Managing the Rehabilitation Wave: Rehabilitation Services for COVID-19 Survivors

Abstract

The COVID-19 pandemic is having a profound impact on the provision of medical care. As the curve progresses and patients are discharged the rehabilitation wave brings a high number of post-acute COVID-19 patients suffering from physical, mental, and cognitive impairments threatening their return to normal life. The complexity and severity of disease in patients recovering from severe COVID-19 infection require an approach that is implemented as early in the recovery phase as possible, in a concerted and systematic way. To address the rehabilitation wave, we describe a spectrum of interventions that start in the ICU and continue through all the appropriate levels of care. This approach requires organized rehabilitation teams including physical therapists, occupational therapists, speech-language pathologists, rehabilitation psychologists/neuropsychologists, and physiatrists collaborating with acute medical teams. Here, we also discuss administrative factors that influence the provision of care during the COVID-19 pandemic. The services that can be provided are described in detail to allow the reader to understand what services may be appropriate locally. We have been learning and adapting real-time during this crisis and hope that sharing our experience facilitates the work of others as the pandemic evolves. It is our goal to help reduce the potentially long-lasting challenges faced by COVID-19 survivors.

Long COVID and Health Inequities: The Role of Primary Care

“…Patients without concerning symptoms should be supported but spared overinvestigation and overmedicalization 6,16,17 . Those who have survived admission to an intensive care unit and those with preexisting respiratory, cardiovascular, or cerebrovascular disease are likely to require more specialized and prolonged rehabilitation 16,18,19 . Given the paucity of evidence, it is currently unclear which of these issues related to long COVID are directly related to or caused by the disease itself and which are unrelated but may be made more difficult to treat owing to COVID‐19 and its after‐effects.…”

Persistent Symptoms and Disability After COVID-19 Hospitalization: Data From a Comprehensive Telerehabilitation Program

“…Given the increasing number of cases and its potential disability rates, COVID-19 is placing an enormous strain on rehabilitation services worldwide. [11][12][13][14] To muster the appropriate resources to respond to this disability epidemic, rehabilitation services require data about frequency of persistent symptoms, disability rates, and rehabilitation referral needs in this population, which are currently scarce. 1 Identifying risk factors for disability is also important for an appropriate response plan.…”

Rehabilitation and physical activity for COVID-19 patients in the post infection period

“…Many patients suffer from postintensive care syndrome (PICS) after hospitalization in the intensive care unit. This syndrome causes a signifi cant decline in muscle strength, physical performance, myopathy, and in individual cases neuropathy, loss of muscle mass, lack of nutrition, as well as an impaired emotional and physical health (16,17). In addition to the post-intensive care syndrome, in the post-infection period patients also experience adverse symptoms.…”