Last updated December 4, 2021
ID | Update | Author | DOI | Year | Country | Dates | Aim of the study | Study Design | Type of rehabilitation service | Research Question | LFRI | COVID-19 Phases | Population | N° of participants | Clinical presentation | Intervention | Comparator | Outcomes | Adverse events | Diagnostic test | Sensitivity | Specifity | Types of validity | Attributes of reliability | Main findings |
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1 | June | Aoyagi Y | 10.1007/s00455-020-10140-z | 2020 | Japan | N/R | To report the first case of a patient with oropharyngeal dysphagia associated with COVID-19 and discuss the potential underlying cause. | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Clinical presentation | Digestive functions (b510) | Acute | COVID-19 patient with dysphagia | 1 | At admission: - sore throat, cough, and high fever 20 day from admission: - dysphagia - persistent taste impairment - aspiration pneumonia | antibiotics, mechanical ventilation dysphagia rehabilitation program including tongue-hold swallow, tongue base exercise, Shaker exercise, and transcutaneous electrical sensory stimulation using interferential current | N/A | - NRRSv - NRRSp - mesopharyngeal peak pressure - mesopharyngeal contractile integral - SRI | N/A | N/A | N/A | N/A | N/A | N/A |
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2 | June | Assini A | 10.1007/s10072-020-04484-5 | 2020 | Italy | N/R | To report two different clinical manifestations of COVID-19 related GBS; one is a GBS/MF overlap syndrome, the other one an Acute Motor Sensory Axonal Neuropathy (AMSAN) with massive vegetative impairment, both highly responsive to intravenous immunoglobulins. | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients | 2 | > Case 1: - at admission: severe respiratory syndrome preceded by anosmia and ageusia, fever, and cough - 20 day from admission: bilateral eyelid ptosis, dysphagia, and dysphonia, bilateral masseter weakness, tongue protrusion deficit, and hyporeflexia of upper and lower limbs (without muscle weakness) and deficit of elevation of the soft palate. > Case 2: - at admission: fever and cough - during hospitalization: acute weakness in lower limbs with distal distribution and foot drop on the right side associated with massive gastroplegia, paralytic ileus, and loss of blood pressure control | hydroxychloroquine, antiretroviral therapy, and tocilizumab, intravenous immunoglobulins | N/A | case 1: swallowing, speech, and tongue motility and strength, as well as on eyelid ptosis case 2: vegetative symptomatology, osteotendinous hyporeflexia, right foot drop | N/A | N/A | N/A | N/A | N/A | N/A | The first patient was a 55-year-old man hospitalized for severe respiratory syndrome due to
COVID-19
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3 | June | Bao Y | 10.1007/s42399-020-00315-y | 2020 | China | February-March 2020 | To report a case of COVID-19 complicated with cerebral hemorrhage and summarize the relevant treatment experience. | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patient | 1 | Sudden disturbance of consciousness | - Craniotomy - Antiviral treatment and COVID-19 convalved patient plasma infusion | N/A | Symptoms, dyspnea, body temperature | N/A | N/A | N/A | N/A | N/A | N/A |
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4 | June | Bracaglia M | 10.1007/s00415-020-10014-2 | 2020 | Italy | March 15th, 2020 | To describe a case of COVID-19 presenting with acute demyelinating polyneuritis in absence of respiratory symptoms common to SARS-CoV-2 infection | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patient | 1 | The patient reported hyposthenia in the four limbs (MRC scale of 1/5 in distal and 2/5 in proximal lower extremities and 3/5 in distal and 4/5 in proximal upper extremities), distal tingling sensation, pronounced lumbar pain for about eight days, tendon reflexes abolished, inability to walk, difficulty in swallowing and speeching. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The case highlights the chance that COVID-19 manifests with neurological symptoms in absence of any usual infectious manifestations (fever....) probably as part of a dysimmune process. |
5 | June | Brugliera L | 10.1038/s41430-020-0664-x | 2020 | Italy | March - April 2020 | To discuss the efficacy of an interdisciplinary management of nutrition for COVID-19 patients. | Analytical: Cohort study | N/A | Micro - Interventions (efficacy/harms) | Digestive functions (b510) | Acute | COVID-19 patients | 32 | Dependence for motor or respiratory functions at FIM assessment and risk of malnutrition | Three-step nutritional protocol | N/A | Malnutrition Universal Screen Tool (MUST), Body Mass Index (BMI) | N/A | N/A | N/A | N/A | N/A | N/A | Cohort study assessing the efficacy of a three-step nutritional protocol:
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6 | June | de Lima MS | 10.6061/clinics/2020/e2021 | 2020 | Brazil | N/R | To investigate the incidence of dysphagia, its time course, and its association with clinically relevant outcomes in extubated critically ill patients with COVID-19, compared to data of non-COVID-19 patients who were also subjected to prolonged orotracheal intubation. | Analytical: Case-control study | N/A | Epidemiology - Clinical presentation | Digestive functions (b510) | Acute | COVID-19 patients referred for a bedside swallowing assessment | 101 COVID-19 vs 150 controls | COVID-19 patients subjected to orotracheal intubation, Glasgow Come Scale ≥ 14, stable medical respiratory condition | Exposure to COVID-19 | Not exposure to COVID-19 | - American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS) swallowing level scale [Level 1 – the individual is not able to swallow safely orally. Nutrition and hydration are received through non-oral means; Level 7 – an individual’s ability to eat independently is not limited by the swallow function. Swallowing would be safe and efficient for all consistencies. Compensatory strategies are effectively used when needed], within 24 hours after extubation and at ICU discharge. - Days of intubation - Sessions for dysphagia resolution | N/A | N/A | N/A | N/A | N/A | N/A |
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7 | June | Decavel P | 10.1212/WNL.0000000000010011 | 2020 | France | March 20, 2020 | To describe a case of Tapia syndrome after prolonged intubation due to severe COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 patient | 1 | The patient presented dysphonia and swallowing difficulties after removal of orotracheal intubation. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The paper describe a case of a 62-year-old patient that required ventilatory assistance for 16 days. After removal of orotracheal intubation, the patient presented dysphonia and swallowing difficulties. Neurological evaluation and nasofybroscopy revelead a paralysis of left hypoglossal and vagus nerve. One month later the clinical status of the patient still was not improved. |
8 | June | Efe IE | 10.1016/j.wneu.2020.05.194 | 2020 | Turkey | N/R | To present a patient with COVID-19-associated encephalitis mimicking a glial tumor | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patient | 1 | Headache, nausea, dizziness and drug-refractory seizures | Left anterior temporal lobectomy | N/A | Neurologic symptoms | N/A | N/A | N/A | N/A | N/A | N/A |
