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Abstract
BACKGROUND: A proportion of patients with COVID-19 need hospitalization due to severe respiratory symptoms. We sought to analyze characteristics of survivors of severe COVID-19 subsequently admitted to in-patient pulmonary rehabilitation and identify their rehabilitation needs.
METHODS: From the COVID-19 Registry of Fondazione Don Gnocchi, we extracted 203 subjects admitted for in-patient pulmonary rehabilitation after severe COVID-19 from April 2020–September 2021. Specific information on acute-hospital stay and clinical and functional characteristics on admission to rehabilitation units were collected.
RESULTS: During the acute phase of disease, 168 subjects received mechanical ventilation for 26 d; 85 experienced delirium during their stay in ICU. On admission to rehabilitation units, 20 subjects were still on mechanical ventilation; 57 had tracheostomy; 142 were on oxygen therapy; 49 were diagnosed critical illness neuropathy; 162 showed modified Barthel Index < 75; only 51 were able to perform a 6-min walk test; 32 of 90 scored abnormal at Montreal Cognitive Assessment; 43 of 88 scored abnormal at Hospital Anxiety and Depression Scale; 65 scored ≥ 2 at Malnutrition Universal Screening Tool, and 95 showed dysphagia needing logopedic treatment.
CONCLUSIONS: Our analysis shows that subjects admitted for in-patient pulmonary rehabilitation after severe COVID-19 represent an extraordinarily multifaceted and clinically complex patient population who need customized, comprehensive rehabilitation programs carried out by teams with different professional skills. The need for step-down facilities, such as sub-intensive rehabilitation units, is also highlighted.
- COVID-19 survivors
- pulmonary rehabilitation
- prolonged hospitalization
- functional dependency
- severe disability
- multidisciplinary rehabilitation program
Footnotes
- Correspondence: Silvia Campagnini. E-mail: scampagnini{at}dongnocchi.it
The authors have disclosed no conflicts of interest.
The study was performed at rehabilitation centers of Fondazione Don Carlo Gnocchi in Milano, Firenze, and Brescia-Rovato, Italy.
- Copyright © 2023 by Daedalus Enterprises
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