Ambulatory Rehabilitation of Patients Hospitalized with SARS CoV‐2 Infections: Early Pandemic Experience in New York City and Boston

Abstract

The current COVID‐19 pandemic has rapidly affected a large number of people across the world. In the US, New York and Massachusetts were two states significantly affected early on in the pandemic. Many individuals infected with COVID‐19 require hospitalization and following discharge, a subset develop longer‐term rehabilitation needs. To address the ongoing rehabilitation needs in this growing population, multidisciplinary teams at academic centers in NYC and Boston designed and implemented post‐COVID outpatient clinical recovery programs. In this report, we describe the local development of the outpatient programs and characteristics of the initial patient cohort referred for evaluation. This article is protected by copyright. All rights reserved.

Outcomes of a COVID‐19 recovery program for patients hospitalized with SARS‐CoV‐2 infection in New York City: A prospective cohort study

“…5 As this large group of patients recovers from the acute phase of the illness, we expect to see significant residual deficits in strength and cardiopulmonary endurance. A virtual outpatient pulmonary rehabilitation program, which we have previously demonstrated to be feasible to develop and institute rapidly, 13 may be an intervention that is easily adoptable at other centers and would be expected to substantially decrease morbidity related to COVID-19. If a virtual program is unavailable or too technically challenging, our study also suggests that a home physical therapy program has similar benefits and could also help patients with prolonged COVID-19 symptoms.…”

“…An outpatient rehabilitation program was implemented to evaluate and treat persistent symptoms as well as to address the functional impairments after COVID-19 hospitalization. 13 Patients were referred to this program through discharging hospital teams and a remote patient monitoring program that our two affiliated hospitals used to follow patients after discharge. This is further described in our initial publication on designing our COVID-19 rehabilitation program.…”

“…This is further described in our initial publication on designing our COVID-19 rehabilitation program. 13 These medical teams identified patients with persistent symptoms and referred to our program for continued care with the following criteria: (1) discharge from the hospital with persistent symptoms of weakness, fatigue, shortness of breath that interfered with daily activities; (2) difficulty weaning from supplemental oxygenation; or (3) discharge from acute rehabilitation unit with need to continue physiatry-led care. Exclusion criteria included patients who were unable to participate in a virtual exercise program owing to safety concerns regarding their concurrent medical conditions.…”

When Disparities and Disabilities Collide: Inequities during the COVID‐19 Pandemic

“…However, we do not have published data on how COVID‐19 is affecting persons with disabilities who also belong to racial and ethnic minority groups. Steere and colleagues recently described the development of a telehealth post‐COVID‐19 rehabilitation program in New York City and Boston 8 . In their described experience, early in the pandemic, they cared for a high percentage of persons from racial and ethnic minority groups including a 35% Hispanic, 15% Black, and 33% White patient population via telehealth.…”

“…Steere and colleagues recently described the development of a telehealth post-COVID-19 rehabilitation program in New York City and Boston. 8 In their described experience, early in the pandemic, they cared for a high percentage of persons from racial and ethnic minority groups including a 35% Hispanic, 15% Black, and 33% White patient population via telehealth. With the troubling trend of increased risk of infection and mortality in people belonging to minority groups, there is reason to suspect that long-term health and functional outcomes are even more devastating for those with disabilities who come from communities of color.…”