Safety, Feasibility, and Outcomes of Frequent, Long-Duration Rehabilitation in an Inpatient Rehabilitation Facility after Prolonged Hospitalization for Severe COVID-19: An Observational Study

Vickory, Frank; Ridgeway, Kyle; Falvey, Jason; Houwer, Beth; Gunlikson, Jennifer; Payne, Katherine; Niehaus, William

OBJECTIVES: The objective of this study was to evaluate safety, feasibility, and outcomes of 30 patients within an inpatient rehabilitation facility following hospitalization for severe COVID-19 infection. METHODS: This was an Observational Study of 30 patients (ages 26–80) within a large, metropolitan academic hospital following hospitalization for complications from severe COVID-19. Ninety percent of the participants required critical care and 83% required mechanical ventilation during their hospitalization. Within an inpatient rehabilitation facility and model of care, frequent, long duration rehabilitation was provided by occupational therapists, physical therapists, and speech language pathologists. RESULTS: The average inpatient rehabilitation facility length of stay was 11 days (ranging from 4–22 days). Patients averaged 165 minutes per day (ranging from 140–205 minutes) total of physical therapy, occupational therapy, and speech therapy. Twenty eight of the 30 patients (93%) discharged to the community. One patient required readmission from the inpatient rehabilitation facility to the acute hospital. All 30 patients improved their functional status with inpatient rehabilitation. CONCLUSION: In this cohort of 30 patients, inpatient rehabilitation after severe COVID-19 was safe and feasible. Patients were able to participate in frequent, long duration rehabilitation with nearly all patients discharging to the community. Clinically, inpatient rehabilitation should be considered for patients with functional limitations following severe COVID-19. Given 90% of our cohort required critical care, future studies should investigate the efficacy and effectiveness of inpatient rehabilitation following hospitalization for critical illness. Frequent, long duration rehabilitation shows promising potential to address functional impairments following hospitalization for severe COVID-19. IMPACT STATEMENT: Inpatient rehabilitation facilities should be considered as a discharge location for hospitalized survivors of COVID-19, especially severe COVID-19, with functional limitations precluding community discharge. Clinicians and administrators should consider inpatient rehabilitation and inpatient rehabilitation facilities to address the rehabilitation needs of COVID-19 and critical illness survivors.