Shabat Sheer, Marmor Anat, Tsenter Jeanne, Shiri Shimon, Schwartz Isabella, Meiner Zeev
Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Harefuah. 2024 Sep;163(9):579-584.
The COVID-19 pandemic has long-lasting deleterious effects on many aspects of the survivors' life. However, the correlations between the severity of COVID-19 infection and rehabilitation outcomes are still unknown.
Sixty-one post-acute COVID-19 patients underwent a customized rehabilitation program in a rehabilitation daycare facility. The severity of the COVID-19 infection was measured according to the WHO clinical progression scale (CPS). Motor, cognitive, psychological and functional variables were measured using standard and specified scales; 19 out of 61 patients underwent nerve conduction studies.
The mean age of participants was 54 years (range 18-84 years), 66% were males, 65% had severe disease according to CPS. The mean length of acute hospitalization was 5.6 ± 4.2 weeks, mean rehabilitation time and mean follow up time was 3.2 ± 2.1 months and 7.2 ± 3.2 months, respectively. A significant improvement was found in activities of daily living (ADL) functions as well as in hand motor strength and walking endurance. A significant correlation was found between higher CPS, prolonged acute hospitalization and ventilation and lower admission functional independence measure (FIM), however no correlation was found between the parameters of acute diseases and FIM at discharge. Moreover, lower CPS was correlated with higher anxiety, depression and lower executive functions score. There was correlation between electrophysiological findings of the median and the peroneal nerves and the motor FIM at discharge.
A customized rehabilitation program can overcome initial motor, mental and cognitive impairments and significantly improves the motor function of covid-19 recovered patients. The results of this study highlight the importance of monitoring and treating the emotional status, particularly anxiety, of COVID-19 patients. Nerve conduction measurements in COVID-19 patients are important in order to evaluate prognosis and improvement in rehabilitation outcomes.
新冠疫情对幸存者生活的诸多方面产生了长期的有害影响。然而，新冠病毒感染的严重程度与康复结果之间的相关性仍不明确。
61名新冠康复后患者在康复日托机构接受了定制的康复计划。根据世界卫生组织临床进展量表（CPS）评估新冠病毒感染的严重程度。使用标准和特定量表测量运动、认知、心理和功能变量；61名患者中有19名接受了神经传导研究。
参与者的平均年龄为54岁（范围18 - 84岁），66%为男性，65%根据CPS患有严重疾病。急性住院的平均时长为5.6±4.2周，平均康复时间和平均随访时间分别为3.2±2.1个月和7.2±3.2个月。日常生活活动（ADL）功能以及手部运动力量和步行耐力有显著改善。发现较高的CPS、较长的急性住院时间和通气与较低的入院时功能独立性测量（FIM）之间存在显著相关性，但急性疾病参数与出院时的FIM之间未发现相关性。此外，较低的CPS与较高的焦虑、抑郁和较低的执行功能评分相关。正中神经和腓总神经的电生理检查结果与出院时的运动FIM之间存在相关性。
定制的康复计划可以克服最初的运动、心理和认知障碍，并显著改善新冠康复患者的运动功能。本研究结果凸显了监测和治疗新冠患者情绪状态，尤其是焦虑情绪的重要性。对新冠患者进行神经传导测量对于评估预后和康复结果的改善很重要。