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9 | June | Garg A | 10.7759/cureus.8847 | 2020 | USA | N/R | To describe a case of COVID-19 infection with delayed thromboembolic complication on Warfarin | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patient | 1 | One month after recovering from COVID-19 pneumonia he referred worsening shortness of breath and cough | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This case highlights the risk of delayed thromboembolic complications (a month after recovering from pneumonia) in patients with COVID-19 and the need to identify and monitor the patients with a higher risk of thromboembolism ( those with underlying comorbid conditions that may require anticoagulation for a longer duration) |
10 | June | Grimaud M | 10.1186/s13613-020-00690-8 | 2020 | France | April 15th - 27th, 2020 | To describe the characteristics, management and time course of 20 critically ill children admitted to the PICU with cardiogenic shock secondary to acute myocarditis and suspected SARS-CoV-2 infection. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Cardiovascular functions (Heart b410) | Acute | Critically ill children patients with suspected COVID-19 infection | 20 | Hypotensive shock, abdominal pain, vomiting, fever, acute myocarditis and arterial hypotension with mainly vasoplegic clinical presentation | Exposure to COVID-19 | N/A | Clinical, biological and hemodynamic characteristics | N/A | N/A | N/A | N/A | N/A | N/A |
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11 | June | Gutierrez-Ortiz C | 10.1212/WNL.0000000000009619 | 2020 | Spain | N/R | To report two COVID-19 patients presenting with Miller Fisher syndrome and polyneuritis cranialis, respectively. | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Acute | COVID-19 patients | 2 | Patient 1: 50-year-old man presenting with anosmia, ageusia, right internuclear ophthalmoparesis, right fascicular oculomotor palsy, ataxia, areflexia, albuminocytologic dissociation and positive testing for GD1b-IgG antibodies. Patient 2: 39-year-old man presenting with ageusia, bilateral abducens palsy, areflexia and albuminocytologic dissociation. | Patient 1: treated with intravenous immunoglobulin. Patient 2: treated with acetaminophen. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | These 2 cases highlight the occurrence of Miller Fisher syndrome and polyneuritis cranialis in COVID-19 patients. Neurological manifestations might occur because of an aberrant immune response to COVID-19 |
12 | June | Heman-Ackah SM | 10.1093/neuros/nyaa198 | 2020 | USA | N/R | To describe 2 patients who required ECMO for refractory hypoxia secondary to COVID-19 and developed neurologically devastating intraparenchymal hemorrhage (IPH) despite lacking the classical risk factors. | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patients | 2 | - Case 1: at admission: cough, fever, and shortness of breath acute event: nonreactive right pupil - Case 2: at admission: cough, fever, and shortness of breath acute event: fixed and dilated left pupil | Case 1: intubation, ECMO, prone positioning, heparine Case2: intubation, ECMO, heparine | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
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13 | June | Iaccarino MA | 10.1097/PHM.0000000000001502 | 2020 | USA | N/R | To report the neurological symptoms associated with COVID-19 in hospitalized patients | Descriptive: Historical cohort | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patients | 214 | Approximately one-third (36.4%) of patients had neurological manifestation of the disease. Of those with neurological manifestations, 67.9% had central nervous system symptoms, most commonly dizziness (46.2%) and headache (35.8%), and 24.4% had peripheral nervous system manifestations including impaired taste (15.4%) and smell (14.1%). Other notable manifestations included stroke (n=6) and altered mental status (n=16). | Reporting prevalence of neurological clinical manifestations | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Approximately one-third of hospitalized patients with COVID-19 displayed neurological signs or symptoms, including a small subset of patients for which stroke-like symptoms were the primary presentation of infection. |
14 | June | Iannaccone S | 10.2340/16501977-2704. | 2020 | Italy | 2 months of 2020 | To describe the organizational needs and operational costs of COVID-19 rehabilitation units, by comparing its activity, organization, and costs with 2 other functional rehabilitation units (Cardiologic and the Motor Rehabilitation) | Analytical: Case-control study | Specialized postacute rehabilitation | Meso Level | Health services, systems and policies (e580) | Post-acute | COVID-19 patients | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The COVID-19 Rehabilitation Unit had the same number of care beds as the Cardiac and Motor Rehabilitation Units, but required twice the amount of staff and instrumental equipment, leading to a deficit in costs. |
15 | June | Kishfy L | 10.1016/j.jns.2020.116943 | 2020 | USA | April 2020 | To present the first case series of posterior reversible encephalopathy syndrome (PRES) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patients | 2 | Patients diagnosed with COVID-19 requiring mechanical ventilation due to acute hypoxic respiratory failure | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
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16 | June | Landes SD | 10.1016/j.dhjo.2020.100969 | 2020 | USA (New York State) | Beginning of the pandemic through May 28, 2020 | To describe COVID-19 outcomes among people with intellectual and developmental disabilities (IDD) living in residential groups homes in the state of New York and the general population of New York State. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | N/A | COVID 19 patients with or without intellectual and developmental disabilities | 1,602 people with IDD living in residential group homes versus 371,559 people without IDD | N/A | N/A | N/A | COVID-19 incidence COVID-19 case fatality | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19 case rate per 100000 is 7,841 for people with IDD compared to 1,910 for people without IDD; case fatality is 15.0% for people with IDD compared to 7.9% for people without IDD; mortality rate per 100,000 is 1,175 for people with IDD compared to 151 for people without IDD. COVID-19 appears to present a greater risk to people with IDD, especially those living in congregate settings. |
17 | June | Liu K | 10.1016/j.ctcp.2020.101166 | 2020 | China | Patient enrolment: January 1st to February 6th, 2020 | To investigate the effects of respiratory rehabilitation on respiratory function, ADL, QoL, and psychological status in elderly patients with COVID-19 who were discharged from the hospital with satisfying results. | Randomised controlled trial | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | Elderly patients with COVID-19 | 76 | N/A | (1) respiratory muscle training; (2) cough exercise; (3) diaphragmatic training; (4) stretching exercise; and (5) home exercise | NR | Primary: Respiratory function Secondary: Exercise endurance (6-min walk distance), ADL and QoL, psychological status assessment (anxiety, depression scores). | N/A | N/A | N/A | N/A | N/A | N/A |
