Characteristics and outcomes of COVID-19-positive individuals admitted for inpatient rehabilitation in Toronto, Canada

Journeay, W. Shane; Robinson, Lawrence R.; Titman, Rebecca; MacDonald, Shannon L

doi:10.2340/20030711-1000053

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…Patient-tailored rehabilitation was also endorsed by Ferraro et al, concluding that this is mandatory for reducing fatigue and improving functional outcome [ 65 ]. Motor-based FIM score improvements after COVID-19–positive individual rehabilitation were also reported by Journeay et al They noticed a relatively rapid improvement in mobility and motor function in many cases [ 66 ]. A study performed by Fundarò et al indicated that Lokomat training significantly improved the parameters provided by the Lokomat itself, as well as global and motor FIM scores [ 67 ].…”

Section: Discussionsupporting

confidence: 58%

Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study

Cevei

Onofrei

Gherle

et al. 2022

IJERPH

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The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients’ reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients’ musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19.

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Section: Discussionsupporting

confidence: 58%

Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study

Cevei

Onofrei

Gherle

et al. 2022

IJERPH

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“…Based on the analysis, there was no significant difference in baseline demographic and clinical characteristics identified to contribute to the risk of developing debilitated pulmonary symptoms when compared with the group without significant respiratory symptoms after COVID-19 infection. The clinical characteristics of the cohort of patients in this study did have a higher prevalence of obesity (100%), hypertension (70%–90%), and diabetes (>40%) than other published cohorts in Austria, 16 France, and United Kingdom, 17 but comparable with characteristics found in other cohorts in North America 18,19 …”

Section: Discussionsupporting

confidence: 77%

Efficacy of Early Inpatient Rehabilitation of Post COVID 19 Survivors-Single Center Retrospective Analysis

Cao

Barcikowski

Womble

et al. 2022

Am J Phys Med Rehabil

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The aim of this study was to understand the demographic, clinical characteristics, and effectiveness of early inpatient rehabilitation of post-COVID survivors. Design: A single-center retrospective chart review analysis of 100 patients admitted to a newly created acute COVID rehabilitation unit (CORE+) from April to December 2020 was conducted. Results: The demographic and clinical characteristics and complications of 100 post-COVID patients were reviewed. Functional outcomes of GG Self-care and Mobility Activities Items (Section GG0130 and GG0170) of the Centers for Medicare & Medicaid Services of the Inpatient Rehabilitation Facility Patient Assessment Instrument (Version 3.0) at admission and discharge, prevalence of oxygen requirement, the need for cognitive and neuropsychology support by discharge, and dispositions after completion of inpatient rehabilitation facility stay were analyzed. The functional outcomes of 59 primary pulmonary manifestations of COVID patients were further analyzed based on the presence of intensive care unit stay before transfer to the COVID rehabilitation unit. Most patients demonstrated significant functional gains after completion of inpatient rehabilitation facility stay; however, a considerable number of patients continued to require cognitive support by discharge. Conclusion:The data suggested the benefit of early rehabilitation for hospitalized post-COVID patients. Services need to be geared to include patients' cognitive deficits.

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“…21,22 Significant functional gains have been demonstrated by those recovering from severe COVID-19 in the inpatient rehabilitation setting. [23][24][25][26][27] Although outcomes data for outpatient rehabilitation a sparse, expert guidance statements recommend the cautious inclusion of rehabilitation in the comprehensive care of certain individuals with post COVID-19 condition. [9][10][11] One prospective, observational cohort study investigating the impact of outpatient rehabilitation on the functioning of individuals with post COVID-19 condition found that those who completed 8 weeks of rehabilitation reported significant improvement in motor function, respiratory muscle strength, fatigue, and overall quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…There has been an increasing call for specialized, comprehensive rehabilitation care to improve function, neuropsychiatric deficits, and quality of life among COVID‐19 survivors 21,22 . Significant functional gains have been demonstrated by those recovering from severe COVID‐19 in the inpatient rehabilitation setting 23–27 . Although outcomes data for outpatient rehabilitation a sparse, expert guidance statements recommend the cautious inclusion of rehabilitation in the comprehensive care of certain individuals with post COVID‐19 condition 9–11 .…”

Section: Discussionmentioning

confidence: 99%

Race, ethnicity, and utilization of outpatient rehabilitation for treatment of post COVID‐19 condition

Hentschel

Abramoff

Dillingham

et al. 2022

PM&R

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Introduction Outpatient rehabilitation is recommended in the treatment of post coronavirus disease 2019 (COVID‐19) condition. Although racial and ethnic disparities in the incidence and severity of COVID‐19 have been well documented, little is known about the use of outpatient rehabilitation among patients with post COVID‐19 condition. Objective To examine factors associated with outpatient rehabilitation use following COVID‐19 and to ascertain whether differential incidence of sequelae explain variation in post COVID‐19 rehabilitation utilization by race and ethnicity. Design Case–control study. Setting Community. Participants U.S. adults with COVID‐19 during 2020 in the TriNetX database. Intervention N/A. Main Outcome Measures Receipt of outpatient rehabilitation services within 6 months of COVID‐19 diagnosis and incidence of post COVID‐19 condition symptoms (weakness, fatigue, pain, cognitive impairment, mobility difficulties, and dyspnea). Results From 406,630 laboratory‐confirmed COVID‐19 cases, we identified 8724 individuals who received outpatient rehabilitation and matched 28,719 controls. Of rehabilitation users, 43.3% were 40 years old or younger, 54.8% were female, 58.2% were White, 17.9% were African American/Black, 2.1% were Asian, 13.0% were Hispanic, 39.2% had no comorbidities, and 40.3% had been hospitalized for COVID‐19. Dyspnea (20.4%), fatigue (12.4%), and weakness (8.2%) were the most frequently identified symptoms. Although there were no racial differences in the incidence of the six post COVID‐19 condition symptoms considered, African American/Black individuals were significantly less likely than their White counterparts to receive outpatient rehabilitation (odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.84–0.96; p = .003). Hispanic individuals had higher outpatient rehabilitation utilization (OR = 1.22; 95% CI: 1.11–1.33; p < .001) and a significantly higher incidence of post COVID‐19 fatigue. Conclusions In this large nationally representative study, African American/Black race was associated with lower utilization of outpatient rehabilitation services despite a similar incidence of post COVID‐19 condition symptoms. Further research is needed to better understand access barriers to rehabilitation services for post COVID‐19 condition recovery care and address racial inequalities in receipt of care.

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Characteristics and outcomes of COVID-19-positive individuals admitted for inpatient rehabilitation in Toronto, Canada

Cited by 7 publications

References 23 publications

Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study

Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study

Efficacy of Early Inpatient Rehabilitation of Post COVID 19 Survivors-Single Center Retrospective Analysis

Race, ethnicity, and utilization of outpatient rehabilitation for treatment of post COVID‐19 condition

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