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COVID-19 幸存者的康复后考虑因素。

Considerations for Postacute Rehabilitation for Survivors of COVID-19.

机构信息

Bruyère Research Institute, Ottawa, ON, Canada.

出版信息

JMIR Public Health Surveill. 2020 May 8;6(2):e19462. doi: 10.2196/19462.

Abstract

Coronavirus disease (COVID-19), the infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported on December 31, 2019. Because it has only been studied for just over three months, our understanding of this disease is still incomplete, particularly regarding its sequelae and long-term outcomes. Moreover, very little has been written about the rehabilitation needs of patients with COVID-19 after discharge from acute care. The objective of this report is to answer the question "What rehabilitation services do survivors of COVID-19 require?" The question was asked within the context of a subacute hospital delivering geriatric inpatient and outpatient rehabilitation services. Three areas relevant to rehabilitation after COVID-19 were identified. First, details of how patients may present have been summarized, including comorbidities, complications from an intensive care unit stay with or without intubation, and the effects of the virus on multiple body systems, including those pertaining to cardiac, neurological, cognitive, and mental health. Second, I have suggested procedures regarding the design of inpatient rehabilitation units for COVID-19 survivors, staffing issues, and considerations for outpatient rehabilitation. Third, guidelines for rehabilitation (physiotherapy, occupational therapy, speech-language pathology) following COVID-19 have been proposed with respect to recovery of the respiratory system as well as recovery of mobility and function. A thorough assessment and an individualized, progressive treatment plan which focuses on function, disability, and return to participation in society will help each patient to maximize their function and quality of life. Careful consideration of the rehabilitation environment will ensure that all patients recover as completely as possible.

摘要

新型冠状病毒病(COVID-19)是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的感染,于 2019 年 12 月 31 日首次报告。由于对这种疾病的研究仅超过三个月,我们对其的了解仍不完整,尤其是在其后遗症和长期结果方面。此外,关于 COVID-19 患者在急性护理出院后的康复需求,几乎没有相关报道。本报告的目的是回答“COVID-19 幸存者需要哪些康复服务?”这一问题。该问题是在一家提供老年住院和门诊康复服务的亚急性医院背景下提出的。确定了与 COVID-19 后康复相关的三个领域。首先,总结了患者可能出现的情况,包括合并症、入住重症监护病房且有或无插管的并发症,以及病毒对包括心脏、神经、认知和心理健康等多个身体系统的影响。其次,我建议了有关 COVID-19 幸存者住院康复病房设计、人员配备以及门诊康复考虑因素的程序。第三,提出了 COVID-19 后康复(物理治疗、职业治疗、言语治疗)的指导方针,包括呼吸系统恢复以及活动能力和功能恢复。彻底的评估和以功能、残疾和重返社会参与为重点的个体化、渐进式治疗计划将帮助每位患者最大限度地提高其功能和生活质量。仔细考虑康复环境将确保所有患者尽可能完全康复。

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