The Effect of Early Rehabilitation on COVID-19: A Prospective, Observational Study

Abstract

Objective:The aim of this study was to investigate the effect of early pulmonary rehabilitation (PR) on the course of the disease, respiratory functions, physical activity, fatigue, and discharge time in Coronavirus disease-2019 (COVID-19) patients in the intensive care unit (ICU) setting.Method:A total of 31 patients (20 females, 11 males) with COVID-19 confirmed by real-time polymerase chain reaction who were admitted to the ICU were included. Demographic, clinical, and laboratory data of the patients were recorded. Physical activity, dyspnea, and fatigue of all patients were evaluated before and after PR program. All patients were evaluated on the day of PR in the ICU, the day of discharge from ICU to the ward, and on the day of discharge from hospital. Functional status was evaluated using the functional disability questionnaire (FDQ), the ambulation status using the functional ambulation classification (FAC), dyspnea using the modified Borg scale (MBS), and fatigue using the fatigue severity scale.Results:The mean length of ICU and hospital stay was 17.93±11.54 days and 18.29±8.41 days, respectively. The mean number of sessions was 8.87±7.66. The mean time from hospitalization to recovery was 13.00±9.62 days. Median FDQ and MBS scores were significantly higher during the ICU stay than the ward stay and at the time of discharge (p<0.05). Median FAC scores were significantly higher at the time of discharge than the ward and ICU scores (p<0.05). There was a positive and statistically significant correlation between the FDQ scores during the ward stay and C-reactive protein (CRP) values during the ICU stay (r=0.382, p=0.034) and CRP values during the ward stay (r=0.379, p=0.035). There was a negative and statistically significant correlation between the FDQ scores at the time of discharge and ferritin levels during the ICU stay (r=-0.421, p=0.018). A positive and statistically significant correlation was observed between MBS scores at the time of discharge and CRP values during the ward stay (p=0.418, p=0.019).Conclusion:Our study suggests that PR is an effective and safe approach with improved physical and functional results and COVID-19 survivors should undergo a PR program in an individualized manner using a multidisciplinary approach to improve short- and long-term outcomes.

Keywords

• covid-19
• early rehabilitation
• pulmonary rehabilitation
• intensive care unit