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Published on: April 19, 2019
Functional outcomes of protocol-based rehabilitation for patients with coronavirus disease 2019 in an acute care
Yoshitaka Wada1, Seiko Shibata1, Ayato Shinohara2
1Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Insights
This study evaluated functional outcomes in COVID-19 patients undergoing rehabilitation. Severe COVID-19 disease significantly impacted functional independence at discharge, highlighting the need for tailored rehabilitation programs.
Area of Science:
- Rehabilitation Medicine
- Infectious Diseases
- Clinical Outcomes
Background:
- Coronavirus disease 2019 (COVID-19) poses significant challenges to patient recovery and functional independence.
- Protocol-based rehabilitation programs are emerging as a critical component of acute care for COVID-19 survivors.
Purpose of the Study:
- To assess the functional outcomes of patients hospitalized with COVID-19 after implementing a novel protocol-based rehabilitation program.
- To identify factors influencing functional recovery in COVID-19 patients.
Main Methods:
- Retrospective cohort study of 78 hospitalized COVID-19 patients in Japan (September 2020 - July 2021).
- Primary outcome: Functional Independence Measure (FIM) motor subtotal score at discharge.
- Secondary outcomes: FIM cognitive score, hospital stay, rehabilitation duration, and discharge destination.
Main Results:
- Disease severity significantly influenced FIM motor scores at discharge (p=0.027).
- Patients with severe COVID-19 had significantly lower FIM motor scores compared to those with moderate II severity (p=0.030).
- 30.8% of enrolled patients died during hospitalization.
Conclusions:
- COVID-19 disease severity is a significant determinant of functional outcomes at hospital discharge.
- The protocol-based rehabilitation program serves as a valuable benchmark for managing COVID-19 patients in acute care settings.
Objectives:
To examine the functional outcomes of patients with coronavirus disease 2019 (COVID-19) who underwent a new protocol-based rehabilitation program.
Methods:
In this retrospective cohort study, we enrolled patients who were hospitalised in a university hospital in Japan because of COVID-19 from 1st September, 2020-5th July, 2021. The primary outcome was the Functional Independence Measure (FIM) subtotal score for motor items at discharge. The secondary outcomes included the FIM cognitive subtotal score, length of hospital stay, rehabilitation period, total rehabilitation time, final rehabilitation protocol level, and discharge destination.
Results:
Of the 78 enrolled patients (49 men; mean age [standard deviation], 70.3 [13.9] years), 24 died (30.8%) during hospitalisation. Disease severity was classified as mild, moderate I, moderate II, and severe in 1, 6, 41, and 30 patients, respectively. The FIM motor subtotal score differed significantly among groups for all participants (p=0.027). Post hoc analysis revealed that the FIM motor subtotal score in the severe group was significantly lower than that in the moderate II group (p=0.030).
Conclusions:
Disease severity significantly affected patients' functional outcome for COVID-19 at discharge. Our protocol-based program provides a benchmark for COVID-19 rehabilitation in an acute care setting.
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