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18 | June | Mo X | 10.1183/13993003.01217-2020 | 2020 | China | Patient enrolment: February 5th to March 17th | To describe the characteristics of pulmonary function in COVID-19 survivors after discharge from hospital | Descriptive Study - Retrospective uncontrolled cohort | N/A | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patients | 110 | - mild illness: mild symptoms without radiographic appearance of pneumonia - pneumonia: having symptoms and the radiographic evidence of pneumonia, with no requirement for supplemental oxygen - severe pneumonia: having pneumonia, including one of the following: respiratory rate > 30 breaths/minute; severe respiratory distress; or SpO2 ≤ 93% on room air at rest | COVID-19 | N/A | - SpO2% on room air - Spirometry:TLC%, FVC%, FEV1, FEV1/FVC - DLCO% - DLCO/VA | N/A | N/A | N/A | N/A | N/A | N/A |
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19 | June | Mukaino M | 10.1097/PHM.0000000000001441 | 2020 | Japan | N/R | To describe a preliminary attempt to use a telerehabilitation system to deliver exercise opportunities to individuals isolated because of SARS-CoV-2 infection. | Descriptive: Case Series | Rehabilitation in acute care | Meso Level | Products and technology (Products for communication e125) | Acute | Patients in need of rehabilitation | 4 | NR | telerehabilitation | N/A | - satisfaction, - whether the patients felt it meaningful for their health to participate in the program - whether they would recommend this exercise to others | No adverse events | N/A | N/A | N/A | N/A | N/A |
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20 | June | Novi G | 10.1212/NXI.0000000000000797 | 2020 | Italy | N/R | To report on a COVID-19 case presenting with ADEM, preceded by an influenza-like syndrome | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Acute | COVID-19 patient | 1 | Before admission: influenza-like syndrome, anosmia and ageusia At admission: - mild behavioral abnormalities (irritability) - headache - bilateral relative afferent pupillary defect - ageusia and anosmia - severe visual loss - right abdominal sensory level - left-sided lower limb hyper-reflexia with positive Babinski sign | - high-dose steroids (IV methylprednisolone 1 g/d for 5 days tapered with oral prednisone 75mg/d) associated with - IV immunoglobulins (2 g/kg in 5 T8days) | N/A | - Vision - Visual-evoked potential - MRI Gd-enhancing lesions. | N/A | N/A | N/A | N/A | N/A | N/A |
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21 | June | Pancera S | 10.1097/HCR.0000000000000529 | 2020 | Italy | March 27th - April 21st, 2020 | To describe the respiratory rehabilitation program in a patient with severe COVID-19, referred to a tertiary subacute rehabilitation center | Descriptive: Case Report | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patient | 1 | Barthel index based on dyspnea: 61/100; EuroQol questionnaire—5 dimensions, 3 levels: 12/15; Short Physical Performance Battery= 0/12 | COVID-19 ward: Early mobilization; Leg/arm cranking; neuromuscular electrical stimulation; seat-to-stand training; Walking training; Weaning from mechanical ventilation. COVID-19 free ward: Aerobic training (cycle ergometer); Resistance training (elastic bands/free weights); Stair climbing. | N/A | BI, Barthel index; BID, Barthel index based on dyspnea; EQ-5D-3L, EuroQol questionnaire—5 dimensions, 3 levels; MRC sum score, Medical Research Council sum score; Q girth, quadriceps size (taken 10 cm above patella); SPPB, Short Physical Performance Battery; | N/A | N/A | N/A | N/A | N/A | N/A | A 51-year-old man with acute respiratory distress syndrome (ARDS) related to coronavirus disease-2019 (COVID-19) infection. The patient achieved autonomous walking within 1 week from intensive care unit (ICU) discharge. After 38 days of hospitalization , the patient recovered muscle function and increased quadriceps size (13%). Maximal inspiratory pressure and maximal expiratory pressure results showed a 7% improvement. |
22 | June | Patelli G | 10.1016/j.ejrad.2020.109121 | 2020 | Italy | April 15th-30th, 2020 | To review lung CT findings and report the preliminary results in relation to lung perfusion conditions more than one month after remission of the symptoms | Analytical: Case-control study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patients | 20 + 4 controls | Patients observed 40 +/- 13 days after fever resolution, in the phase where they were asymptomatic or slightly dyspnoic and with negative swab | Exposure to COVID-19 | Not exposure to COVID-19 | Volume of low perfusion tissue at chest CT | N/A | N/A | N/A | N/A | N/A | N/A |
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23 | June | Pattanakuhar S | 10.1097/phm.0000000000001485 | 2020 | Thailand | N/R | To present a patient with cervical traumatic SCI who developed COVID-19 in the acute phase and to describe the consequences at the individual and service level | Descriptive: Case Report | Specialized postacute rehabilitation | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | SCI patient developing COVID-19 | 1 | At admission: - weakness and numbness of upper and lower extremities bilaterally - grade 5 of biceps brachialis and grade 0 of all muscles below the C5 myotome of both sides - absent deep anal pressure and voluntary anal contraction - absent anal and bulbocavernosus reflexes At day 4: - 39°C fever, with mild dyspnea | - anterior cervical discectomy, and fusion with plates and screws and iliac bone grafting - Daily subcutaneous injection of 0.6 ml (60 mg) of enoxaparin - rehabilitation program: range of motion and isometric strengthening exercises of bilateral elbow flexors - hydroxychloroquine and azithromycin - lopinavir/ritonavir - oxygen therapy | N/A | - SaO2 - body temperature - heart rate - blood pressure | N/A | N/A | N/A | N/A | N/A | N/A |
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24 | June | Poussardin C | 10.1016/j.accpm.2020.06.002 | 2020 | France | February 24th - April 15th, 2020 | To provide an immediate feedback on a specialised ICU, allowing to increase knowledge and understanding of follow-up care requirements | Analytical: Cross-sectional study | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patients | 51 | 48/51 (94%) patients reported severe respiratory symptoms: 39/51 (76%) required orotracheal intubation and 9/51 (18%) tracheotomy. 13/51 patients (26%) exhibited neurologic disorders. | Reporting prevalence of clinical manifestations in COVID-19 patients admitted to the ICU | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors estimated that among the 51 patients, 5 (11%) patients will die within the ICU. If the 46 remaining patients should be weaned from ICU life support, 5 patients will need active post-resuscitation care (APRC) and 45 follow-up care. From the hospital perspective, it was estimated that 14 patients will need APRC and 205 follow-up care. From a population-based perspective, it was estimated that the need for APRC and follow-up care were respectively four and 40 per 100 000 inhabitants. Therefore, this study provides immediate patients’ characteristics and a first rough estimation of requirements for COVID-19 post-resuscitation care. |
25 | June | Prada V | 10.1097/MRR.0000000000000418 | 2020 | Italy | March 2020 | To describe the case of a patient with Charcot-Marie -Tooth who developed COVID-19 during the rehabilitation following tendon transfer surgery and was managed postoperatively by telemedicine. | Descriptive: Case Report | Rehabilitation services at home | Meso Level | Products and technology (Products for communication e125) | Post-acute | Charcot-Marie-Tooth patient developing COVID-19 | 1 | Headache, constant leg pain, and fever | Eight telerehabilitation sessions | N/A | Thumb Opposition Test, ad-hoc developed dexterity tests | N/A | N/A | N/A | N/A | N/A | N/A |
