Rehabilitation and COVID-19: the Cochrane Rehabilitation 2020 rapid living systematic review

Ceravolo, Maria Gabriella; Arienti, Chiara; Sire, Alessandro de; Andrenelli, Elisa; Negrini, Francesco; Lazzarini, Stefano Giuseppe; Patrini, Michele; Négrini, Stefano

doi:10.23736/s1973-9087.20.06501-6

Cited by 106 publications

(77 citation statements)

References 52 publications

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“…[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. ICU admission correlates to more severe disease and prevalent disability rates in those hospitalized because of COVID-19.…”

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confidence: 99%

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

Leite¹,

Rampim²,

Jorge³

et al. 2021

Archives of Physical Medicine and Rehabilitation

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Objective To report symptoms, disability and rehabilitation referral rates after COVID-19 hospitalization in a large, predominantly elderly population Design Cross-sectional study, with post-discharge telemonitoring of individuals hospitalized with confirmed COVID-19, at the first month after hospital discharge, as part of a comprehensive telerehabilitation program Setting Private verticalized healthcare network specialized in the elderly population Participants Individuals hospitalized due to COVID-19 Interventions Not applicable Main Outcome Measure(s) Dependence for basic and instrumental activities of daily living (ADLs and IADLs, respectively) using Barthel's Index and Lawton's Scale. We compared the outcomes between participants admitted to the intensive care unit (ICU) vs. those admitted to the ward. Results We included 1,696 consecutive patients, aging 71.8±13.0 years-old, with 56.1% of females. Comorbidities were present in 82.3% of the cases. Participant were followed up for 21.8±11.7 days after discharge. During post-discharge assessment, independence for ADLs was found to be lower in the group admitted to the intensive care unit (ICU) than the ward group (61.1% [95%CI 55.8-66.2%] vs. 72.7% [95%CI 70.3-75.1], p<0.001). Dependence for IADLs was also more frequent in the ICU group (84.6%, 95%CI [80.4-88.2%], vs. 74.5%, [95%CI 72.0-76.8%], p<0.001). Individuals admitted to ICU required more oxygen therapy (25.5% vs 12.6%, p<0.001), presented more shortness of breath during routine (45.2% vs 34.5%, p<0.001) and non-routine activities (66.3% vs 48.2%, p<0.001), had more difficulty standing up for 10 minutes (49.3% vs 37.9% p<0.001). The rehabilitation treatment plan consisted mostly of exercise booklets, which were offered to 65.5% of participants. The most referred rehabilitation professionals were psychologists (11.8%), physical therapists (8.0%), dietitians (6.8%), and speech-language pathologists (4.6%). Conclusions Individuals hospitalized due to COVID-19 present high levels of disability, dyspnea, dysphagia, and dependence for both ADLs and IADLs. Those admitted at the ICU presented more advanced disability parameters.

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mentioning

confidence: 99%

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

Leite¹,

Rampim²,

Jorge³

et al. 2021

Archives of Physical Medicine and Rehabilitation

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“…The swallow process is inherently interconnected with the respiration systems [38]. Mechanical damage due to intubation or issues of respiratory-swallow coordination will need addressing in long-term rehabilitation efforts [39]. People with COVID-19 related and unrelated dysphagia will need care [40].…”

Section: Clinical Significancementioning

confidence: 99%

Is Dysphagia Under Diagnosed or is Normal Swallowing More Variable than We Think? Reported Swallowing Problems in People Aged 18–65 Years

