COVID-19 Patient Returned to Work after Long Hospitalization and Follow-up: A Case Report

Uchiyama, Yuki; Sasanuma, Naoki; Nanto, Tomoki; Fujita, Kouhei; Takahashi, Miyako; Iwasa, Saya; Koyama, Tetsuo; Kodama, Norihiko; Domen, Kazuhisa

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes severe respiratory dysfunction and post-intensive care syndrome (PICS), which can significantly affect the return to work after discharge from the hospital. This report describes the first case of a patient with severe COVID-19 at our institution during the first wave of the COVID-19 pandemic (February to June 2020) who returned to work following rehabilitation management. CASE: A 48-year-old female nurse was admitted with COVID-19 and underwent mechanical ventilation (MV). Respiratory and anti-gravity training was conducted as physical therapy; however, the patient developed PICS, muscle weakness, delirium, and psychological problems. After the withdrawal of MV, muscle strengthening activities, activities of daily living (ADL) training, family visits, and occupational and speech therapy were started. On day 60 post-admission, the patient was able to perform ADL independently and was discharged; however, she continued to experience shortness of breath during exertion. Post-discharge, follow-up assessments for symptoms, respiratory function, and exercise capacity were continued. On day 130, she returned to work as a nurse. DISCUSSION: The PICS noted during hospitalization in this patient improved, but at discharge, the patient had difficulty completing the practical tasks involved in a nurse’s workload. Follow-up assessments of symptoms, respiratory function, and exercise capacity after discharge helped to determine whether the patient could return to work.