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26 | June | Righi G | 10.1038/s41394-020-0274-9 | 2020 | Italy | N/A | To present the clinical manifestation of COVID-19 in a person affected by tetraplegia. | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | Tetraplegia patient developing COVID-19 | 1 | - AIS A C4 tetraplegia since 2013 - Fever - mild dyspnea | - home therapy: oxybutynin, rivaroxaban, gabapentin, tramadol - before admission: trimethoprim/sulfamethoxazole - during hospital stay: various broad spectrum antibiotics, Furosemide, manually assisted cough, low-dose oxygen therapy Lopinavir/Ritonavir, hydroxychloroquine | N/A | - fever - arterial blood gas - nasopharyngeal swabs for the detection of SARS-CoV-2 | N/A | N/A | N/A | N/A | N/A | N/A |
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27 | June | Simonelli C | 10.4081/monaldi.2020.1085 | 2020 | Italy | March 14th - April 14th 2020 | To describe the unexpected and urgent organizational change of the Cardio-Pulmonary Rehabilitation (CPR) Service during the COVID-19 emergency in an Italian rehabilitation hospital, with focus on the Respiratory Physiotherapist Therapists’ (RPTs) role | Descriptive Study - Retrospective uncontrolled cohort | Specialized postacute rehabilitation | Meso Level | Health services, systems and policies (e580) | Post-acute | COVID-19 patients | 170 | Moderate/severe impairment of motor functional capacity with a SPPB 3 (0-7) points out of 12 | Organizational plan: general new hospital organization, role of RPTs, the number of all tasks performed by the RPTs during a typical working day, as well as the percentage of patients who needed a specific performance | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
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28 | June | Su XW | 10.1002/mus.26988 | 2020 | USA | N/R | To describe a patient who developed quadriplegic GBS with dysautonomia preceded by mild COVID-19–induced diarrhea. | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patient | 1 | - 7 days before admission: mild diarrhea, anorexia, and chills, without fever or respiratory symptoms - at admission: Quadriplegic Guillain-Barré syndrome with dysautonomia and syndrome of inappropriate antidiuretic hormone secretion | - mechanical ventilation - sulfamethoxazole-trimethoprim | N/A | - strength and extremities strength - nerve conduction studies - blood electrolytes | N/A | N/A | N/A | N/A | N/A | N/A |
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29 | June | Tatu L | 10.1007/s00415-020-10005-3 | 2020 | France - Switzerland | From March to April 2020 | To report an unusually high number of cases with diagnosis of Guillain–Barré syndrome during COVID-19 pandemic | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | N/A | Patients with diagnosis of Guillain–Barré syndrome with negative findings on SARS-CoV-2 nasopharyngeal swab and SARSCoV-2 serology | 6 | All 6 patients reported paresthesia. 4 patients reported paraparesis. 2 patients reported tetraparesis. 4 patients reported ataxia. 1 reported facial paralisis. | Reporting clinical manifestations of 6 patients with diagnosis of Guillain–Barré syndrome during COVID-19 pandemic in a Neurologic Unit | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Patient 3 had an acute motor-sensory axonal neuropathy; acute inflammatory demyelinating polyneuropathy (AIDP) was found in the other 5 patients. The neurological progression was favorable in 5 cases. Two patients (patients 1 and 2) relapsed, one of whom died from a severe acute respiratory syndrome. |
30 | June | Tunç A | 10.1016/j.jocn.2020.05.018 | 2020 | Turkey | Up to April 14th, 2020 | To describe a series of simultanously diagnosed COVID-19 and acute ischemic stroke | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients | 4 | Case 1 presented left facial paresis, dysarthria, left hemiparesis (NIHSS: 16), high fever, and cough. Case 2 suffered from dysarthria and right hemiparesis (NIHSS: 5), intermittent fever, and upper respiratory tract symptoms. Case 3 reported loss of consciousness, dysarthria, right hemiparesis ( NIHSS: 10), and mild cough. Case 4 left hemi-hypoesthesia with mild ataxia ( NIHSS: 2), fever, cough and shortness of breath. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Ischemic stroke may simultaneously develop in the course of Covid-19 independently of the critical disease process. In this study the average of time from Covid-19 onset to the diagnosis of ischemic stroke was 2 days (no cardioembolic type) |
31 | June | Vitale JA | 10.1080/07420528.2020.1775241 | 2020 | Italy | April 27th - May 12th, 2020 | To describe the quality of sleep of four COVID-19 recovered patients during the sub-acute stage of the disease | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 patients | 4 | Patient 1: able to walk autonomously without aid; Patient 2: able to walk autonomously without aid; Patient 3: able to walk autonomously using a single crutch; Patient 4: not able to stand up or walk autonomously. | Wearing an actigraph around the clock and completing a daily sleep diary to record bedtime, get-up time, and the spans of the day and night when the actigraph was not worn. Furthermore, the 4 patients underwent functional evaluation tests | N/A | Sleep parameters (time in bed, total sleep time, sleep efficiency, sleep latency, wake after sleep onset, immobility time, fragmentation index), assessed through an actigraph on the wrist of the non-dominant hand; the Pittsburgh Sleep Quality Index (PSQI); 30 s Sit-To-Stand Test (STST) and Timed Up and Go Test (TUG) | N/A | N/A | N/A | N/A | N/A | N/A | The mean sleep duration was 6.3 hours, indicating an insufficient sleep duration that could be partially attributed to the forced early awakening. Three out of four subjects were able to perform functional tests. These preliminary data suggest that functional recovery could not be considered as directly linked to sleep quality |
32 | June | Wang X | 10.1093/qjmed/hcaa178 | 2020 | China | February 3rd - 21st, 2020 | To track the course of clinical outcomes of COVID-19 patients after discharge, and the transmission risk during the observation period, therefore to make improvement on post-discharge management if necessary. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patients | 131 | On discharge, 78 of the 131 (59.54%) patients had no symptoms. However, 38 (29.01%) patients had cough, 10 (7.63%) had fatigue, 8 (6.11%) had expectoration, 8 (6.11%) had chest tightness, 5 (3.82%) had dyspnea, 4 (3.05%) had chest pain, 2 (1.53%) had dizziness and 2 (1.53%) had palpitation. Other rare symptoms, including pharyngeal pain, nausea, inappetence and vomiting were presented in 1 (0.76%) patient, respectively | Exposure to COVID-19 | N/A | Information regarding symptoms and treatment post hospitalization (detailed treatment of oxygen therapy and medicines), reexamined outcomes, distribution of quarantine locations and close contact history after discharge | N/A | N/A | N/A | N/A | N/A | N/A |
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33 | June | You J | 10.1016/j.jinf.2020.06.003 | 2020 | China | March 26th - May 1st, 2020 | To report the pulmonary function and chest CT changes in COVID-19 patients after discharge | Descriptive Study - Retrospective uncontrolled cohort | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patient | 18 | N/A | Spirometry Lung CT at 40 +/- 11 days of hospital discharge | N/A | All spirometry parameters of ventilation function Lung CT features | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19 survivors after discharge may report persistent restrictive ventilatory defect and small airway function impairment, regardless of their disease severity. So a long-term follow-up of lung function after discharge should be performed in clinical practice to provide a guideline for pulmonary rehabilitation. |
