Chelsea physical assessment tool for evaluating functioning in post‐intensive care unit COVID‐19 patients

Sire, Alessandro de; Giray, Esra; Taşkıran, Özden Özyemişçi

doi:10.1002/jmv.26867

Cited by 9 publications

(14 citation statements)

References 12 publications

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Section: Introductionmentioning

confidence: 99%

“…5 One of the main causes of this failure was the lack of specialized workers and structures, particularly intensive care units and in the rehabilitation units overloaded by the recent pandemic due to the growing rehabilitation needs of COVID-19 patients. [6][7][8][9][10][11][12][13] Consequently, healthcare workers (HCWs) had to intensify their work shift to cope with this sanitary emergency 14 ; overwork and the small numbers of adequate personal protective equipment were associated with stress, 15 especially during the initial part of the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

“…The rapid spread of the infection and the severity of the COVID‐19 caused a partial collapse of the sanitary systems in many countries of the world 5 . One of the main causes of this failure was the lack of specialized workers and structures, particularly intensive care units and in the rehabilitation units overloaded by the recent pandemic due to the growing rehabilitation needs of COVID‐19 patients 6–13 …”

Section: Introductionmentioning

confidence: 99%

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Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Farì

Sire

Giorgio

et al. 2021

Journal of Medical Virology

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The COVID‐19 pandemic has had a strong impact on healthcare workers (HCWs), affecting their physical and mental health. In Italy, HCWs have been among the first exposed to unprecedented pressure, dealing with large numbers of infections during the first pandemic wave. However, the severe psychological consequences on HCWs find little evidence in the literature, especially in terms of comparison to the status quo ante pandemic. The aim of this study was to provide an assessment of the mental health burden in a cohort of Italian HCWs during the COVID‐19 pandemic, comparing their condition with that before the emergency, to direct the promotion of mental well‐being among HCWs worldwide. In this retrospective study, we included physicians, physical therapists, and nurses working in the Respiratory Intensive Care Unit, Neurology Unit, and Rehabilitation Unit from a Southern Italy University Hospital. All study participants underwent a battery of psychological tests, aimed at verifying their state of mental health during the COVID‐19 emergency and before it. Depressive, anxiety, and burnout symptoms were assessed using the following questionnaires: Maslach Burnout Inventory, Patient Health Questionnaire‐9 (PHQ‐9), and General Anxiety Disorder‐7. Depressive, anxiety, and burnout clinical relevance symptoms were present in HCWs during the COVID‐19 pandemic more than those before the emergency. Fifty percent of the HCWs obtained a score clinically significant during the emergency. Moreover, a depersonalization factor showed a statistically significant increase in average scores ( p < 0.0001). The PHQ‐9 scale showed that 47.1% of the operators reported depressive state presence. The number of operators scoring above the cut‐off for the anxiety scale tripled during the emergency ( p < 0.0001). The female gender conferred greater risks for depression. Taken together, the findings of this study showed that our sample of Italian HCWs showed a greater risk for depression, anxiety, and stress during the COVID‐19 pandemic. These data might be a starting point to plan mental health monitoring and prevention programs for HCWs, thus ensuring patients receive the best possible care performances even during healthcare crises such as the current pandemic.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Farì

Sire

Giorgio

et al. 2021

Journal of Medical Virology

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“… 15 , 16 , 17 , 18 , 19 Taken together, the advantages of CPAx has experts to advocate for its use specifically in the functional assessment of post‐ICU COVID‐19 patients. 5 …”

Section: Discussionmentioning

confidence: 99%

Physical recovery of COVID‐19 pneumosepsis intensive care survivors compared with non‐COVID pneumosepsis intensive care survivors during post–intensive care hospitalization: The RECOVID retrospective cohort study

