Geriatric rehabilitation and Covid-19 : a Case Report

Abstract

Introduction : Covid-19 infection has particularly affected older adults. Clinical observations in this population highlight major respiratory impairment associated with development or aggravation of frailty state.Case Presentation : Mr P is a 93 years old frail patient, hospitalized after a COVID-19 infection. The assessment process of this patient has been supported by an innovative multi-systemic tool developed in view of the COVID-19 clinical consequences and a systemic evaluation of motor functions by the Frail BESTest. This process allowed presenting a mixed clinical picture associating an important respiratory distress (linked with the acute respiratory distress syndrome) and an evident motor frailty. The care plan was developed accordingly, and four assessment were done in the same manner until the return home of Mr PConclusion : This case report allows seeing holistically a COVID-19 clinical picture, showing the different axis of clinical reasoning to enhance the rehabilitation process. Furthermore, this case report illustrate the importance of rehabilitation in the Covid-19 context.

Rehabilitation and COVID-19: a rapid living systematic review by Cochrane Rehabilitation Field updated as of December 31st, 2020 and synthesis of the scientific literature of 2020

“…Supplementary Digital Material 1: Supplementary Table I (available on the Cochrane Rehabilitation website: https://tr.im/rr_dyn) provides a detailed overview of the new evidence. The studies published in this update were conducted in the following World Health Organization Regions: 31 in Europe (8 Italy 9-16 , 5 United Kingdom [17][18][19][20][21] , 3 Spain [22][23][24] , 2 France 25,26 , 1 Austria 27 , 1 Denmark 28 , 1 Germany 29 , 1 Ireland 30 , 1 Israel 31 , 1 Netherlands 32 , 1 Romania 33 , 2 Russia 34,35 , 1 Switzerland 36 , 1 Turkey 37 , 1 Netherlands and Belgium 38 , and 1 United Kingdom and Italy 39 ), 13 in the Americas (11 United States of America [40][41][42][43][44][45][46][47][48][49][50] , 1 in Canada 51 , 1 Mexico 52 ), 5 in Eastern Mediterranean (3 Iran [53][54][55] , 1 Qatar 56 , 1 Tunisia 57 ), 3 in Western Pacific (China [58][59][60] ), and 2 in South-East Asia (India 61,62 ).…”

“…Due to the heterogeneity of published studies, a meta-analysis was not appropriate; thus, the results are described qualitatively. Based on the Oxford Centre for Evidence-Based (OCEBM) 2011 Levels of Evidence, 63 most studies (n=35, 64.8%) were Level 4 (13 case reports 20,[22][23][24][25][26][42][43][44]48,50,54,62 , 12 case series [9][10][11][12]14,33,34,46,47,49,55,56 , and 10 historical cohort studies 17,31,36,37,40,41,51,[57][58][59] ), whereas the remainder 19 (35.2%) were Level 3 (8 cohort studies 15,19,21,27,28,32,39,60,64 , 8 cross-sectional studies 13,16,18,29,30,38,…”

“…Most studies (n=39, 72.2%) investigated the natural history/determining factors of the disease (14 cohort studies 15,17,19,21,27,28,31,32,39,40,51,58,59,60 2 cross-sectional 18,45 , 1 case control study 52 , 11 case reports 20,22,23,25,26,[42][43][44]48,54,62 , and 11 case series [9][10][11][12]14,33,34,46,47,49,55 ). Seven papers (13%) reported COPYRIGHT© EDIZIONI MINERVA MEDICA epidemiological data on disease prevalence (6 cross-sectional studies 13,16,29,30,38,53 and 1 historical cohort study 57 ), and four (7.4%) described the clinical presentation of COVID-19 infection (2 case report 24,50 , 1 case series 56 , and 1 historical cohort study 37 ).…”

“…Most studies (n=24, 44.4%) included COVID-19 patients in the post-acute phase [11][12][13][14]16,19,23,25,30,32,34,37,[39][40][41][42]44,45,52,54,55,58,59,61 , 18 in the acute phase 15,17,[20][21][22]24,26,35,36,[46][47][48]50,51,56,57,60,62 , and 10 in the chronic phase 9,10,18,[27][28][29]31,33,38,53 , one manuscript described the late-onset consequences of COVID-19 43…”

“…Accordingly, follow-up evaluations are needed, and rehabilitation might be helpful even in a later phase. The remaining three descriptive papers illustrated the importance of a patient-tailored rehabilitation approach in acute 46 and post-acute phase 14,25 .…”