New Study Examines Outcomes of Rehab Inpatients with Severe COVID-19 Infections
(Boston, MA) – A group based at Spaulding Rehabilitation Hospital and Harvard Medical School Department of Physical Medicine and Rehabilitation published a new study titled “Functional outcomes in the inpatient rehabilitation setting following severe COVID-19 infection” in PLOS One Journal. The retros study examined patients admitted during the first surge of COVID-19 during the Spring 2020. The study found that patients admitted to inpatient rehabilitation after hospitalization with COVID-19 demonstrated deficits in mobility, cognition, speech and swallowing at admission and improved significantly in all of these domains by discharge. However, a significant number of patients exhibited residual deficits at discharge highlighting the post-acute care needs of this patient population.
“As we now start to understand the long term aspects of COVID-19 infections and the aftermath, this study begins to create a road map to create the care designs that will be critical to enable people to maximize their recoveries. The study also demonstrates the need for long term characterization of both the recovery and deficits experienced by those with post-acute COVID syndrome,” said Ross Zafonte, DO study co-author, Chairman of the Department of Physical Medicine and Rehabilitation at Harvard Medical School and Senior Vice President Medical Affairs Research and Education at Spaulding Rehabilitation.
The study population included 29 patients and was 70% male, 58.6% white and with a mean age of 59.5. The mean length of acute hospitalization was 32.2 days with a mean of 18.7 days intubated. Patients spent a mean of 16.7 days in inpatient rehabilitation and 90% were discharged home. Patients demonstrated significant improvement from admission to discharge in measures of fall risk, endurance, gait speed, mobility, cognition, speech and swallowing.
The cohort of severe COVID-19 patients experienced multidimensional functional deficits in mobility, cognition, speech and swallowing were pervasive at the time of admission to rehabilitation. Although the study population demonstrated significant improvements in all domains examined, deficits remained in domains of fall risk, gait speed and cognition at rehab discharge.
“This study highlights the prevalence of persistent functional deficits after severe COVID-19 that will require ongoing treatment and may, in some cases lead to longer-term impairments. Additionally, this study begins to illuminate the post-acute care needs of this population. We need to devote resources to further study this population and begin to understand how we can address these long-term impacts and to determine what post-acute care settings and services are needed,” said co-author Jeffrey Schneider, MD Medical Director, Burn and Trauma Rehabilitation Program at Spaulding Rehabilitation Hospital and Associate Professor of Physical Medicine and Rehabilitation, Harvard Medical School.
"This study is the first to quantitatively characterize the functional and cognitive deficits that COVID-19 survivors exhibit during inpatient rehabilitation. Although patients demonstrated significant functional improvement, persistent deficits in mobility, cognition and swallowing remained pervasive. This highlights the importance of post-acute rehabilitation and the potential for long-term impairments in COVID-19 survivors" Cameron Olezene, MD study first author, PGY-4 resident at the Spaulding Physical Medicine and Rehabilitation residency program.
About Spaulding Rehabilitation
A member of MassGeneral Brigham Health System, Spaulding Rehabilitation includes Spaulding Rehabilitation Hospital, with a main campus in Charlestown the 2nd ranked rehabilitation hospital in the country by U.S. News & World Report, along with Spaulding Rehabilitation Hospital Cape Cod, Spaulding Hospital Cambridge, Spaulding Nursing and Therapy Center Brighton, and over 25 outpatient sites throughout Eastern Massachusetts. An acclaimed teaching hospital of Harvard Medical School and home to the Department of Physical Medicine and Rehabilitation, Spaulding is recognized as the top residency program in the U.S. in the 2020/2021 Doximity Residency Navigator. Spaulding also was recognized by the 2020 Disability Equality Index as a “Best Places to Work for Disability Inclusion.” For more information, visit www.spauldingrehab.org.