Moonen

Strookappe

Zanten

2021

J Parenter Enteral Nutr

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Background. Coronavirus Disease 2019 pneumosepsis survivors are at a high risk of developing ICU acquired weakness (ICUAW), due to high incidence of acute respiratory distress syndrome and the common need for prolonged invasive ventilation. It remains unknown if regular post-pneumosepsis physical rehabilitation strategies are suitable for this extraordinary patient category.Methods. We retrospectively compared the physical recovery of COVID-19 and non-COVID pneumosepsis ICU survivors between ICU-and hospital discharge, defined as the difference in performance on the Medical Research Council Sum-Score (MRC-SS), Chelsea Critical Care Physical Assessment tool (CPAx), and percentage of predicted handgrip strength (POP-HGS). An ANCOVA model was built using age, sex, Barthel-index, BMI, admission APACHE-II score, adequacy of protein delivery during ICU stay and ward length of stay as covariates. Results. 35 COVID-19 ICU patients could be compared to 21 non-COVID pneumosepsis ICU survivors. All patients scored ≤48 on the MRC-SS at ICU discharge, indicating ICUAW. ICUAW had resolved in more COVID-19, than in non-COVID patients upon hospital discharge, although not significantly (52% vs. 22%, p=.081). When controlling for covariates, COVID-19 patients performed worse on all physical functioning assessments upon ICU discharge, but had improved more at hospital discharge on the MRC-SS (ɳ 2 =0.214, p=.002) and CPAx (ɳ 2 =0.153, p=.011). POP-HGS remained lower in COVID-19 patients throughout hospital stay. Conclusion. COVID-19 ICU-survivors are a vulnerable group concerning ICUAW, but they show better tendency towards physical rehabilitation than non-COVID pneumosepsis ICU-survivors during the post-ICU hospitalization period regarding MRC-SS and CPAx. COVID-19 ICU patients might benefit from early, more intensive physical therapy. Clinical Relevancy Statement. COVID-19 ICU survivors are at high risk for ICU-acquired weakness, which is well known to have immense personal and societal consequences. As the group of COVID-19 ICU survivors is

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“…Early rehabilitation therapy was commenced in the ICU, despite the patient being deeply sedated. There have been only a few reports, to date, on rehabilitation for patients with COVID-19 (6)(7)(8); however, there have been no reports on rehabilitation during deep sedation for patients with COVID-19 and underlying COPD. In this case report, we provide a practical report delineating information on early rehabilitation for patients with COVID-19 and COPD, the underlying disease, while in the ICU.…”

Section: Introductionmentioning

confidence: 99%

Case Report: A Rehabilitation Practice Report During ICU Management for a Patient With Multiple Disabilities Due to COVID-19 Pneumonia and COPD

et al. 2021

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Patients with severe coronavirus disease (COVID-19) and admitted to the intensive care unit (ICU) are at high risk of developing ICU-acquired weakness and disuse syndrome. Although their medical management may include prolonged deep sedation for pulmonary protection and ventilator management, we aim for early mobilization of these patients with COVID-19. We present the case of a 71-year-old man with chronic obstructive pulmonary disease (COPD) and COVID-19 pneumonia. Passive range of motion training and sitting on the edge of the bed were started in the ICU while the patient was under deep sedation. His activities of daily living eventually improved to where he could independently walk to the toilet without respiratory distress. Patients with severe COVID-19 who require mechanical ventilation are at risk of muscle weakness and exercise intolerance. These patients require rehabilitation therapy, beginning in the acute phase of illness, to recover their physical function. Although validation with a larger cohort is necessary, our results suggest that patients with COPD and COVID-19 pneumonia should undergo rehabilitation concurrently with status-driven changes in respiratory management.

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Chelsea physical assessment tool for evaluating functioning in post‐intensive care unit COVID‐19 patients

Cited by 9 publications

References 12 publications

Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Physical recovery of COVID‐19 pneumosepsis intensive care survivors compared with non‐COVID pneumosepsis intensive care survivors during post–intensive care hospitalization: The RECOVID retrospective cohort study

Case Report: A Rehabilitation Practice Report During ICU Management for a Patient With Multiple Disabilities Due to COVID-19 Pneumonia and COPD

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