1887
Volume 2024, Issue 3
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

ملخص

Background: Patients recovering from severe COVID-19 infections have experienced prolonged cognitive, physical, and psychological sequelae, including cardiorespiratory and motor deconditioning, neurological deterioration, anxiety, and depression. The impact of rehabilitation post-acute COVID-19 infection was recognized in the literature, but studies assessing and quantifying specific functional outcomes were lacking. This study aims to describe the characteristics and quantify the changes in functional outcomes of patients admitted to Qatar Rehabilitation Institute (QRI) for inpatient rehabilitation (IPR) post-COVID-19 infection during a 10-month period in 2021.

Methods: This is a retrospective observational cohort study, which included individuals over 18 years of age with a documented COVID-19-positive diagnosis who were admitted to QRI for IPR due to COVID-19 complications. Data was collected by the investigators from January 1, 2021, until October 30, 2021. A total of 243 patients were included in this study. The changes in functional rehabilitation outcomes were assessed and quantified at both the patient’s baseline (on admission to QRI) and after completion of IPR (on discharge). The duration of the IPR program varied based on each patient’s baseline assessment. Patients were given a total of 8–12 weeks to achieve their rehabilitation goals and were discharged once those goals were met. Several validated tools were utilized in this study including Functional Independence Measure (FIM), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Modified Medical Research Council (mMRC) Dyspnea Scale, Mini-Mental State Examination (MMSE), and Right- and left-Hand Grip Strength. In addition, patients’ diet, the need for respiratory support, and the presence of a tracheostomy tube before and after IPR were also recorded.

Results: In total, 84.4% of the included patients were males (n = 205); with a mean age of 52.44 ± 12.99 years. The most commonly reported comorbidities were type 2 diabetes (62.1%) and hypertension (49.8%) with 83.5% of patients experiencing critical illness neuromyopathy. The average patients’ length of stay in QRI was 33.92 ± 27.72 days. A statistically significant improvement in all functional outcome scales was noted following the completion of the IPR program ( = 0.001). The number of patients requiring modification to their diet or feeding via nasogastric tube (NGT) significantly decreased by 35% and 93%, respectively ( = 0.001). Patients requiring respiratory support decreased by 98% ( = 0.001) and the need for a tracheostomy tube among patients was reduced by 95% ( = 0.001).

Conclusion: IPR following COVID-19 infection was associated with significant functional, motor, and cardiorespiratory improvement. Dedicating clinics for post-COVID-19 rehabilitation would ensure improved patient outcomes and enhanced recovery.

Loading

جارٍ تحميل قياسات المقالة...

