Outcomes after specialized rehabilitation for patients with critical COVID-19 and prolonged intensive care unit stays

Advances in intensive care have improved survival in patients with prolonged critical illness, including those with critical COVID-19. However, prolonged stays in intensive care units are associated with impairments in physical function, mental health, and health-related quality of life.

This retrospective study analyzed outcomes for 30 patients admitted to a specialized intensive care rehabilitation center between August 2020 and April 2022 after critical COVID-19.

Patients had a median age of 62 years and had spent a median of 52 days in an intensive care unit prior to admission, followed by 32 days at the center. At the center, weaning from invasive mechanical ventilation via a tracheostomy tube was achieved in 12 of 13 patients within a median of 17 days, and 23 of 25 patients with a tracheostomy were decannulated after a median of 18 days. Functional outcomes improved significantly, as measured by the Functional Oral Intake Scale, the Chelsea Critical Care Physical Assessment Tool, and the Katz Index of Independence in Activities of Daily Living (p < 0.001). One- and two-year survival rates were 90% and 86%, respectively. Assessments of health-related quality of life showed physical functioning as the most affected domain.

These findings suggest that specialized rehabilitation may support functional recovery and favorable long-term outcomes in patients recovering from critical COVID-19, consistent with reports from other populations with prolonged critical illness.