Rehabilitation of a Patient with Severe COVID-19 Using Extracorporeal Membrane Oxygenation：A Case Report

Tsukakoshi, Daichi; Yamamoto, Shuhei; Wada, Yosuke; Terashima, Satsuki; Osawa, Ryuji; Matsumori, Keiji; Ito, Shun; Nakamura, Yukio; Nagamine, Kohei; Ikegami, Shota; Horiuchi, Hiroshi

doi:10.2490/jjrmc.20042

Cited by 1 publication

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“…A previous study from Italy also reported an ICU mortality rate of 44% for patients with COVID-19 admitted to the ICU [ 17 ]; however, an extremely important finding of our study was that the overall ICU mortality rate for patients admitted to our ICU was 7% in our hospital. Although patients with COVID-19 on ECMO were excluded owing to in-hospital death, it is remarkable that our hospital provided a phased rehabilitation intervention for patients on ECMO as well [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, only very few reports have investigated the clinical outcomes of COVID-19, particularly in more severe patients who underwent rehabilitation interventions in Japan, especially from a single institution. As our hospital received the first COVID-19 patient in February 2020, we have treated primarily severe cases requiring respiratory management and intensive care [ 10 ]. Although multicenter studies allow the analysis of several cases, they also have drawbacks in examining the effects of rehabilitation because of the lack of uniformity in rehabilitation protocols.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes and Prevalence of Sarcopenia in Patients with Moderate to Severe COVID-19

Yamamoto

Sakai

Matsumori

et al. 2022

JCM

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Background: The purpose of this study was to investigate the effectiveness and clinical outcomes of inpatient rehabilitation for patients with severe COVID-19 in Japan. Methods: Patients with severe COVID-19 who underwent rehabilitation during hospitalization were included. The Medical Research Council (MRC) score and short physical performance battery (SPPB), such as physical function assessment and the intensive care unit (ICU) mobility scale, the functional status score for the ICU, and Barthel index as activities of daily living (ADLs) were evaluated at admission and discharge or transfer from the hospital. The correlation between SPPB at discharge and each factor at admission were also analyzed. Furthermore, the prevalence of sarcopenia was evaluated by defining SPPB of <9 points at discharge as sarcopenia. Results: The median age of the total of 23 patients was 59 years (interquartile range (IQR): 47–67), 73.9% were male, and the median PaO2/FiO2 at admission was 172.0 (IQR: 123.0–209.0). All physical function and ADL parameters were significantly improved from the time of admission to discharge (p = 0.014 for the MRC score and p < 0.001 for all others). Moreover, SPPB at discharge significantly correlated with WBC (Spearman’s rho = −0.473, p = 0.041), C-reactive protein (Spearman’s rho = −0.468, p = 0.044), and exhibited a significant trend with PaO2/FiO2 (Spearman’s rho = 0.429, p = 0.067) and age (Spearman’s rho = 0.409, p = 0.083). Although the median Barthel index at discharge was 90 points, 47% of patients had sarcopenia as defined by an SPPB of <9 points. Conclusions: Early rehabilitation for patients with severe COVID-19 improved physical function and ADLs during hospitalization. However, 47% of patients had the same level of sarcopenia at discharge.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%