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Functional and Clinical Characteristics of Individuals Attending Pulmonary Rehabilitation After Severe COVID-19

Overview
Journal Respir Care
Publisher Mary Ann Liebert
Specialty Pulmonary Medicine
Date 2022 Sep 27
PMID 36167848
Authors
Affiliations
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Abstract

Background: A proportion of patients with COVID-19 need hospitalization due to severe respiratory symptoms. We sought to analyze characteristics of survivors of severe COVID-19 subsequently admitted to in-patient pulmonary rehabilitation and identify their rehabilitation needs.

Methods: From the COVID-19 Registry of Fondazione Don Gnocchi, we extracted 203 subjects admitted for in-patient pulmonary rehabilitation after severe COVID-19 from April 2020-September 2021. Specific information on acute-hospital stay and clinical and functional characteristics on admission to rehabilitation units were collected.

Results: During the acute phase of disease, 168 subjects received mechanical ventilation for 26 d; 85 experienced delirium during their stay in ICU. On admission to rehabilitation units, 20 subjects were still on mechanical ventilation; 57 had tracheostomy; 142 were on oxygen therapy; 49 were diagnosed critical illness neuropathy; 162 showed modified Barthel Index < 75; only 51 were able to perform a 6-min walk test; 32 of 90 scored abnormal at Montreal Cognitive Assessment; 43 of 88 scored abnormal at Hospital Anxiety and Depression Scale; 65 scored ≥ 2 at Malnutrition Universal Screening Tool, and 95 showed dysphagia needing logopedic treatment.

Conclusions: Our analysis shows that subjects admitted for in-patient pulmonary rehabilitation after severe COVID-19 represent an extraordinarily multifaceted and clinically complex patient population who need customized, comprehensive rehabilitation programs carried out by teams with different professional skills. The need for step-down facilities, such as sub-intensive rehabilitation units, is also highlighted.

References
1.
Holland A, Spruit M, Troosters T, Puhan M, Pepin V, Saey D . An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014; 44(6):1428-46. DOI: 10.1183/09031936.00150314. View

2.
Ceriana P, Vitacca M, Paneroni M, Belli S, Ambrosino N . Usefulness of step down units to manage survivors of critical Covid-19 patients. Eur J Intern Med. 2021; 88:126-128. PMC: 7936554. DOI: 10.1016/j.ejim.2021.03.002. View

3.
Gandotra S, Lovato J, Case D, Bakhru R, Gibbs K, Berry M . Physical Function Trajectories in Survivors of Acute Respiratory Failure. Ann Am Thorac Soc. 2018; 16(4):471-477. PMC: 6441696. DOI: 10.1513/AnnalsATS.201806-375OC. View

4.
LINN B, Linn M, GUREL L . Cumulative illness rating scale. J Am Geriatr Soc. 1968; 16(5):622-6. DOI: 10.1111/j.1532-5415.1968.tb02103.x. View

5.
Rodriguez-Morales A, Cardona-Ospina J, Gutierrez-Ocampo E, Villamizar-Pena R, Holguin-Rivera Y, Escalera-Antezana J . Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020; 34:101623. PMC: 7102608. DOI: 10.1016/j.tmaid.2020.101623. View