From the University College London, London, United Kingdom (FMB); Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi (FMB, JR, BM); College of Medicine, University of Malawi, Physiotherapy Department, Blantyre, Malawi (EC); Liverpool School of Tropical Medicine, Liverpool, United Kingdom (JR, BM); and Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom (BM).
Am J Phys Med Rehabil. 2021 Mar 1;100(3):209-212. doi: 10.1097/PHM.0000000000001666.
Postacute COVID-19 patients are at risk of long-term functional impairment, and the rehabilitation community is calling for action preparing for a "tsunami of rehabilitation needs" in this patient population. In the absence of standard guidelines and local evidence, a 3-wk pulmonary telerehabilitation program was successfully delivered to a postacute severe COVID-19 patient in Malawi. The patient experienced persistent dyspnea and fatigue, with a remarkable impact on his health status. On the final assessment, all his respiratory severity scores had fallen by more than their thresholds for clinical significance. He reported no continued or new complaints, was walking longer distances, had returned to work, and was discharged from follow-up. Our case shows that an improvised pulmonary telerehabilitation program for postacute COVID-19 patients could be feasible and acceptable in a low-resource setting. Benefits include reducing risk of transmission and use of personal protective equipment.
急性新冠病毒感染后患者存在长期功能损害的风险,康复医学领域呼吁行动起来,为这一患者群体的“康复需求海啸”做好准备。由于缺乏标准指南和当地证据,马拉维成功为一名急性新冠病毒感染后患者实施了为期 3 周的远程肺部康复计划。该患者持续存在呼吸困难和疲劳,对其健康状况产生了显著影响。在最终评估时,他所有的呼吸严重程度评分都下降了超过其具有临床意义的阈值。他报告没有持续或新的不适,行走距离更长,已返回工作岗位,且已停止随访。我们的病例表明,在资源匮乏的环境中,为急性新冠病毒感染后患者实施的临时性远程肺部康复计划可能是可行且可接受的。该计划的益处包括降低传播风险和减少个人防护设备的使用。