/content/journals/10.5339/qmj.2024.45
٢٠٢٤-٠٩-٢٤
٢٠٢٤-١١-٠٥
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2024/3/qmj.2024.45.html?itemId=/content/journals/10.5339/qmj.2024.45&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). Coronavirus disease (COVID-19). Geneva: World Health Organization (WHO); 2024[cited April 21, 2024]. Available from: https://www.who.int/health-topics/coronavirus#tab=tab_1
    [Google الباحث العلمي]
  2. World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic. Geneva:. World Health Organization (WHO); 2024[cited April 21, 2024]. Available from: https://www.who.int/europe/emergencies/situations/covid-19
    [Google الباحث العلمي]
  3. World Health Organization. COVID-19 Dashboard; 2024[cited April 21, 2024]. Available from: https://data.who.int/dashboards/covid19/cases?n=c
    [Google الباحث العلمي]
  4. Çelik I, Öztürk R. From asymptomatic to critical illness: Decoding various clinical stages of COVID-19. Turk J Med Sci. 2021; 51:(Si-1):3284-300.
    [Google الباحث العلمي]
  5. Gibson PG, Qin L, Puah SH. COVID-19 acute respiratory distress syndrome (ARDS): Clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust. 2020; 213:(2):54-6.e1. https://doi.org/10.5694/mja2.50674
    [Google الباحث العلمي]
  6. Pfortmueller CA, Spinetti T, Urman RD, Luedi MM, Schefold JC. COVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment - A narrative review. Best Pract Res Clin Anaesthesiol. 2021; 35:(3):351-68https://doi.org/10.1016/j.bpa.2020.12.011
    [Google الباحث العلمي]
  7. Simpson R, Robinson L. Rehabilitation after critical illness in people with COVID-19 infection. Am J Phys Med Rehabil. 2020; 99:(6):470-4https://doi.org/10.1097/PHM.0000000000001443
    [Google الباحث العلمي]
  8. Curci C, Negrini F, Ferrillo M, Bergonzi R, Bonacci E, Camozzi DM, et al.. Functional outcome after inpatient rehabilitation in postintensive care unit COVID-19 patients: Findings and clinical implications from a real-practice retrospective study. Eur J Phys Rehabil Med. 2021; 57:(3):443-50https://doi.org/10.23736/S1973-9087.20.06660-5
    [Google الباحث العلمي]
  9. Ngai JC, Ko FW, Ng SS, To KW, Tong M, Hui DS. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology. 2010; 15:(3):543-50https://doi.org/10.1111/j.1440-1843.2010.01720.x
    [Google الباحث العلمي]
  10. Brown SM, Bose S, Banner-Goodspeed V, Beesley SJ, Dinglas VD, Hopkins RO, et al.. Approaches to addressing post-intensive care syndrome among intensive care unit survivors. A narrative review. Ann Am Thorac Soc. 2019; 16:(8):947-56https://doi.org/10.1513/AnnalsATS.201812-913FR
    [Google الباحث العلمي]
  11. Faghy MA, Maden-Wilkinson T, Arena R, Copeland RJ, Owen R, Hodgkins H, et al.. COVID-19 patients require multi-disciplinary rehabilitation approaches to address persisting symptom profiles and restore pre-COVID quality of life. Expert Rev Respir Med. 2022; 16:(5):595-600https://doi.org/10.1080/17476348.2022.2063843
    [Google الباحث العلمي]
  12. Gutenbrunner C, Stokes EK, Dreinhöfer K, Monsbakken J, Clarke S, Côté P, et al.. Why rehabilitation must have priority during and after the COVID-19-pandemic: A position statement of the Global Rehabilitation Alliance. J Rehabil Med. 2020; 52:(7):jrm00081. https://doi.org/10.2340/16501977-2713
    [Google الباحث العلمي]
  13. Wasilewski MB, Cimino SR, Kokorelias KM, Simpson R, Hitzig SL, Robinson L. Providing rehabilitation to patients recovering from COVID-19: A scoping review. PM R. 2022; 14:(2):239-58https://doi.org/10.1002/pmrj.12669
    [Google الباحث العلمي]
  14. Beqaj S, Mačak Hadžiomerović A, Pašalić A, Jaganjac A. Effects of physiotherapy on rehabilitation and quality of life in patients hospitalized for COVID-19: A review of findings from key studies published 2020-2022. Med Sci Monit. 2022; 28:e938141https://doi.org/10.12659/MSM.938141
    [Google الباحث العلمي]
  15. Fugazzaro S, Contri A, Esseroukh O, Kaleci S, Croci S, Massari M, et al.. Rehabilitation interventions for post-acute COVID-19 syndrome: A systematic review. Int J Environ Res Public Health. 2022; 19:(9):5185https://doi.org/10.3390/ijerph19095185
    [Google الباحث العلمي]
  16. Webber SC, Tittlemier BJ, Loewen HJ. Apparent discordance between the epidemiology of COVID-19 and recommended outcomes and treatments: A scoping review. Phys Ther. 2021; 101:(11):pzab155https://doi.org/10.1093/ptj/pzab155
    [Google الباحث العلمي]
  17. Piquet V, Luczak C, Seiler F, Monaury J, Martini A, Ward AB, et al.. Do patients With COVID-19 benefit from rehabilitation? Functional outcomes of the first 100 patients in a COVID-19 rehabilitation unit. Arch Phys Med Rehabil. 2021; 102:(6):1067-74https://doi.org/10.1016/j.apmr.2021.01.069
    [Google الباحث العلمي]
  18. Journeay WS, Robinson LR, Titman R, Macdonald SL. Characteristics and outcomes of COVID-19-positive individuals admitted for inpatient rehabilitation in Toronto, Canada. J Rehabil Med Clin Commun. 2021; 4:1000053. https://doi.org/10.2340/20030711-1000053
    [Google الباحث العلمي]
  19. Olezene CS, Hansen E, Steere HK, Giacino JT, Polich GR, Borg-Stein J, et al.. Functional outcomes in the inpatient rehabilitation setting following severe COVID-19 infection. PLoS One. 2021; 16:(3):e0248824https://doi.org/10.1371/journal.pone.0248824
