Pulmonary Rehabilitation of a Critically Ill Patient with Severe COVID-19: A Case Report

Abstract

Coronavirus 19 disease (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This is a case of a previously healthy 61-year-old man who presented to the emergency department with progressive dyspnea and a confirmed COVID-19 test, who was critically ill with severe acute respiratory distress syndrome. The principles of pulmonary rehabilitation were implemented starting from the sixth hospital day (time of referral from the intensive care unit) until he was transferred to a non-COVID ward and discharged. The patient participated in six treatment sessions while admitted, with each session lasting nearly 30 minutes. His Barthel index score improved from 0 (total dependence) to 85/100 (modified independence), with improvements in pulmonary secretions, shortness of breath, rate of perceived exertion, muscle strength, and endurance. He was able to return to work after three months. The application of the principles of pulmonary rehabilitation for critically ill patients with severe COVID-19 helped improve the cardiopulmonary, cognitive, and functional aspects of the patient throughout the course of hospital admission and beyond discharge.