Clinic for Rehabilitation Münster and Karl Landsteiner Institut für Interdisziplinäre Forschung am Reha Zentrum Münster, Münster, Austria.
Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria.
Eur J Phys Rehabil Med. 2021 Apr;57(2):189-198. doi: 10.23736/S1973-9087.21.06549-7. Epub 2021 Jan 15.
The Coronavirus Disease 2019 (COVID-19) pandemic increases the demand for postacute care in patients after a severe disease course. Various long-term sequelae are expected and rehabilitation medicine is challenged to support physical and cognitive recovery.
We aimed to explore the dysfunctions and outcome of COVID-19 survivors after early postacute rehabilitation.
Observational cohort study.
This study evaluated the postacute sequelae of patients hospitalized for SARS-CoV-2 infection and analyzed rehabilitative outcomes of a subgroup of patients included in the prospective observational multicenter CovILD study.
A total of 23 subjects discharged after severe to critical COVID-19 infection underwent an individualized, multiprofessional rehabilitation. At the start of postacute rehabilitation, impairment of pulmonary function (87%), symptoms related to postintensive care syndrome, and neuropsychological dysfunction (85%) were frequently found, whereas cardiac function appeared to be largely unaffected. Of interest, multi-disciplinary rehabilitation resulted in a significant improvement in lung function, as reflected by an increase of forced vital capacity (P=0.007) and forced expiratory volume in one second (P=0.014), total lung capacity (P=0.003), and diffusion capacity for carbon monoxide (P=0.002). Accordingly, physical performance status significantly improved as reflected by a mean increase of six-minute walking distance by 176 (SD±137) meters. Contrarily, a considerable proportion of patients still had limited diffusion capacity (83%) or neurological symptoms including peripheral neuropathy at the end of rehabilitation.
Individuals discharged after a severe course of COVID-19 frequently present with persisting physical and cognitive dysfunctions after hospital discharge. Those patients significantly benefit from multi-disciplinary inpatient rehabilitation.
Our data demonstrated the highly promising effects of early postacute rehabilitation in survivors of severe or critical COVID-19. This findings urge further prospective evaluations and may impact future treatment and rehabilitation strategies.
2019 年冠状病毒病（COVID-19）大流行增加了重症患者在疾病后期对康复护理的需求。预计会出现各种长期后遗症，康复医学面临着支持身体和认知康复的挑战。
我们旨在探讨 COVID-19 后早期康复后幸存者的功能障碍和结局。
观察性队列研究。
本研究评估了因 SARS-CoV-2 感染住院患者的急性后期后遗症，并分析了前瞻性观察性多中心 CovILD 研究中纳入的亚组患者的康复结果。
共有 23 名因严重至危重新冠肺炎感染出院的患者接受了个体化的多专业康复。在急性后期康复开始时，经常发现肺功能受损（87%）、与重症监护后综合征相关的症状和神经心理功能障碍（85%），而心脏功能似乎基本不受影响。有趣的是，多学科康复导致肺功能显著改善，用力肺活量（P=0.007）和一秒用力呼气量（P=0.014）、总肺容量（P=0.003）和一氧化碳弥散量（P=0.002）均增加。相应地，身体活动能力状况也显著改善，六分钟步行距离平均增加了 176 米（SD±137 米）。相反，相当一部分患者在康复结束时仍存在弥散量受限（83%）或神经症状，包括周围神经病。
从严重 COVID-19 病程中出院的个体在出院后经常出现持续的身体和认知功能障碍。这些患者从多学科住院康复中显著获益。
我们的数据表明，早期急性后期康复对严重或危重新冠肺炎幸存者具有非常有希望的效果。这些发现促使进一步进行前瞻性评估，并可能影响未来的治疗和康复策略。