    [Google الباحث العلمي]
  20. Groah SL, Pham CT, Rounds AK, Semel JJ. Outcomes of patients with COVID-19 after inpatient rehabilitation. PM R. 2022; 14:(2):202-9https://doi.org/10.1002/pmrj.12645
    [Google الباحث العلمي]
  21. Chuang HJ, Hsiao MY, Wang TG, Liang HW. A multi-disciplinary rehabilitation approach for people surviving severe COVID-19-a case series and literature review. J Formos Med Assoc. 2022; 121:(12):2408-15https://doi.org/10.1016/j.jfma.2022.02.002
    [Google الباحث العلمي]
  22. Hamad Medical Corporation (HMC). Qatar Rehabilitation Institute. Hamad Medical Corporation (HMC)2023[cited April 17, 2023]. Available from: https://www.hamad.qa/EN/Hospitals-and-services/Physiotherapy/Facilities/Pages/Qatar-Rehabilitation-Institute.aspx
    [Google الباحث العلمي]
  23. Hartsgrove C, Guevarra-Fernandez J, Kendall J, Delauter G, Kirshblum S. Measuring discharge outcomes, length of stay, and functional ADL score during COVID-19 in inpatient rehabilitation hospitals. Arch Phys Med Rehabil. 2021; 102:(12):2291-9https://doi.org/10.1016/j.apmr.2021.07.003
    [Google الباحث العلمي]
  24. Rodrigues M, Costa AJ, Santos R, Diogo P, Gonçalves E, Barroso D, et al.. Inpatient rehabilitation can improve functional outcomes of post-intensive care unit COVID-19 patients-a prospective study. Disabil Rehabil. 2023; 45:(2):266-76https://doi.org/10.1080/09638288.2022.2032408
    [Google الباحث العلمي]
  25. Direct Healthcare Group. What is the functional independence measure (FIM)?; 2022 [cited April 18, 2023]. Available from: https://www.directhealthcaregroup.com/what-is-the-functional-independence-measure-fim/
    [Google الباحث العلمي]
  26. Barry D. 217 - Sarcopenia. In: Pizzorno JE, Murray MT, editors. Textbook of natural medicine. 5th edn. St. Louis (MO):Churchill Livingstone; 2020. p. 1781-803.e19.
    [Google الباحث العلمي]
  27. [Google الباحث العلمي]
  28. Independent Health and Aged Care Pricing Authority (IHACPA). Standardised mini-mental state examination; 2023[cited April 18, 2023]. Available from: https://www.ihacpa.gov.au/health-care/classification/subacute-and-non-acute-care/standardised-mini-mental-state-examination
    [Google الباحث العلمي]
  29. Gebhard C, Regitz-Zagrosek V, Neuhauser HK, Morgan R, Klein SL. Impact of sex and gender on COVID-19 outcomes in Europe. Biol Sex Differ. 2020; 11:(1):29https://doi.org/10.1186/s13293-020-00304-9
    [Google الباحث العلمي]
  30. Meng Y, Wu P, Lu W, Liu K, Ma K, Huang L, et al.. Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients. PLoS Pathog. 2020; 16:(4):e1008520https://doi.org/10.1371/journal.ppat.1008520
    [Google الباحث العلمي]
  31. [Google الباحث العلمي]
  32. [Google الباحث العلمي]
  33. Mi J, Zhong W, Huang C, Zhang W, Tan L, Ding L. Gender, age and comorbidities as the main prognostic factors in patients with COVID-19 pneumonia. Am J Transl Res. 2020; 12:(10):6537-48.
    [Google الباحث العلمي]
  34. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al.. Comorbidity and its Impact on patients with COVID-19. SN Compr Clin Med. 2020; 2:(8):1069-76https://doi.org/10.1007/s42399-020-00363-4
    [Google الباحث العلمي]
  35. Ejaz H, Alsrhani A, Zafar A, Javed H, Junaid K, Abdalla AE, et al.. COVID-19 and comorbidities: Deleterious impact on infected patients. J Infect Public Health. 2020; 13:(12):1833-9https://doi.org/10.1016/j.jiph.2020.07.014
    [Google الباحث العلمي]
  36. de Almeida-Pititto B, Dualib PM, Zajdenverg L, Dantas JR, de Souza FD, Rodacki M, et al.. Severity and mortality of COVID 19 in patients with diabetes, hypertension and cardiovascular disease: A meta-analysis. Diabetol Metab Syndr. 2020; 12:75. https://doi.org/10.1186/s13098-020-00586-4
    [Google الباحث العلمي]
  37. Miller LE, Bhattacharyya R, Miller AL. Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis. Medicine (Baltimore). 2020; 99:(40):e22439https://doi.org/10.1097/MD.0000000000022439
    [Google الباحث العلمي]
  38. Stam HJ, Stucki G, Bickenbach J. Covid-19 and post intensive care syndrome: A call for action. J Rehabil Med. 2020; 52:(4):jrm00044https://doi.org/10.2340/16501977-2677
    [Google الباحث العلمي]
  39. Flaatten H, Waldmann C. The post-ICU syndrome, history and definition. In: Preiser JC, Herridge M, Azoulay E, editors. Post-intensive care syndrome: Lessons from the ICU. Cham:Springer; 2020. Available from: https://doi.org/10.1007/978-3-030-24250-3_1
    [Google الباحث العلمي]
  40. Albu S, Rivas Zozaya N, Murillo N, García-Molina A, Figueroa Chacón CA, Kumru H. Multidisciplinary outpatient rehabilitation of physical and neurological sequelae and persistent symptoms of covid-19: A prospective, observational cohort study. Disabil Rehabil. 2022; 44:(22):6833-40https://doi.org/10.1080/09638288.2021.1977398
    [Google الباحث العلمي]
/content/journals/10.5339/qmj.2024.45
Loading
/content/journals/10.5339/qmj.2024.45
Loading

جارٍ تحميل البيانات والوسائط...

  • نوع المستند: Research Article
الموضوعات الرئيسية COVID-19functional outcomesQatar and Rehabilitation

الأكثر اقتباسًا لهذا الشهر Most Cited RSS feed

هذه الخانة مطلوبة
يُرجى إدخال عنوان بريد إلكتروني صالح
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error