Leslie

Smithard

2020

Dysphagia

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Purpose Dysphagia prevalence in younger community dwelling adults and across nations is sparse. We investigated the prevalence of swallowing problems in an unselected cohort of people aged 18–65 years. Methods The EAT-10 Assessment Tool was converted into an anonymized online survey. Invitations were e-mailed to author contacts and onwards dispersal encouraged. Analysis was performed using non-parametric test for group comparison (Mann–Whitney U) and Spearman’s rho correlation. Results From March 2014 to October 2017: 2054 responses (32 reported ages outside of 18–65 or undeclared) from Africa, Asia, Australasia/Oceania, Europe, and North and South America. Responses: 1,648 female, 364 male, (10 reported as both), median age 34, (range 18–65, mean 37.12, SD 12.40) years. Total EAT-10 scores: median 0 (range 0–36, mean 1.57, SD 3.49). EAT-10 score ≥ 3 (337) median 5 (range 3–36, mean 7.02 SD 5.91). Median age 36 (range 19–65, mean 37.81, SD 13.21) years. Declared sex was not statistically significantly associated with non-pathological vs. pathological EAT-10 score (p = 0.665). Female scores (median 0.00, mean 1.56, SD 3.338) were significantly higher than for males (median 0.00, mean 1.62, SD 4.161): U (Nfemale = 1648, Nmale = 364) = 275,420.000, z = − 2.677, p = 0.007. Age and EAT-10 score were not associated: females rs = − 0.043, p = 0.079, N = 1648, males rs = − 0.003, p = 0.952, N = 364. Considerable impact on people: “I take ages to eat a main course … This is embarrassing and I often leave food even though I am still hungry.” (no diagnosis, EAT-10 = 17). Conclusion Concerns regarding swallowing exist in people undiagnosed with dysphagia, who may feel uncomfortable seeking professional help. Dysphagia may be under reported resulting in a hidden population. Subtle changes are currently seen as subtle markers of COVID-19. Further work is required to ensure that what is an essentially normal swallow does not become medicalized.

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“…However, the field of rehabilitation, which is highly relevant to the care of patients with COVID-19, has lagged behind during the emergency (5). Only limited high-quality evidence has emerged thus far compared to other medical fields (6,7). Of further concern are the persistent gaps in specific areas of rehabilitation research to guide clinical care and service organization for patients with COVID-19 (6,7).…”

Section: Introductionmentioning

confidence: 99%

“…Only limited high-quality evidence has emerged thus far compared to other medical fields (6,7). Of further concern are the persistent gaps in specific areas of rehabilitation research to guide clinical care and service organization for patients with COVID-19 (6,7). It is evident that both greater advocacy and support for rehabilitation research relating to COVID-19 are required, as well as stronger coordination to ensure that all areas of enquiry are addressed (8,9).…”

Section: Introductionmentioning

confidence: 99%

“Rehabilitation Research Framework for Patients With COVID-19” Defined by Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme

Négrini

Mills

Arienti

et al. 2021

Archives of Physical Medicine and Rehabilitation

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The COVID-19 pandemic resulted in surge of research activity. Since its outset, efforts have been made to guide the rapid generation of research in medicine. There are gaps in some areas of rehabilitation research for patients with COVID-19. The development of a specific research framework might serve to help monitor the status of research (mapping), shape and strengthen research by pointing to under-investigated areas, and promote rehabilitation research in this context. This paper introduces and discusses the COVID-19 Rehabilitation Research Framework (CRRF) and presents the methodology used for its development. The questions have been developed among the World Health Organization Rehabilitation Programme, Cochrane Rehabilitation and the experts of its REH-COVER (Rehabilitation – COVID-19 Evidence-based Response) Action International Multiprofessional Steering Committee. The framework is divided into two parts and includes 20 questions organized in four groups: epidemiology, and evidence at the micro- (individual), meso- (health services) and macro- (health systems) level. The CRRF offers a comprehensive view of the research areas relevant to COVID-19 and rehabilitation that are necessary to inform best practice and ensure rehabilitation services and health systems can best serve the COVID-19 population. The collaboration between Cochrane Rehabilitation and the WHO Rehabilitation Programme in establishing the CRRF brought together perspectives from the health systems, health management and clinical evidence. The authors encourage researchers to use the CRRF when planning studies on rehabilitation in the context of COVID-19.

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Rehabilitation and COVID-19: the Cochrane Rehabilitation 2020 rapid living systematic review

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Cited by 106 publications

References 52 publications

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

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

Is Dysphagia Under Diagnosed or is Normal Swallowing More Variable than We Think? Reported Swallowing Problems in People Aged 18–65 Years

“Rehabilitation Research Framework for Patients With COVID-19” Defined by Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme

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