Functional Outcome in an Inpatient Rehabilitation Setting After Post-Intensive Care Syndrome due to COVID-19: A Retrospective Study
DOI :
https://doi.org/10.25759/spmfr.491Mots-clés :
COVID-19/rehabilitation, Inpatients, Intensive Care Units, Recovery of FunctionRésumé
Introduction: Coronavirus disease 2019 (COVID-19) can cause acute respiratory distress syndrome and acute respiratory failure, requiring hospitalization. The complications and functional consequences of hospitalization at intensive-care units (ICU) are called post-intensive care syndrome (PICS). This study aimed to describe functional outcomes in patients with PICS due to COVID-19 and evaluate the factors that could influence or even predict these outcomes.Methods: This retrospective study included all patients admitted to an inpatient rehabilitation facility (IRF) following hospitalization for critical COVID-19. We recorded the potentially useful patient demographics and clinical characteristics.
Results: This study included 18 patients, most of them male, with a mean age of 60 years. We noted an important radiological pulmonary involvement by the disease in all patients, and most required oxygen supply upon admission to the IRF. The total functional independence measure (FIM) and medical research council sum scores (MRC-SS) significantly improved from admission to discharge. A higher percentage of radiological pulmonary involvement and a higher fraction of inspired oxygen (FiO2) at admission to the IRF were associated with greater FIM variation between admission and discharge. Additionally, a lower FIM at admission correlated with a greater variation in FIM during the IRF stay. A higher MRC-SS at discharge was associated with a higher FIM. Conversely, a greater need for oxygen support at discharge predicted a lower FIM score.
Conclusion: Inpatient rehabilitation was associated with significant motor and functional improvement in our sample. The functional recovery of our patients correlated more with radiological pulmonary involvement, the need for oxygen support, and the overall functionality at admission rather than with the muscle weakness. Cardiopulmonary condition at discharge, as expressed by FiO2, was more important than muscle strength in defining functional outcomes at discharge and even predicted FIM at discharge. According to our study, patients with more severe respiratory/pulmonary involvement by COVID-19 and lower levels of functional independence at admission may benefit the most from integrating an inpatient rehabilitation program into an acute/subacute IRF.
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