Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)

Aerts, Joachim; Bek, L. Martine; Berentschot, Julia C.; Berg-Emons, Rita J G van den; Bindraban, Sieshem; Blox, Wouter J. B.; Bommel, Jasper van; Gajadin, Shai A.; Genderen, Michel E van; Gommers, Diederik; Heijenbrok‐Kal, Majanka H.; Hellemons, Merel E.; Heller, Roxane; Huijts, Susanne M.; Ista, Erwin; Loon-Kooij, Stephanie van; Osterthun, Rutger; Oswald, Laurien; Ribbers, Gerard M.; Rossem, Ronald N. van; Sande, Herbert J. van de; Slingerland, Rob; Stoep, Robert van der; Tazmi-Staal, Janette J.; Visser, Martijn S.; Wijffels, Markus P. J. M.; Willems, Eva G.

doi:10.1016/j.lanepe.2022.100485

Cited by 21 publications

(26 citation statements)

References 36 publications

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“…In wave 2, fewer patients were offered remote rehabilitation, with a greater proportion re-referred to primary care and to the bespoke DCRS, reflecting the move back to face-to-face clinical services. Overall, 61% of individuals were offered rehabilitation, which is lower than the 80% of individuals from a study in the Netherlands over a similar period (March 2020 to June 2021); however, their study population was post-hospital discharge with a median age of 60 27…”

Section: Discussionmentioning

confidence: 67%

“…Overall, 61% of individuals were offered rehabilitation, which is lower than the 80% of individuals from a study in the Netherlands over a similar period (March 2020 to June 2021); however, their study population was post-hospital discharge with a median age of 60. 27 The increase in DCRS referrals is understandable as, although this cross-cadre collaborative clinical and occupational assessment service to ensure safe return to duty was established with the Defence and NHS partners in a matter of months, 28 it became fully active and ready for referrals by the second wave. This was not the entirety of DCRS referrals, as the majority were direct referrals.…”

Section: Assessment Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Changing characteristics of post-COVID-19 syndrome: Cross-sectional findings from 458 consultations using the Stanford Hall remote rehabilitation assessment tool

Houston¹,

Tovey²,

Rogers-Smith³

et al. 2023

BMJ Mil Health

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BackgroundIn the UK, there have been multiple waves of COVID-19, with a five-tier alert system created to describe the transmission rate and appropriate restrictions. While acute mortality decreased, there continued to be a significant morbidity, with individuals suffering from persistent, life-restricting symptoms for months to years afterwards. A remote rehabilitation tool was created at the Defence Medical Rehabilitation Centre (DMRC) Stanford Hall to assess post-COVID-19 symptoms and their impact on the UK military.This study aims to understand changes in post-COVID-19 syndrome between wave 1 and wave 2, identify interactions between alert level and symptoms and investigate any predictive nature of acute symptoms for postacute symptomology in a young, physically active population.MethodsCross-sectional study of 458 consecutive remote rehabilitation assessments performed at DMRC Stanford Hall between 2 April 2020 and 29 July 2021. Consultations were coded, anonymised, and statistical analysis was performed to determine associations between acute and postacute symptoms, and between symptoms, alert levels and waves.Results435 assessments were eligible; 174 in wave 1 and 261 in wave 2. Post-COVID-19 syndrome prevalence reduced from 43% to 2% between the waves. Acutely, widespread pain was more prevalent in wave 2 (p<0.001). Postacutely, there was increased anxiety (p=0.10) in wave 1 and increased sleep disturbance (p<0.001), memory/concentration issues (p<0.001) and shortness of breath/cough (p=0.017) in wave 2. Increasing alert level was associated with increased postacute symptom prevalence (p=0.046), with sleep disturbance increasing at higher alert level (p=0.016). Acute symptoms, including fatigue, sleep disturbance and myalgia, were associated with multiple postacute symptoms.ConclusionsThis study reports the overall prevalence and symptom burden in the UK military in the first two waves of COVID-19. By reporting differences in COVID-19 in different waves and alert level, this study highlights the importance of careful assessment and contextual understanding of acute and postacute illnesses for individual management plans.

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Section: Discussionmentioning

confidence: 67%

Section: Assessment Outcomesmentioning

confidence: 99%

Changing characteristics of post-COVID-19 syndrome: Cross-sectional findings from 458 consultations using the Stanford Hall remote rehabilitation assessment tool

Houston¹,

Tovey²,

Rogers-Smith³

et al. 2023

BMJ Mil Health

View full text Add to dashboard Cite

show abstract

“…These findings support previous work and advance our understanding of the effectiveness of postacute rehabilitation in the recovery of severe COVID-19 patients. [4][5][6] The study should be interpreted considering its limitations. First, our findings on intensive inpatient rehabilitation may not be generalizable to outpatient and at-home rehabilitation models.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence shows that postacute intensive rehabilitation can help these patients restore function, avoid hospital readmissions, and improve satisfaction with received care 3–5 . Despite such potential benefits, the characteristics of postacute care in patients who have experienced COVID‐19 compared to those with other well‐known respiratory infections, such as pneumonia caused by influenza or bacterial pathogens, remain unclear 4–6 . This is a relevant issue as post‐COVID‐19 conditions become widespread, with millions of people recovering from the disease as the pandemic advances 6–8 .…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of postacute intensive rehabilitation on severe COVID‐19 patients: A case‐control study

Aliberti,

Levites,

Berardo

2023

Health Science Reports

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Coronavirus Disease 2019 (COVID-19) can cause multiorgan failure and longer-term consequences, particularly in patients requiring inhospital care. [1][2][3][4] Studies indicate that approximately 60% of these patients have persistent symptoms-commonly called "long COVID"-such as fatigue, breathlessness, and joint pain. [5][6][7] These long-term effects hinder a smooth transition back to independent living, which encompasses challenges for performing essential selfcare activities. 2 Although similar manifestations have been documented in patients recovering from other critical illnesses, emerging evidence suggests that severe COVID-19 patients may encounter distinctive challenges. For instance, earlier research reported a higher rate of muscle mass and strength reduction in COVID-19 patients than in other acutely ill individuals. 8 Such findings imply a unique

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“…The median age of patients enrolled in this study was 60 years, nearly 97% received supplemental oxygen, 40.7% were treated in ICU and 70.4% treated with steroids during hospitalization, indicating high risk for long COVID and rehabilitation training needs. 6 Different from previous studies, this study not only focused on the rehabilitation of cardiopulmonary function, but also focused on changes in muscle strength and mobility. Among the three dimensions of assessed physical function, cardiorespiratory fitness and muscle strength improved most significantly within the first 6 months after discharge, suggesting that the first 6-month post-discharge is the optimal recovery period for COVID-19 patients.…”

mentioning

confidence: 99%

Post-infection rehabilitation of COVID-19 patients: Findings and prospects

Zhang

Cao

2022

The Lancet Regional Health - Europe

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Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)

Cited by 21 publications

References 36 publications

Changing characteristics of post-COVID-19 syndrome: Cross-sectional findings from 458 consultations using the Stanford Hall remote rehabilitation assessment tool

Changing characteristics of post-COVID-19 syndrome: Cross-sectional findings from 458 consultations using the Stanford Hall remote rehabilitation assessment tool

The effectiveness of postacute intensive rehabilitation on severe COVID‐19 patients: A case‐control study

Post-infection rehabilitation of COVID-19 patients: Findings and prospects

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