; 16 UT Health Science Center San Antonio Department of Rehabilitation Medicine, San Antonio, TX, USA; 17 Neurological Rehabilitation & Physical Therapy, Department of Neurology with Stroke Unit, Vivantes Hospital Spandau, Berlin, Germany; 18 Valduce Hospital, Villa Beretta Rehabilitation Center, Costamasnaga, Lecco, Italy


BACKGROUND: COVID-19 pandemic is rapidly spreading all over the world, creating the risk for an 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.
AIM: To share the experience and the international perspective of different rehabilitation centers, treating COVID-19 survivors.
DESIGN: Not applicable.
POPULATION: COVID-19 survivors.
METHODS: A group of Physical Medicine & 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.
RESULTS: In our experience the most important sequelae of severe and critical forms of COVID-19 are: 1) respiratory; 2) cognitive, central and peipheral nervous system; 3) deconditioning; 4) critical illness related myopathy and neuropathy; 5) dysphagia; 6) joint stiffness and pain; 7) psychiatric.
CONCLUSIONS: 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.
CLINICAL REHABILITATION IMPACT: 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; Recommendations; Organization and administration

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