34 | June | Zanin L | 10.1007/s00701-020-04374-x | 2020 | Italy | N/R | To describe the case of a COVID-19 patient presenting with neurological symptoms associated with demyelinating brain lesions. | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patient | 1 | - at admission: GCS of 12 (E3 M6 V3), anosmia and ageusia, interstitial pneumonia - during hospital stay: seizures | - Antiretroviral, hydroxychloroquine - lacosamide, levetiracetam, phenytoin - mechanical ventilation - High-dose steroid treatment | N/A | - pulmonary impairment - sensorimotor deficits | N/A | N/A | N/A | N/A | N/A | N/A |
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35 | June | Zheng Z | 10.1002/jmv.26040 | 2020 | China | February 2020 | To introduce the authors' experience in treating two COVID-19 cases by ozone therapy | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 patients | 4 | Fever, dyspnea, headache, runny nose, fatigue, loss of appetite, cough, sore throat, altered laboratory and imaging findings | Ozone therapy - Major Autohemotherapy (MAH) for seven consecutive days | N/A | Symptoms, laboratory indicators, chest imaging | N/A | N/A | N/A | N/A | N/A | N/A | Two COVID-19 patients who underwent ozone therapy MAH for seven days showed fast recovery of symptoms and normal range of laboratory indicators. |
36 | June | Zheng QN | 10.1017/dmp.2020.214 | 2020 | China | January -February 2020 | To develop a model able to predict the length of rehabilitation from the analysis of clinical risk factors | Descriptive Study - Retrospective uncontrolled cohort | Specialized postacute rehabilitation | Meso Level | Health services, systems and policies (e580) | Post-acute | COVID-19 patients | 90 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors developed, through multivariate stepwise linear regression, a model to predict lenght of stay of post-acute mild COVID-19 patients in an inpatient rehabilitation setting. The five parameters included in the model were white blood count, partial pressure of carbon dioxide, serum potassium, total bilirubin and aspartate aminotransaminase. |
37 | July | Burns SP | 10.1038/s41393-020-0529-0 | 2020 | USA | March 9th - June 30th, 2020 | To describe case fatality of COVID-19 infection in Veterans with SCI/D | Analytical: Cohort study | Specialized postacute rehabilitation | Epidemiology - Prevalence | N/A | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Veterans with SCI/D with diagnosis of COVID-19 | 140 | N/R | N/A | Veterans with SCI/D without diagnosis fo COVID-19 | Case fatality rate | N/A | N/A | N/A | N/A | N/A | N/A | The SCI/D Veteran case fatality rate with COVID-19 was 19%; it was 2.4 times the rate observed in the non-SCI/D Veteran population with an absolute rate that is 11% greater (95% CI: 5–19%; Z score = 4.8; p < 0.0002). |
38 | July | Curci C | 10.23736/S1973-9087.20.06339-X | 2020 | Italy | March 10th - April 15th, 2020 | 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 a Rehabilitation Unit. | Analytical: Cross-sectional study | Specialized postacute rehabilitation | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patients | 32 | Most patients needed respiratory supports (mainly nasal cannula and Venturi Mask) with a sustained FiO2 to maintain a good peripheral oxygen saturation. Moreover, the majority was bedridden and suffered from dyspnoea and shortness of breath even for minimal activities | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
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39 | July | Di Stefano V | 10.1007/s00415-020-10064-6 | 2020 | Italy | April 20th - May 4th, 2020 | To quantify the reduction of PA in patients with NMD due to lockdown, and its impact on quality of life | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | N/A | N/A | Patients with pre-existing NMD and healthy age-matched controls | NMD group= 149; healthy controls= 119 | N/A | N/A | N/A | Levels of PA measured by IPAQ-SF as energy expenditure (MET–minutes/week), both before and in the last 7 days of the quarantine. The distribution of MET was calculated for different levels of PA intensity (vigorous-intensity PA; moderate-intensity PA; moderate-to-vigorous PA; walking activity) in all subjects. SF-12 was also administered by telephone to NMD group . | N/A | N/A | N/A | N/A | N/A | N/A | In healthy controls, a significant reduction of PA was reported during quarantine compared to before quarantine for vigorous-intensity, moderate-intensity and moderate-to-vigorous intensity and total PA levels, and for walking activity. In NMD, a significant reduction of PA was reported for walking activity, moderate-to-vigorous and total PA levels, while no difference was found for vigorous-intensity and moderate-intensity PA. Furthermore, NMD showed reduced scores for SF12. |
40 | July | Diaz-Segarra N | 10.1097/PHM.0000000000001532 | 2020 | USA | N/R | To report clinical findings of four COVID-19 patients that developed acute ischemic stroke | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients | 4 | Patient 1: Dysarthria; left hemiparesis, and reduced LOC + cough, fever, chills; deceased on day 3; Patient 2: Aphasia, facial droop; right hemiparesis, sensory deficit, complete hemianopsia + None symptoms of COVID-19; discharged home on day 9; Patient 3: Reduced LOC + Shortness of breath, fevers; ARDS; sepsis, MOF, deceased on day 42; Patient 4: Reduced LOC + Cough, SOB, diarrhea; ARDS, sepsis, MOF, discharged to rehabilitation on day 29. | Patient 1: Mechanical thrombectomy, aspirin; Patient 2: IV t-PA, mechanical thrombectomy, aspirin; Patient 3: Aspirin; Patient 4: Aspirin | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This case series highlights that COVID-19 ischemic strokes had a heterogeneuos clinical presentation with an unknown duration of the COVID-19 related prothrombotic state. Therefore, the authors concluded that the physiatric awareness of this prothrombotic state is mandatory, taking into account the increased incidence of ischemic strokes in COVID-19 patients referred to rehabilitation units. |
41 | July | Gualtieri P | 10.3390/ijms21134670 | 2020 | Italy | March 19th - April 27th, 2020 | To evaluate the differences in body composition during a ICU hospitalization in overall, lean, and obese COVID-19 patients. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Acute | COVID19 patients | 30 (13 lean and 17 obese patients) | N/R | Chest CT within 24 hours and about 20 days later | N/A | Differences in body composition and liver composition during ICU hospitalization (assessed by chest CT) | N/A | N/A | N/A | N/A | N/A | N/A | Subscapular thickness, suprailiac thickness, sum thickness, body density, FM%, and waist circumference were statically increased in the obese group compared to the lean group. Liver attenuation and liver/spleen ratio were statistically reduced in the obese group compared to the lean group. These findings could be co-caused by COVID-19, prolonged bed rest, and a low-grade inflammation typical of obesity. |
