Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey.
Rheumatol Int. 2021 Dec;41(12):2167-2175. doi: 10.1007/s00296-021-05003-1. Epub 2021 Sep 27.
This study aimed to detect patients' characteristics who suffered severe and critical COVID-19 pneumonia admitted to the post-acute COVID-19 rehabilitation clinic in Ankara City Hospital, Physical Medicine and Rehabilitation Hospital and to share our experiences and outcomes of rehabilitation programmes applied. This study was designed as a single-centre, retrospective, observational study. Severe and critical COVID-19 patients, admitted to the post-acute COVID-19 rehabilitation clinic, were included in patient-based rehabilitation programmes, targeting neuromuscular and respiratory recovery. Functional status, oxygen (O) requirement and daily living activities were assessed before and after rehabilitation. Eighty-five patients, of which 74% were male, were analysed, with the mean age of 58.27 ± 11.13 and mean body mass index of 25.29 ± 4.81 kg/m. The most prevalent comorbidities were hypertension (49.4%) and diabetes mellitus (34.1%). Of the 85 patients, 84 received antiviral drugs, 81 low-molecular-weight heparin, 71 corticosteroids, 11 anakinra, 4 tocilizumab, 16 intravenous immunoglobulin and 6 plasmapheresis. 78.8% of the patients were admitted to the intensive care unit, with a mean length of stay of 19.41 ± 18.99 days, while those who needed O support with mechanic ventilation was 36.1%. Neurological complications, including Guillain-Barré syndrome, critical illness-related myopathy/neuropathy, cerebrovascular disease and steroid myopathy, were observed in 39 patients. On initial functional statuses, 55.3% were bedridden, 22.4% in wheelchair level and 20% mobilised with O support. After rehabilitation, these ratios were 2.4%, 4.7% and 8.2%, respectively. During admission, 71 (83.5%) patients required O support, but decreased to 7 (8.2%) post-rehabilitation. Barthel Index improved statistically from 44.82 ± 27.31 to 88.47 ± 17.56. Patient-based modulated rehabilitation programmes are highly effective in severe and critical COVID-19 complications, providing satisfactory well-being in daily living activities.
本研究旨在检测在安卡拉市医院、物理医学与康复医院的后急性 COVID-19 康复诊所接受重症和危重症 COVID-19 肺炎治疗的患者的特征，并分享我们应用康复方案的经验和结果。本研究设计为单中心、回顾性、观察性研究。将重症和危重症 COVID-19 患者纳入基于患者的康复方案，以实现神经肌肉和呼吸恢复为目标。在康复前后评估功能状态、氧气（O）需求和日常生活活动。共分析了 85 名患者，其中 74%为男性，平均年龄为 58.27±11.13 岁，平均体重指数为 25.29±4.81kg/m。最常见的合并症是高血压（49.4%）和糖尿病（34.1%）。85 名患者中，84 名接受了抗病毒药物治疗，81 名接受了低分子肝素治疗，71 名接受了皮质类固醇治疗，11 名接受了阿那白滞素治疗，4 名接受了托珠单抗治疗，16 名接受了静脉免疫球蛋白治疗，6 名接受了血浆置换治疗。78.8%的患者入住重症监护病房，平均住院时间为 19.41±18.99 天，需要机械通气支持氧气的患者为 36.1%。39 名患者出现神经系统并发症，包括吉兰-巴雷综合征、危重病相关肌病/神经病、脑血管病和类固醇肌病。在初始功能状态下，55.3%的患者卧床不起，22.4%的患者坐在轮椅上，20%的患者在吸氧支持下活动。康复后，这些比例分别为 2.4%、4.7%和 8.2%。住院期间，71 名（83.5%）患者需要氧气支持，但康复后降至 7 名（8.2%）。巴氏指数从 44.82±27.31 显著提高到 88.47±17.56。基于患者的调制康复方案对重症和危重症 COVID-19 并发症非常有效，可在日常生活活动中提供令人满意的幸福感。
