From the Department of Physical Medicine and Rehabilitation, Sunnyview Rehabilitation Hospital, Schenectady, New York (SG, MBS); and James A. Eddy Research Institute, Sunnyview Rehabilitation Hospital, Schenectady, New York (EYH, AET).
Am J Phys Med Rehabil. 2023 Mar 1;102(3):206-213. doi: 10.1097/PHM.0000000000002059. Epub 2022 Jun 27.
Many survivors of severe or critical COVID-19 have required rehabilitation during the pandemic. The primary objective was to compare characteristics and outcomes of survivors of severe or critical COVID-19 admitted to the inpatient rehabilitation facility during the first two waves of the pandemic. Our secondary objective was to identify the factors contributing to functional dependence on admission, discharge, and length of stay.
This is a retrospective cohort study of 138 patients admitted to an inpatient rehabilitation facility in two waves after hospitalization for severe or critical COVID-19 illness between April 1, 2020, and May 3, 2021.
Inpatient rehabilitation facility patients in wave 2 had significantly greater functional independence (GG scores) on admission (52; interquartile range, 44-58 vs 41; interquartile range, 28-52), lower incidence of dysphagia and anemia. The patients in both waves experienced similar functional improvement efficiencies with a median GG score change of 3.6 per day and similar discharge GG scores. Neurological sequela (odds ratio, 0.12; P < 0.001) and anemia (odds ratio, 1.35; P < 0.002) were identified as independent predictors of functional independence on admission.
Patients with functional deficits after COVID-19 should be considered for acute inpatient rehabilitation as both patient cohorts benefited from their inpatient rehabilitation facility stays with similar length of stays (11-12 days) and discharge to home rates (88%-90%).
许多严重或危重新冠肺炎幸存者在大流行期间需要康复治疗。主要目的是比较大流行的前两个波次中入住住院康复设施的严重或危重新冠肺炎幸存者的特征和结局。我们的次要目标是确定导致入院时、出院时和住院时间出现功能依赖的因素。
这是一项回顾性队列研究,纳入了 2020 年 4 月 1 日至 2021 年 5 月 3 日期间因严重或危重新冠肺炎住院后分两波入住住院康复设施的 138 例患者。
第 2 波住院康复设施患者入院时的功能独立性(GG 评分)显著更高(52;四分位距,44-58 比 41;四分位距,28-52),且吞咽困难和贫血的发生率较低。两波患者的功能改善效率相似,中位 GG 评分每天变化 3.6,出院时 GG 评分相似。神经后遗症(比值比,0.12;P<0.001)和贫血(比值比,1.35;P<0.002)是入院时功能独立性的独立预测因素。
患有新冠肺炎后存在功能缺陷的患者应考虑进行急性住院康复治疗,因为两个患者队列都从住院康复设施治疗中获益,住院时间(11-12 天)和出院回家率(88%-90%)相似。