Rehabilitation of COVID-19 Patients in the Acute Hospital Setting: An Observational Retrospective Study
DOI:
https://doi.org/10.25759/spmfr.449Keywords:
COVID-19, Intensive Care Units, Physical Therapy Modalities, SARS-CoV-2Abstract
Introduction: COVID-19 has a wide clinical spectrum and, in severe cases, can lead to serious functional impairments. The role of Physical and Rehabilitation Medicine (PRM) in the subacute and chronic phases of this novel disease has become indisputable but remains unclear in the acute phase. Our aim was to describe the impact of a PRM intervention in acute COVID-19 patients.
Methods: Observational retrospective study of the COVID- 19 patients admitted to the ICU and Internal Medicine wards and referred for inpatient intervention by the PRM department of an acute care Portuguese hospital during April and May of 2020. Recommendations from the Portuguese Society of PRM regarding rehabilitation of COVID-19 patients in the intensive care unit (ICU) were followed. Two assessments were performed by a PRM physician: prior to the intervention and at discharge. Demographic data, comorbidities, Medical Research Council Sum Score (MRC-SS), handgrip dynamometry and Chelsea Critical Care Physical Assessment Tool (CPAx) were recorded in electronic health records and were afterwards retrieved for analysis.
Results: Twenty-two patients were eligible. Sixteen (72.7%) were male and six (27.3%) were female with a mean age of 65.36 ± 14.07 years old. Mean duration of hospitalization was 25.64 ± 10.25 days, with 18/22 patients being admitted to the ICU (mean of 11.39 days). At discharge, there was: a mean improvement of 16.96 points in MRC-SS; a difference in median handgrip dynamometry of 10.00 kg, (improvements in 21/22 patients); a difference in median CPAx total score of 24.00 points, (improvements in 21/22 patients); improvements in all CPAx subscores. All results were statistically significant (p<0.05). There were no adverse events in patients or infections in the PRM team.
Conclusion: A PRM intervention in the acute COVID-19 inpatient is safe both for patients and PRM team. It seems to have a positive effect on physical and functional status of the patients, reflected by improvements in all of the parameters evaluated.
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