Beneficial effects of multi-disciplinary rehabilitation in postacute COVID-19: an observational cohort study

• Published in: European journal of physical and rehabilitation medicine Vol. 57; no. 2; p. 189
• Main Authors: Puchner, Bernhard, Sahanic, Sabina, Kirchmair, Rudolf, Pizzini, Alex, Sonnweber, Bettina, Wöll, Ewald, Mühlbacher, Andreas, Garimorth, Katja, Dareb, Bernhard, Ehling, Rainer, Wenter, Johanna, Schneider, Sybille, Brenneis, Christian, Weiss, Günter, Tancevski, Ivan, Sonnweber, Thomas, Löffler-Ragg, Judith
• Format: Journal Article
• Language: English
• Published: Italy 01.04.2021
• ISSN: 1973-9087; 1973-9095
• DOI: 10.23736/s1973-9087.21.06549-7

The Coronavirus Disease 2019 (COVID-19) pandemic increases the demand for postacute care in patients after a severe disease course. Various long-term sequelae are expected and rehabilitation medicine is challenged to support physical and cognitive recovery. We aimed to explore the dysfunctions and outcome of COVID-19 survivors after early postacute rehabilitation. Observational cohort study. This study evaluated the postacute sequelae of patients hospitalized for SARS-CoV-2 infection and analyzed rehabilitative outcomes of a subgroup of patients included in the prospective observational multicenter CovILD study. A total of 23 subjects discharged after severe to critical COVID-19 infection underwent an individualized, multiprofessional rehabilitation. At the start of postacute rehabilitation, impairment of pulmonary function (87%), symptoms related to postintensive care syndrome, and neuropsychological dysfunction (85%) were frequently found, whereas cardiac function appeared to be largely unaffected. Of interest, multi-disciplinary rehabilitation resulted in a significant improvement in lung function, as reflected by an increase of forced vital capacity (P=0.007) and forced expiratory volume in one second (P=0.014), total lung capacity (P=0.003), and diffusion capacity for carbon monoxide (P=0.002). Accordingly, physical performance status significantly improved as reflected by a mean increase of six-minute walking distance by 176 (SD±137) meters. Contrarily, a considerable proportion of patients still had limited diffusion capacity (83%) or neurological symptoms including peripheral neuropathy at the end of rehabilitation. Individuals discharged after a severe course of COVID-19 frequently present with persisting physical and cognitive dysfunctions after hospital discharge. Those patients significantly benefit from multi-disciplinary inpatient rehabilitation. Our data demonstrated the highly promising effects of early postacute rehabilitation in survivors of severe or critical COVID-19. This findings urge further prospective evaluations and may impact future treatment and rehabilitation strategies.