The Coronavirus has made us live an unprecedented situation in Spain. The serious consequences that the pandemic, from which it seems to have passed its worst moment, still interfere in the lives of thousands of people who at some point were hospitalized for Covid-19 and that they continue to require rehabilitation to return to his correct physical condition.
According to a study carried out by the Covid-19 Working Group of the Spanish Society for Rehabilitation and Physical Medicine (SERMEF); half of the patients hospitalized for Covid-19 (54%) need Physical Medicine and Rehabilitation treatment once they have been discharged, especially due to limited mobility due to problems derived from their poor muscular and respiratory condition.
As the study points out, only 10% of the patients were discharged home completely autonomously. This research was carried out during the first and second waves of the pandemic -between March 15, 2020 and December 31, 2020- in the university hospitals of Albacete, Guadalajara, Sant Pau de Barcelona, Joan XXIII of Tarragona and Miguel de Servet de Zaragoza, evaluated 339 patients.
The people investigated during the study were around 63 years old and the most affected were men, accounting for 62.5% of all patients. A quarter of the sample had previous heart or respiratory diseases and the risk of admission to the ICU was higher in those with a history of heart disease.
For its part, the mean stay for admission to the ICU was 19 days and in the hospital ward in the Pulmonology or Internal Medicine Services was 25 days.
Covid-19 has been a challenge for the Spanish Society for Rehabilitation and Physical Medicine
The SERMEF stresses that the Covid-19 pandemic has increased “the burden of diseases and disabilities around the world.” «This new disease and its consequences have been a great challenge for all Physical Medicine and Rehabilitation services: on the one hand, it has caused serious disorders in the care and organization of the units, and on the other it has allowed the deployment of resources and forms of previously unknown attention ”, they point out.
During the study, it was found that two out of three patients had a sensation of suffocation or dyspnea when walking fast, climbing hills or even on flat terrain. Thus, of the 339 patients, only 5.9% needed oxygen to walk after discharge, something that in patients admitted to the ICU increased to 6.4%.
Likewise, 27.4% of the total of the patients analyzed (1 in 4 patients) needed help to walk (cane, walker or support in another person), few needed a wheelchair, only 7.4%.
However, if the subset of patients admitted to the ICU is analyzed, it is observed that this need for rehabilitation was greater; being the percentage of patients dependent on gait of 32.9% (1 out of 3), demonstrating, therefore; a statistically significant relationship between stay in the ICU and the need for walking aids.
On the other hand, 54% of patients who have been admitted to a hospital for Covid-19 have needed to receive medical-rehabilitative treatment upon discharge. The patients who required Rehabilitation had limited mobility mainly due to problems derived from their poor muscular and respiratory condition.
7 out of 10 ICU patients required rehabilitation
The study also shows the distribution during outpatient treatment, with 22% being hospital and 22% being treatment at home. Despite the development and rise of tele-rehabilitation due to the needs of the pandemic, only 1 patient out of 339 in the sample used this treatment modality. In addition to the need for physical therapy, 1 in 4 required respiratory muscle training.
Regarding the patients admitted to the Intensive Care Unit (ICU), 7 out of 10 required medical-rehabilitative treatment upon discharge (68.5%). However, in those who did not require admission to the ICU, only 3 out of 10 patients (27.7%) required rehabilitative treatment at hospital discharge. Therefore, ICU stay is clearly and strongly related to the need for post-hospital rehabilitation (statistically significant relationship).
For this reason, the SERMEF explains that the interventions carried out from Rehabilitation allow studying and addressing the sequelae that a severe Covid patient may present. These usually range from physical limitations to swallowing disorders, limitations due to respiratory failure, or cognitive and behavioral deficits.
“It is important to guarantee a continuity in the Rehabilitation treatment: the ideal thing would be that there should be no interruptions in the treatment in the moments in which the patient changes of scope (from ICU to ward, from ward to hospital discharge)”, they affirm from the society that values the importance of rehabilitation in hospitalized patients who have passed the Covid-19.