Functional outcomes and post‐discharge care sought by patients with COVID‐19 compared to matched controls after completing inpatient acute rehabilitation

Abstract

Introduction: A subset of patients with coronavirus disease 19 (COVID-19) can develop severe illness, resulting in significant functional and cognitive deficits that require acute inpatient rehabilitation. Guidelines following discharge from acute inpatient rehabilitation have not yet been established. This study seeks to establish outcomes of rehabilitation patients with COVID-19 and characterize their need for long-term care. Objective: To determine the functional outcomes and utilization of follow-up medical care for patients with COVID-19 90 days following discharge from acute inpatient rehabilitation, as compared to rehabilitation impairment and age-matched controls. Design: Prospective, single-center cohort study. Setting: Inpatient rehabilitation facility (IRF). Patients: Sixty-four patients recovering from COVID-19 and 64 age and impairment group category controls were identified to answer survey questions following discharge from inpatient rehabilitation. A total of 36 patients participated in the study (18 patients with COVID-19 and 18 controls). Interventions: Not applicable. Main Outcome Measure(s): Functional outcomes at discharge (GG Self-Care and Mobility Activities items of the IRF-PAI Version 3.0), hospital readmissions, and follow-up care sought by patients. Results: The COVID-19 patient group had similar improvements in functional outcomes as compared to controls. Patients with COVID-19 required fewer 0-90 day readmissions than their matched controls (22.2% vs 61.1%, P < .05), but there were no differences in 0-90 day urgent care/emergency department visits, clinic visits and use of outpatient therapies. Conclusions: Patients with functional deficits as a result of COVID-19 who require multiple therapy disciplines should be considered for acute inpatient rehabilitation as this study demonstrates their ability to participate in and benefit from IRF level care.

Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis

“…In the manual search of gray literature and preprints, 18 potentially related papers were included. After reviewing the titles and abstracts of the articles, 157 peer-reviewed papers or preprinted manuscripts were reviewed and a total of 91 articles were entered into the present meta-analysis [ 8 , [14] , [15] , [16] , [17] , [18] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] ,…”

Risk factors and preventive interventions for post Covid-19 condition: systematic reviews

“…Interventions identified as potentially preventing post Covid-19 condition included standard medication (14, 19, 36, 41, 47, 50, 56-59), traditional/ayurvedic medication (52, 53), stem cell therapy (49), rehabilitation or similar therapies (46, 51, 54), and screening and referrals (48, 55). We grouped interventions by timing, as those implemented during acute (symptom onset to 4 weeks) phase of Covid-19 with outcomes assessed at shorter (12-16 weeks) or longer (>16 weeks) follow-up duration post Covid-19; and interventions implemented during early post-acute (4-8 weeks) phase of Covid-19 with aforementioned shorter and longer follow-up time ( Table 3 ).…”

“…We identified 3,595 records from searching databases and 186 records from other sources; 18 unique records, including 8 studies identified through the KQ1 search, met the eligibility criteria and were included (Figure 1; Tables 1 and S9) (14,19,36,41,(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59). Most of the studies originated from China (n=7); others were from USA (n=3), Italy (n=2), and one each from India, Iran, Belgium, Norway, Spain and Switzerland.…”

Inpatient Rehabilitation Outcomes After Severe COVID-19 Infections

“…Olezene et al 23 (2021) evaluated the effectiveness of inpatient rehabilitation for 29 patients presenting after COVID-19 infection, showing statistically significant improvements in mobility, cognition, speech, swallowing, and balance by time of discharge. Jain et al 24 (2021) examined the outcomes of 64 patients admitted to acute inpatient rehabilitation after COVID-19. They also compared 18 patients admitted to inpatient rehabilitation after an admission for COVID-19 to 18 patients with the same impairment code and similar ages.…”

“…They found that individuals with COVID had similar functional outcomes, longer LOSs, and more cognitive symptoms compared with the comparison group. 24 …”