Rehabilitation needs of long COVID patients in British Columbia

COVID-19 can result in persistent symptoms and functional impairment that significantly impact daily functioning, highlighting the need for targeted rehabilitation. However, there is a lack of data on what proportion of long COVID patients need rehabilitation and which types are required.

To estimate the rehabilitation needs of patients with long COVID.

Retrospective, cross-sectional analysis of clinical data.

Post-COVID recovery clinic in British Columbia, Canada.

Individuals with long COVID, defined as having symptoms persisting beyond 3 months post infection, with the first clinic visit occurring within 6 months post infection.

Not applicable.

We created thresholds based on objective tests and patient-reported outcomes to determine rehabilitation needs.

Data from 3709 patients who visited the clinic between March 2020 and May 2023 were available for analysis; 33% met the study eligibility criteria (n = 1237). Patients were primarily women (65%) and white (57%), with a mean age of 49 ± 14 years. Two thirds had required hospitalization. The average time from infection to clinic visit was 136 ± 34 days. At 3-6 months post infection, the most common COVID-19 symptoms were fatigue, dyspnea, muscle weakness, and muscle/joint aches. Most patients exceeded the rehabilitation threshold for dyspnea (83%), fatigue (78%), frailty (74%), and posttraumatic stress disorder (58%). Quality of life was impaired for 80%. Neuropsychological symptoms like anxiety (42%) and depression (36%) were also prevalent. Reductions in 6-minute walk distance (≥25%) and sit-to-stand performance (≥50%) occurred in 26% and 55% of patients, respectively. The majority of participants (98%) exceeded at least one test threshold for rehabilitation, and most (85%) were eligible for more than one type. The most required types of rehabilitation were pulmonary rehabilitation (83%), mental health support (78%), and neurorehabilitation (70%).

The need for rehabilitation services among individuals experiencing long COVID in British Columbia is substantial. Use of predefined thresholds that incorporate measures of both symptom burden and functional impairment can effectively support the identification of high-need patients and their overall rehabilitation needs. Combined with clinicians' expertise, this approach can facilitate timely, evidence-based referrals to specialized care for those who need it.