42 | July | Halpin SJ | 10.1002/jmv.26368 | 2020 | UK | May-June 2020 | To describe the symptoms and rehabilitation needs of COVID-19 patients after discharge | Analytical: Cross-sectional study | Rehabilitation services at home | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patients 4 weeks after hospital discharge | 100 | N/A | Telephonic survey | N/A | Prevalence of post-discharge symptoms | N/A | N/A | N/A | N/A | N/A | N/A | The most common symptom reported was fatigue (72% of post ICU patients; 60.3 % of hospitalized patients), followed by breathlessness (65.6% in ICU group; 42.6% in hospitalized group) and psychological distress (46.9% in ICU group; 23.5% in hospitalized group). There was a clinically significant drop in EQ5D in 68.8% participants in the ICU group and in 45.6% of participants in the ward group. The authors recommend planning rehabilitation services to manage these symptoms appropriately and maximise the functional return of COVID-19 survivors. |
43 | July | Huang Y | 10.1186/s12931-020-01429-6 | 2020 | China | N/R | To investigate the influence of COVID-19 on lung function in early convalescence phase (at 30 days after discharged) | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 57 | N/A | N/A | N/A | Lung volumes (TLC), spirometry (FVC, FEV1), DLCO, ,respiratory muscle strength, 6-MWT and high resolution CT | N/A | N/A | N/A | N/A | N/A | N/A | Out of 57 COVID-19 patients, 40 were non-severe and 17 were severe ones. Impaired diffusing-capacity, respiratory muscle strength decrease, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in the early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment (75.6% vs 42.5%) and encountered more TLC decrease and 6MWT decline. Tha authors showed that most of the COVID-19 patients had a pulmonary function impairment in early convalescence phase, concluding that there is a need of longer follow-up studies in COVID-19 patients to better investigate clinical outcomes (i.e. tendency of lung function and exercise tolerance) in recovered COVID-19 patients. |
44 | July | Khalifa M | 10.1093/jpids/piaa086 | 2020 | Saudi Arabia | From 10th of April, 2020 | To report one of the first descriptions of GBS and COVID-19 association in a child | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 child developing GBS | 1 | After three weeks with mild febrile illness with mild respiratory manifestations and a persistent cough, a eleven-year-old boy presented with typical features of GBS and after five days a morbilliform skin rash over the palms of both hands. | -intravenous immunoglobulin (IVIG) infusions at a dose of 1 gram/kg/day for two days. -paracetamol when needed (10mg/kg/dose) - hydroxychloroquine twice daily (6.5 MG/KG) for one day, and then (3.25 MG/KG) twice daily for seven days. -as thromboprophylaxis low molecular weight heparin (R/ Enoxaparin) was given s.c.20 IU once daily. | N/A | Neurological assessment | N/A | N/A | N/A | N/A | N/A | N/A | This report describes an eleven-year-old boy, who presented with acute GBS, three weeks after a mild symptomatic respiratory illness (positive infection via nasopharyngeal RT-PCR). -Awareness of neuromuscular presentations also in children may have a guiding significance for the early detection of the combined or preceding infection with SARS-CoV-2 |
45 | July | Kirshblum SC | 10.1002/pmrj.12454 | 2020 | USA | April 4th - 27th, 2020 | To determine the prevalence of COVID-19 in asymptomatic individuals referred for admission to an inpatient rehabilitation facility in a high prevalence community setting | Descriptive: Historical cohort | General postacute rehabilitation | Epidemiology - Clinical presentation | N/A | Post-acute | Patients admitted to an inpatient rehabilitation facility and presumed to be COVID-19 free | 103 | N/A | N/A | N/A | Positivity at the reverse transcriptase-polymerase chain reaction SARS-COV-2 testing withing the first two weeks of admission | N/A | N/A | N/A | N/A | N/A | N/A | Seven patients resulted positive at SARS-COV-2 testing at admission (6.8%). Two positive patients stayed asymptomatic while five developed symptoms in the next 5.2 days. Nine patients who tested negative were subsequently re-tested for developing symptoms compatible with COVID-19 infection, and five of them resulted positive. Overall, 12 patients (13.6%) resulted positive in the first 14 days of hospitalization. Screening for SARS-CoV-2 at the time of admission to an inpatient rehabilitation facility can identify pre-symptomatic or asymptomatic individuals, to determine their appropriate placement within a facility and using appropriate infection control practices. However, negative results do not preclude COVID-19 and should not be used as the sole basis for patient management decisions. |
46 | July | Krett JD | 10.1016/j.jneuroim.2020.577326 | 2020 | Canada | N/R | To report a critically ill man with a COVID-19-associated hemorrhagic encephalopathy | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patient | 1 | Cough and fatigue and after 2 days increasing confusion. -At Hospital admission, the patient was disoriented, agitated, without lateralizing neurological deficits. -13 days later, the patient was unresponsive and diffusely paretic. -2 months following admission, the patient gradually recovered. | Mechanical ventilation, minimal vasopressor support, oral hydroxychloroquine, and neurorehabilitation | N/A | Neurological assessment, CSF analyses, brain MRI | N/A | N/A | N/A | N/A | N/A | N/A | This case reports encephalopathy with multifocal cerebral hemorrhages in a COVID-19 patient with
severe, otherwise unexplained cortical dysfunction. SARS-CoV-2 RNA was not detected in cerebrospinal fluid (CSF) or blood. CSF analyses suggested a cytokine release syndrome. Two months following hospital admission, the patient gradually recovered. He was transferred to a neurorehabilitation unit with mild residual physical and cognitive impairments. Awareness of this clinical entity may facilitate the identification of patients with a potentially remediable cause of encephalopathy in COVID-19. |
47 | July | Kushlaf H | 10.1002/mus.27020 | 2020 | USA | N/R | To report the clinical course of a patient with myasthenia gravis who developed COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Patient with myasthenia gravis developing COVID-19 | 1 | The patient presented with fever and SOB | Hydroxychloroquine for 5 days, tocilizumab, and IVIG 1 g/kg daily for two consecutive days. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A 66-year-old woman, who was diagnosed with myastenia gravis at age 44, was intubated for hypoxemic respiratory failure and she also presented with hypotension and acute renal failure for which she was placed on continuous renal replacement therapy followed by intermittent emodialysis. After the COVID-19 treatament, she slowly improved and was extubated after 17 days then discharged to inpatient rehabilitation. |
48 | July | Li Z | 10.23736/S1973-9087.20.06298-X | 2020 | China | February 29th - March 2nd, 2020 | To collect the basic information, dysfunctions, and rehabilitation needs of hospitalized COVID-19 patients. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | Post-acute hospitalized COVID-19 patients | 280 | N/A | A questionnaire that included demographic and clinical history of the patients, the awareness about rehabilitation and the willingness to do it, current dysfunctions they suffer from, and the specific needs for rehabilitation, was administered to all the patients included. | N/A | Awareness and willingness of rehabilitation; common dysfunctions; current rehabilitation needs | N/A | N/A | N/A | N/A | The average Content Validity Index of the questionnaire was 0.958. Cronbach’s alpha was used to assess the internal consistency reliability, which was found to be 0.944 . | N/A | Patients were 51.8% male and 48.2% females. 64.2% of the patients were over 51 years of age, and only 9.3 % below 30 years of age. The most common physical dysfunctions reported by the patients were sleep disorders (63.6%), decreased activity endurance (61.4%), respiratory dysfunction (57.9%), loss of appetite (55.4%), and pain disorder (47.5%). Meanwhile, the most reported psychological dysfunctions were anxiety (62.1%), fear (50.0%), apathy (41.8%), depression (40.7%), and despair (32.5%). The patients felt a high demand for rehabilitation: the sum of the high need and need response with regard to exercise guidance, dietary instruction, and traditional Chinese medicine therapy, were 45.0%, 40.4%, and 39.6%, respectively |
