Claudio Curci1, Fabrizio Pisano1, Eleonora Bonacci2, Danila M Camozzi1, Claudia Ceravolo3, Roberto Bergonzi3, Silvia De Franceschi3, Paolo Moro3, Rodolfo Guarnieri2, Martina Ferrillo4, Francesco Negrini5, Alessandro de Sire6,7. 1. Neurorehabilitation Unit, San Marco Polyclinic Hospital, San Donato Groups, Zingonia, Bergamo, Italy. 2. Pulmonary Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy. 3. Orthopedic Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy. 4. Department of Surgical Sciences, University of Turin, Turin, Italy. 5. IRCCS Galeazzi Orthopedic Institute, Milan, Italy. 6. Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy - alessandro.desire@gmail.com. 7. Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy.
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic is quickly spreading, putting under heavy stress health systems worldwide and especially Intensive Care Units (ICU). Rehabilitation Units have a crucial role in reducing disability in order to reintroduce patients in the community. AIM: The aim of this study is to characterize pulmonary function and disability status and to propose an early rehabilitation protocol in a cohort of post-acute COVID-19 patients admitted to an Italian Rehabilitation Unit. DESIGN: Cross-sectional observational study. SETTING: Inpatients Rehabilitation Unit. POPULATION: Post-acute COVID-19 patients. METHODS: Demographic, anamnestic and clinical characteristics, laboratory exams and medical imaging findings were collected for the entire cohort. Outcome measures evaluated at the admission in Rehabilitation Unit were: type of respiratory supports needed, fraction of inspired oxygen (FiO<inf>2</inf>), partial pressure of oxygen (PaO<inf>2</inf>), FiO<inf>2</inf>/PaO<inf>2</inf>, Barthel Index (BI), modified Medical Research Council (mMRC) Dyspnoea Scale, and 6-Minute Walking Test (6-MWT). Furthermore, we proposed an early rehabilitation protocol for COVID-19 patients based on baseline FiO2. RESULTS: We included 32 post-acute COVID-19 patients (22 male and 10 female), mean aged 72.6±10.9 years. BI was 45.2±27.6, with patients in need of higher FiO<inf>2</inf> (≥40%) showing lower values: 39.6±25.7 vs. 53.3±29.3. All patients had grade 4 or 5 on the mMRC Dyspnea Scale. Only 14 COVID-19 patients were able to walk (43.7%). 6-MWT was feasible in 6 (18.8%) patients with a mean distance of 45.0±100.6 meters. CONCLUSIONS: Taken together, our findings suggest that post-acute COVID-19 patients suffered from dyspnea and shortness of breath even for minimal activities, with a resulting severe disability, and only a few of them were able to perform 6-MWT with poor results. An early rehabilitation protocol was proposed according to the baseline conditions of the patients. CLINICAL REHABILITATION IMPACT: This study could provide an accurate description of COVID-19 sub-acute patients admitted to a Rehabilitation Unit along with a proposal of treatment to help physicians to tailor the best possible rehabilitative treatment.
BACKGROUND:Coronavirus disease 2019 (COVID-19) pandemic is quickly spreading, putting under heavy stress health systems worldwide and especially Intensive Care Units (ICU). Rehabilitation Units have a crucial role in reducing disability in order to reintroduce patients in the community. AIM: The aim of this study is to characterize pulmonary function and disability status and to propose an early rehabilitation protocol in a cohort of post-acute COVID-19patients admitted to an Italian Rehabilitation Unit. DESIGN: Cross-sectional observational study. SETTING: Inpatients Rehabilitation Unit. POPULATION: Post-acute COVID-19patients. METHODS: Demographic, anamnestic and clinical characteristics, laboratory exams and medical imaging findings were collected for the entire cohort. Outcome measures evaluated at the admission in Rehabilitation Unit were: type of respiratory supports needed, fraction of inspired oxygen (FiO<inf>2</inf>), partial pressure of oxygen (PaO<inf>2</inf>), FiO<inf>2</inf>/PaO<inf>2</inf>, Barthel Index (BI), modified Medical Research Council (mMRC) Dyspnoea Scale, and 6-Minute Walking Test (6-MWT). Furthermore, we proposed an early rehabilitation protocol for COVID-19patients based on baseline FiO2. RESULTS: We included 32 post-acute COVID-19patients (22 male and 10 female), mean aged 72.6±10.9 years. BI was 45.2±27.6, with patients in need of higher FiO<inf>2</inf> (≥40%) showing lower values: 39.6±25.7 vs. 53.3±29.3. All patients had grade 4 or 5 on the mMRC Dyspnea Scale. Only 14 COVID-19patients were able to walk (43.7%). 6-MWT was feasible in 6 (18.8%) patients with a mean distance of 45.0±100.6 meters. CONCLUSIONS: Taken together, our findings suggest that post-acute COVID-19patients suffered from dyspnea and shortness of breath even for minimal activities, with a resulting severe disability, and only a few of them were able to perform 6-MWT with poor results. An early rehabilitation protocol was proposed according to the baseline conditions of the patients. CLINICAL REHABILITATION IMPACT: This study could provide an accurate description of COVID-19 sub-acute patients admitted to a Rehabilitation Unit along with a proposal of treatment to help physicians to tailor the best possible rehabilitative treatment.
Authors: Manuela Funke-Chambour; Pierre-Olivier Bridevaux; Christian F Clarenbach; Paola M Soccal; Laurent P Nicod; Christophe von Garnier Journal: Respiration Date: 2021-06-04 Impact factor: 3.580
Authors: Marta Matamala-Gomez; Sara Bottiroli; Olivia Realdon; Giuseppe Riva; Lucia Galvagni; Thomas Platz; Giorgio Sandrini; Roberto De Icco; Cristina Tassorelli Journal: Front Neurol Date: 2021-03-25 Impact factor: 4.003