Department of Physical Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Eur Arch Psychiatry Clin Neurosci. 2024 Dec;274(8):1993-2001. doi: 10.1007/s00406-024-01862-4. Epub 2024 Jul 16.
Survivors of severe COVID-19 often exhibit a variety of sequelae including loss of mobility and ADL (activities of daily living) capacity. Acute rehabilitation (AR) is an interdisciplinary rehabilitation intervention applied early while still in a hospital setting. The goal of AR is to improve functional limitations and to increase functional independence at discharge. It is established in the treatment of patients with other severe diseases such as sepsis, polytrauma, or stroke. Data concerning AR in COVID-19 are sparse.
To evaluate the changes in physical function during AR in patients after severe COVID-19.
This monocentric, retrospective observational study examined the functional outcomes of a sample of COVID-19-patients who received interdisciplinary AR at a university hospital. Inclusion criteria were a positive SARS-CoV-2 test in 05/2020-01/2022 and transfer to AR after intensive care treatment. 87 patients were elegible for evaluation, 3 of whom were excluded because of death during AR. Data were extracted from the hospital information system. In a pre-post analysis, mobility (Charité Mobility Index), ADL (Barthel Index), and oxygen demand were assessed. In addition, discharge location after AR, factors associated with AR unit length of stay, and functional improvements were analyzed.
Data of 84 patients were analyzed. Mobility increased significantly from a median of 4 [1.25-6] CHARMI points at admission to a median of 9 [8.25-9] at discharge (p < 0.001). ADL increased significantly from a median of 52.5 [35.0-68.75] Barthel Index points at admission to a median of 92.5 [85-95] at discharge (p < 0.001). Oxygen demand decreased from 80.7 to 30.5% of patients. The majority (55.9%) of patients were discharged home, while 36.9% received direct follow-up rehabilitation. Older age correlated significantly with lower scores on the discharge assessment for mobility (Spearman's ϱ = -0.285, p = 0.009) and ADL (Spearman's ϱ = -0.297, p = 0.006).
Acute rehabilitation is a viable option for COVID-19 patients with severe functional deficits after ICU treatment to achieve functional progress in mobility and ADL, reduce oxygen requirements and enable follow-up rehabilitation. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION FOR PROSPECTIVELY REGISTERED TRIALS: Trial registration number: DRKS00025239. Date of registration: 08 Sep 2021.
严重 COVID-19 的幸存者通常会出现多种后遗症，包括丧失活动能力和日常生活活动能力。急性康复（AR）是一种在医院环境中早期应用的跨学科康复干预措施。AR 的目的是改善功能受限并在出院时提高功能独立性。它在治疗其他严重疾病（如败血症、多发伤或中风）方面已有既定应用。关于 COVID-19 中 AR 的数据很少。
评估严重 COVID-19 后接受 AR 患者的身体功能变化。
这项单中心、回顾性观察性研究检查了在一所大学医院接受跨学科 AR 的 COVID-19 患者样本的功能结果。纳入标准是 2020 年 5 月至 2022 年 1 月 SARS-CoV-2 检测呈阳性，并在重症监护治疗后转入 AR。87 例患者符合评估条件，其中 3 例因 AR 期间死亡而被排除。数据从医院信息系统中提取。在预-后分析中，评估了移动性（Charité 移动指数）、ADL（Barthel 指数）和氧气需求。此外，还分析了 AR 后的出院地点、与 AR 单元住院时间相关的因素以及功能改善情况。
对 84 例患者的数据进行了分析。移动性从入院时的中位数 4 [1.25-6] CHARMI 点显著增加到出院时的中位数 9 [8.25-9] （p<0.001）。ADL 从入院时的中位数 52.5 [35.0-68.75] Barthel 指数点显著增加到出院时的中位数 92.5 [85-95] （p<0.001）。氧气需求从 80.7%降至 30.5%。大多数（55.9%）患者出院回家，而 36.9%接受了直接后续康复治疗。年龄较大与移动性（Spearman's ϱ = -0.285，p=0.009）和 ADL（Spearman's ϱ = -0.297，p=0.006）出院评估得分较低显著相关。
急性康复是 ICU 治疗后严重功能缺陷 COVID-19 患者的可行选择，可实现移动和 ADL 方面的功能进展，降低氧气需求并能够进行后续康复治疗。
注册号：DRKS00025239。注册日期：2021 年 9 月 8 日。