49 | July | Manganotti P | 10.1002/jmv.26289 | 2020 | Italy | March-April 2020 | To report a case series of 5 COVID-19 patients who developed GBS | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients developing GBS | 5 | Fever and cough, and a significant impairment of taste and smell in 4/5 patients. The patients developed progressive weakness of the upper and lower limbs, in a disto-proximal fashion with a latency ranging from 14 to 30 days. | IVIG therapy was initiated in 4/5 patients at a dose of 0.4 gr/kg for 5 days. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Four out 5 COVID-19 patients with GBS presented with a mild facial nerve involvement limited to the muscles of the lower face; in one patient, taste assessment showed right-sided ageusia of the tongue, ipsilateral to the mild facial palsy. The Authors report that peripheral nervous system involvement after COVID-19 might be successfully treated with IVIG, as showed in 4/5 patients, whose neurological symptoms partially resolved without any side effect. |
50 | July | Ng JA | 10.1093/ptj/pzaa124 | 2020 | USA | April - May, 2020 | To describe the establishment, operation and evolution of a rehabilitation therapist staffed prone team. | Descriptive: Historical cohort | Rehabilitation in acute care | Meso Level | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 patients in need of prone positioning | 934 | N/A | Position change by a prone team. | N/A | Number of position changes in a 7 weeks period, time spent for each position change, number of members of the team needed for each position change. | N/A | N/A | N/A | N/A | N/A | N/A | With the surge of ARDS cases due to COVID-19, the request for proning position increased exponentially. Given the possible side effect of prone positioning, and the complexity of the procedure, a team of rehabilitation therapists expert of mobilisation is needed to improve the outcome of patients. The team achieved during the pandemic the following numbers and goals. Total volume of requests to the prone team for position changes was 934. 70% of position changes involved 3 prone team members, 26% involved 2, 13% involved only 1 and 11% involved 4. The mean (SD) number of minutes for each position change was 20 (9.15) with a range of 5 to 80 minutes. |
51 | July | Pfefferkorn T | 10.1007/s00415-020-09897-y | 2020 | Germany | April 2020 | To report the case of a COVID-19 patient presenting with acute polyradiculoneuritis. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patient | 1 | Fever, cough, tetraparesis and acral paresthesias. | Mechanical ventilation, tracheostomy, intravenous immunoglobulins, plasma exchange therapy. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors report the case of a 52 years old man who presented with tetraparesis after 14 days of fever and respiratory symptoms and was found positive on COVID-19 testing. The patient underwent mechanical ventilation and tracheostomy, and IVIG and plasma exchange therapy were administred. Thirty-one days after admission the patient showed signs of motor improvement with regressive facial and hypoglossal paresis but still needed mechanical ventilation, and was referred to a specialized rehabilitation clinic. |
52 | July | Piscitelli D | 10.1007/s10072-020-04593-1 | 2020 | Italy | March 5th - May 13th,2020 | To report the case of a 39-year-old woman, in- home nurse, of normal social well-being with no history of somatoform or other psychiatric disorder or traumas, who developed, with SARS-CoV-2 infection, functional tremors. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patient | 1 | After 7 days with mild COVID-19 symptoms the patient developed a lower limb tremor with variable frequency and amplitude. She presented abnormal movements while sitting (e.g., lower limb twisted movements), walking (e.g., ataxic gait), or at rest (e.g., jerky movements in supine position) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Case report of a patient without any history of psychiatric/neurologic events.
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53 | July | Rosen K | 10.1007/s11420-020-09774-4 | 2020 | USA | April 8th - May 12th, 2020 | To investigate if an inpatient telerehabilitation program was viable for COVID-19 patients. | Descriptive: Historical cohort | Rehabilitation in acute care | Meso Level | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patients | 33 (12 of whom received only telerehabilitation PT services) | N/A | Telerehabilitation | In person PT or Telerehabilitation PT + in person PT | Percentage of patient that met their PT goals and were discharged. | N/A | N/A | N/A | N/A | N/A | N/A | The Hospital for Special Surgery in New York city, due to COVID-19 outbreak, introduced a
telerehabilitation service for COVID-19 patients, based on a COVID-19 rehabilitation response
algorithm. This latter could identify 3 groups:
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54 | July | Saggese CE | 10.1159/000509453 | 2020 | Italy | March - April, 2020 | To present the case of a COVID-19 patient presenting with stroke and thromboses in different locations | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patient presenting with stroke | 1 | Expressive aphasia, right hemiplegia, right neglect occurring after ten days of fever and cough. | rTPA therapy, oxygen, clopidogrel, atorvastatin, hydroxychloroquine, azithromycin, enoxaparin, amlodipine and ramipril. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The paper describe the case of an acute ischemic stroke patient who was suffering from fever and cough since ten days and was found positive for COVID-19 on admission. Afterwards he developed right dorsalis pedis and distal lateral plantar artery occlusion that were recanalized with balloon catheter, and left forearm superficial thrombophlebitis. The authors underline that although this was not a severe case of COVID-19, the ischemic vascular complications may have been linked to the COVID-19 infection. |
55 | July | Shalash A | 10.1002/mds.28134 | 2020 | Egypt | N/R | To investigate the impact of the COVID-19 pandemic on the mental health, physical activities, and QoL of PD patients. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | N/A | N/A | PD patients | 58 (38 PD, 20 no PD) | N/A | telephone interview | Age- and sex-matched controls without PD | perception of impact of COVID-19, DASS-21, IPAQ, PDQ39 | N/A | N/A | N/A | N/A | N/A | N/A | Compared with controls, PD patients showed significantly worse stress, depression, anxiety,
total
DASS, moderate physical activity, walking, total IPAQ, total and most of the PDQ39 dimensions,
which
were correlated with current mental health and pre- lockdown characteristics (i.e. motor
severity).
