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European Journal of Physical and Rehabilitation Medicine 2021 Jan 15

DOI: 10.23736/S1973-9087.21.06549-7


lingua: Inglese

Beneficial effects of multi-disciplinary rehabilitation in post-acute COVID-19 - an observational cohort study

Bernhard PUCHNER 1, 2, Sabina SAHANIC 2, Rudolf KIRCHMAIR 1, Alex PIZZINI 2, Bettina SONNWEBER 3, Ewald WÖLL 3, Andreas MÜHLBACHER 1, Katja GARIMORTH 1, Bernhard DAREB 1, Rainer EHLING 1, Johanna WENTER 1, Sybille SCHNEIDER 1, Christian BRENNEIS 1, Günter WEISS 2, Ivan TANCEVSKI 2, Thomas SONNWEBER 2 , Judith LÖEFFLER-RAGG 2

1 Clinic for Rehabilitation Münster and Karl Landsteiner Institut für Interdisziplinäre Forschung am Reha Zentrum Münster, Münster, Austria; 2 Department of Internal Medicine II, Medical University Innsbruck, Austria; 3 Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria


BACKGROUND: The Corona Virus Disease 2019 (COVID-19) pandemic increases the demand for post-acute care in patients after a severe disease course. Various longterm sequelae are expected and rehabilitation medicine is challenged to support physical and cognitive recovery.
AIM: We aimed to explore the dysfunctions and outcome of COVID-19 survivors after early post-acute rehabilitation.
DESIGN: Observational cohort study.
METHODS: This study evaluated the post-acute sequelae of patients hospitalized for SARS-Cov-2 infection and analyzed rehabilitative outcomes of a subgroup of patients included in the prospective observational multicenter CovILD study.
RESULTS: A total of 23 subjects discharged after severe to critical COVID-19 infection underwent an individualized, multi-professional rehabilitation. At the start of post-acute rehabilitation, impairment of pulmonary function (87%), symptoms related to postintensive care syndrome, and neuropsychological dysfunction (85%) were frequently found, whereas cardiac function appeared to be largely unaffected. Of interest, multidisciplinary rehabilitation resulted in a significant improvement in lung function, as reflected by an increase of forced vital capacity (p=0.007) and forced expiratory volume in one second (p=0.014), total lung capacity (p=0.003), and diffusion capacity for carbon monoxide (p=0.002). Accordingly, physical performance status significantly improved as reflected by a mean increase of six-minute walking distance by 176 (SD ± 137) meters. Contrarily, a considerable proportion of patients still had limited diffusion capacity (83%) or neurological symptoms including peripheral neuropathy at the end of rehabilitation. CONCLUSIONS: Individuals discharged after a severe course of COVID-19 frequently present with persisting physical and cognitive dysfunctions after hospital discharge. Those patients significantly benefit from multi-disciplinary inpatient rehabilitation.
CLINICAL REHABILITATION IMPACT: Our data demonstrate the highly promising effects of early post-acute rehabilitation in survivors of severe or critical COVID-19. This finding urges the need for further prospective evaluations and may impact future treatment and rehabilitation strategies.

KEY WORDS: COVID-19; Rehabilitation; Lung function; Performance status

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