Postdischarge symptoms and rehabilitation needs in survivors of COVID‐19 infection: A cross‐sectional evaluation

Abstract

Background: There is currently very limited information on the nature and prevalence of post-COVID-19 symptoms after hospital discharge. Methods: A purposive sample of 100 survivors discharged from a large University hospital were assessed 4 to 8 weeks after discharge by a multidisciplinary team of rehabilitation professionals using a specialist telephone screening tool designed to capture symptoms and impact on daily life. EQ-5D-5L telephone version was also completed. Results: Participants were between 29 and 71 days (mean 48 days) postdischarge from hospital. Thirty-two participants required treatment in intensive care unit (ICU group) and 68 were managed in hospital wards without needing ICU care (ward group). New illness-related fatigue was the most common reported symptom by 72% participants in ICU group and 60.3% in ward group. The next most common symptoms were breathlessness (65.6% in ICU group and 42.6% in ward group) and psychological distress (46.9% in ICU group and 23.5% in ward group). There was a clinically significant drop in EQ5D in 68.8% in ICU group and in 45.6% in ward group. Conclusions: This is the first study from the United Kingdom reporting on postdischarge symptoms. We recommend planning rehabilitation services to manage these symptoms appropriately and maximize the functional return of COVID-19 survivors.

Applying the WHO ICF Framework to the Outcome Measures Used in the Evaluation of Long-Term Clinical Outcomes in Coronavirus Outbreaks

“…In the previous coronavirus outbreaks of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), such long-term sequelae spanned across the physical, psychological and social domains of health [5,6]. Early reports of COVID-19 follow-up studies are suggestive of prevalence of similar health problems in COVID-19 survivors as those reported in previous outbreaks of SARS and MERS [7,8]. Considering the multi-systemic impact of COVID-19, follow-up studies across all these domains of health are required in order to truly understand these individuals' experiences and support their return to societal roles.…”

Comparing biomarkers for COVID-19 disease with commonly associated preexisting conditions and complications

“…Early surveillance studies have also reported neurological manifestations, including altered mental status and impaired consciousness along with fatigue, pain, and sensory disturbances (e.g., anosmia, dysgeusia) post-recovery 16,17 ; however, the long-term complications of COVID-19 remain unclear.…”

ABCDEF Bundle and Supportive ICU Care Practices for patients with COVID-19 infection: An international point prevalence study ~The ISIIC Study~

“…The ndings of this study call for urgent efforts to incorporate the ABCDEF bundle of care into routine clinical practice, especially as many countries are dealing with serious concerns for a second wave of COVID-19 infections. The serious disabilities and persistent symptoms after COVID-19 infection [13][14][15][16] raise serious concerns about the long-term outcomes associated with PICS induced by COVID-19 infection [17,18].…”

“…The complicated pathophysiology of the pulmonary illness with two different phases of acute lung injury caused by COVID-19 infection, which need different ventilation strategies to avoid exacerbation of lung injury [33][34][35][36], could limit aggressive mobilization of patients. The variety of neurological complications, such as weakness and fatigue after the acute phase of the disease, often reported as complications associated with COVID-19 infections recently [13][14][15][16]39] and recognized as barriers to mobilization, could also inhibit the implementation of element E. More research is needed to develop the most e cient approach to early rehabilitation of patients with COVID-19 infections and a high risk for developing PICS.…”

“…These challenges may lead to patients not receiving the same quality of clinical care, resulting in poorer outcomes including increased mortality [12]. In addition to increased ICU mortality in patients with COVID-19 infections, recent evidence has highlighted the severe physical disabilities and prolonged symptoms during recovery from COVID-19 infection that limits patients' daily activities and quality of life after discharge from the hospital [13][14][15][16]. Thus, an enhanced recovery program which optimizes evidence-based ICU care and patient recovery is essential [15][16][17][18].…”