Objective To determine the benefits associated with brief inpatient rehabilitation for Covid-19 patients. Design Retrospective chart review. Setting A newly created specialized rehabilitation unit in a tertiary care medical center Participants Consecutive sample of the first 100 patients with Covid-19 infection admitted to rehabilitation. Intervention Inpatient rehabilitation for post-acute care Covid-19 patients Main Outcome Measures Measurements, at admission and discharge, comprised a Barthel Activities of Daily Living Index (including baseline value before Covid-19 infection), time to perform 10 sit-to-stands with associated cardio-respiratory changes, and grip strength (dynamometry). Correlations between these outcomes and the time spent in ICU were explored. Results Patient characteristics upon admission to rehabilitation were: men 66%, age 66±22 years, mean delay from symptom onset 20.4±10.0 days, BMI 26.0±5.4 kg/m 2 , hypertension 49%, diabetes 29%, with 26% having >50% pulmonary damage on CT-scans. Mean length of rehabilitation stay was 9.8±5.6 days. From admission to discharge, the Barthel index (/100) increased from 77.3±26.7 to 88.8±24.5 ( p <0.001), without recovering baseline values (94.5±16.2; p <0.001). There was a 37% improvement in sit-to-stand frequency (0.27±0.16 to 0.37±0.16 Hz; p <0.001), a 13% decrease in post-test respiratory rate (30.7±12.6 to 26.6±6.1; p =0.03), and a 15% increase in grip strength (18.1±9.2 to 20.9±8.9 kg; p <0.001). At both admission and discharge, Barthel score correlated with grip strength (rho=0.39-0.66; p <0.01), which negatively correlated with time spent in ICU (rho=-0.57 to -0.49, p <0.05). Conclusions Inpatient rehabilitation for Covid-19 patients was associated with substantial motor, respiratory and functional improvement, especially in severe cases, even though there remained mild persistent autonomy loss upon discharge. Following acute stages, Covid-19, primarily a respiratory disease, might convert into a motor impairment correlated with the time spent in intensive care.

Background: Neurogenic lower urinary tract dysfunction (NLUTD) is frequent in multiple sclerosis (MS) and renal prognosis is a key point of bladder management.Objective: To assess upper urinary tract damage risk using voiding cystourethrography (VCUG) in patients with (PwMS) and NLUTD. Methods: We conducted a retrospective study between 2010 and 2020.Demographic data, urinary symptoms, urinary tract infection (UTI), renal ultrasounds findings, glomerular filtration rate (GFR), VCUG data, and urodynamic parameters were collected in PwMS with NLUTD.Results: Among 325 PwMS included, 67% were female, mean age was 51.6 ± 12.0 years, and mean EDSS 4.6 ± 1.8. VCUG showed vesicoureteral reflux (VUR) in 18 patients. A link was found between VUR and progressive MS course (p = 0.04), hydronephrosis (odds ratio [OR] = 17.44; 95% confidence interval [CI] = 3.46-87.87; p = 0.001), low GFR (p < 0.001), and detrusor overactivity (p = 0.04). No association with UTIs, EDSS, detrusor sphincter dyssynergia, were elicited. On multivariate analysis, alteration of GFR was independently related to the presence of VUR (OR = 0.95; 95% CI = 0.92-0.98). Conclusions: VUR elicited on VCUG is associated with lower GFR and hydronephrosis. However, due to the low prevalence (5.5%) of this abnormality in PwMS, VCUG should be performed in selected cases and not in routinary practice.