Correlations between Disease Severity and Rehabilitation Outcomes in Patients Recovering from Covid-19 Infection

Abstract

Objective: Based on long-term follow-up of patients with COVID-19, to evaluate whether the severity of acute COVID-19 infection affects rehabilitation outcomes.Design: Observational cohort study.Subjects: A total of 61 post-acute COVID-19 patients underwent inpatient and outpatient customized rehabilitation treatment.Methods: The severity of acute COVID-19 infection was measured with the World Health Organization Clinical Progression Scale (WHO-CPS). Motor, cognitive, and functional variables were measured using standard and specified scales 6 months or more after acute illness.Results: Of the 61 subjects, 65.6% had severe disease according to WHO-CPS. Significant improvement was found in activities of daily living functions (Functional Independence Measure (FIM) at admission 103.7 ± 18.9 vs FIM at discharge 118.7 ± 6.8) (p < 0.00). Of participants, 88% were able to wean off oxygen completely. A significant correlation was found between higher WHO-CPS, prolonged acute hospitalization, and days of ventilation on the one hand, and lower total and motor FIM at admission, but not with cognitive FIM or Montreal Cognitive Assessment (MoCA). No correlation was found between these parameters and functional level at discharge.Conclusion: The severity of acute COVID-19 infection affects the functional status of survivors at admission to rehabilitation, but, contrary to expectations, not the functional outcomes at discharge. These findings emphasize the importance of customized multidisciplinary rehabilitation programmes for improving the daily functioning and wellbeing of patients with severe COVID-19.

Neurorecovery after Critical COVID-19 Illness

“…102 This is true even for patients who have the most severe illness at the time of admission to rehabilitation. 103 Rehabilitation hospitals and systems experienced substantial strain during the heights of the COVID-19 pandemic. 104 Given the multiorgan dysfunction often seen in COVID-19, the multidisciplinary rehabilitation team is critical for framing the ongoing impairments of recovering COVID-19 patients within the biopsychosocial rehabilitation model.…”