Postacute Rehabilitation for Survivors of COVID-19 in an Inpatient Rehabilitation Setting: A Case Series

Lijo, Mithu; Hamilton, Ashley; Wren, Nicole; Russell, Mary

Research Objectives To investigate the rehabilitation outcomes of patients with COVID-19, admitted to an in-hospital inpatient rehabilitation unit. Design Case series method. All patients were followed up by phone call six months after discharge. Setting In-hospital Inpatient Rehabilitation Unit. Participants Subjects included three male patients in the age range of 55-65 with underlying medical conditions after COVID-19 infection with a mean acute hospital stay of 39 days. Interventions All three patients received services from an interdisciplinary team led by a physical medicine and rehabilitation specialist. Interventions were focused on managing ongoing medical issues, weaning off of supplemental oxygen, restorative and compensatory training to improve independence with functional mobility, activities of daily living, assessment and treatment of dysphagia, speech/voice, and cognitive-communication deficits. Main Outcome Measures Six-minute Walk Test, 10-meter Walk Test, GG codes, Berg Balance Scale, MRC sum score, Montreal Cognitive Asessment, Dynamometry and 9-hole Peg Test. Results The average length of stay at the rehabilitation unit was 21 days. The distance on six-minute walk has improved from being unable to walk for six minutes on admission to an average of 921 feet at a speed of 1.05m/s. Two out of three patients remained at medium risk of falls requiring use of assistive devices for mobility. Persisting dysphagia and dependence on supplemental oxygen was an issue for one patient. All three patients discharged home with support from family members and no episode of readmission to hospital within six months after discharge. Conclusions Ongoing fatigue, cognitive impairment and reduced endurance demonstrates the impact of COVID-19 on multiple organ systems in the body. Intensive inpatient rehabilitation is beneficial to accelerate recovery process, while managing ongoing medical issues. Author(s) Disclosures Russell ME: Speakers Bureau for Allergan and Merz. LIjo, Hamilton, Wren: Nothing to disclose.