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56 | July | Tankisi H | 10.1016/j.clinph.2020.06.003 | 2020 | Denmark | March - April, 2020 | To describe the case of a COVID-19 patient who developed critical illness myopathy | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patient | 1 | Severe symmetrical proximal and distal weakness, diffuse muscle wasting, and absent deep tendon reflexes occurring 10 days after COVID-19 infection onset with fever, cough, dyspnea | Piperacillin/tazobactam, oxygen, mechanical ventilation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors describe the case of a severe COVID-19 patient that needed mechanical ventilation and ICU stay. After 65 days of hospitalization the patient presented severe muscle weakness. Electromyography analysis revealed critical illness myopathy. This is the first case of CIM in a patient surviving from severe COVID-19. While clinical and electrophysiological findings resembled CIM of other causes, this case deserves special attention in the context of a growing awareness of long-term complications of COVID-19. |
57 | July | Tay SS | N/A | 2020 | Singapore | March - April, 2020 | To describe the case of a COVID-19 patients who benefitted from the use of a robotic patient-guided suspension system for mobilisation. | Descriptive: Case Report | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 patient | 1 | The patient presented, cough, dyspnea and respiratory failure on admission to acute care | Conventional physiotherapy and occupational therapy, gait training with the Andago V2.0 robot (Hocoma) which is a dynamic patient-guided suspension system for overground walking. | N/A | HADS-A, HADS-D, 6MWT | N/A | N/A | N/A | N/A | N/A | N/A | A severe COVID-19 patient after ICU discharge presented depression and anxiety and severe impairment in gait autonomy and endurance. After conventional physical therapy and training with robotic patient-guided suspension system the patient was able to walk significantly longer in the 6MWT and had lower score in HADS-A and D. The robotic system seemed safe and efficient for recovering gait autonomy in the patient presented. |
58 | July | Tiet MY | 10.1136/bcr-2020-236536 | 2020 | UK | N/R | To report a case of GBS associated with COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 patient developing GBS | 1 | He reported a 3-week history of shortness of breath, headache and cough. -Then, he showed worsening cough and distal lower limb paraesthesia, resulting in difficulty mobilising. -3 days after being discharged home there was worsening lower limb paraesthesia and ascending lower limb weakness. -4 days later, he developed facial diplegia, limbs weakness (MRC: 1/5 in lower limbs, 3/5 proximal upper limbs and 2/5 distal upper limbs), distal reduced sensation to pinprick and vibration sense, dysaesthesia in lower limbs, and he was areflexic. | Monitoring in intensive care -nasogastric tube for feeding due to swallowing difficulties -intravenous immunoglobulin 0.4 g/kg daily for 5 days -neurorehabilitation | N/A | Neurological assessment, SARS-CoV-2 PCR in cerebrospinal fluid and from oropharyngeal swabs | N/A | N/A | N/A | N/A | N/A | N/A | The patient developed GBS as a likely postinfectious complication 3 weeks after the onset of
mild
COVID-19 related symptoms.
|
59 | July | Zhao Y-M | 10.1016/j.eclinm.2020.100463 | 2020 | China | January 20th - February 24th, 2020 | To study the pulmonary function, HRCT scan of the thorax and SARS-CoV-2 IgG in serum in COVID-19 patients 3 months after their hospital discharged and to investigate the relationship between the clinical characteristics and the pulmonary function or CT scores. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Chronic | COVID-19 survivors | 55 | Of 55 patients, including 4 mild (7.27%), 47 moderate (85.45%) and 4 severe (7.27%) cases, 35 presented COVID-19 related symptoms including gastrointestinal symptoms (30.91%), headache (18.18%), fatigue (16.36%), exertional dyspnea (14.55%), as well as cough and sputum (1.81%). Of the 55 patients, 6 experienced olfactory and gustatory dysfunctions during infection period and 2 female still experienced a decrease sense of taste during follow-up period. | pulmonary function test | Clinical assessment, HRCT of the thorax, lung function and serum levels of SARS-CoV-2 IgG antibody tests 3 months after discharge | N/A | N/A | N/A | N/A | N/A | N/A | 3 months after discharge COVID-19 symptoms were detected in 35/55 patients and different degrees
of
radiological abnormalities were detected in 39 patients.
|
|
60 | August | Abdulsalam MA | 10.1111/ane.13321 | 2020 | Kuwait | N/A | To report a case of generalized status epilepticus as a possible initial manifestation of COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 1 | Continuous tonic-clonic seizures | Intubated and mechanically ventilated,Intravenous diazepam but was ineffective, Intravenous midazolam | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is a case of a 32-year-old male who presented generalized status epilepticus without a
prior
history of seizure or epilepsy as a possible initial manifestation of COVID-19 infection. He had
no
other symptoms of COVID-19.
|
61 | August | Akram A | 10.7759/cureus.9320 | 2020 | Pakistan | N/A | To describe the case of an elderly patient with preexisting IPF and laboratory-confirmed SARS-CoV- 2, who presented acutely with rapid progression to septic shock | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Idiopathic Pulmonary Fibrosis developing COVID-19 | 1 | high fever, hypotension, confusion, lethargy, tachypnea, bilateral crackles | hydroxychloroquine 400 mg × BD, IV azithromycin 400 mg × OD, IV solu cortef 100 mg × TDS, heparin, IV fluids and a norepinephrine infusion. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This case reports an acute COVID-19 infection in a elderly patient with IPF.
|
62 | August | Avci A | 10.1007/s13365-020-00888-3 | 2020 | Turkey | N/A | To report a case of subarachnoid hemorrhage developing in patient with Covid-19-related pneumonia | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 1 | Subarachnoid hemorrhage with impaired consciousness | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A 50-year-old male with no concomitant disease was admitted to the emergency department due to impaired consciousness: lung imaging suggested COVID-19-associated pneumonia and cerebral tomography revealed subarachnoidal hemorrhage. The patient was hospitalized in ICU and died on the 83rd day due to COVID-19-associated pneumonia. In the presence of an anamnesis suggesting respiratory system infection such as cough and weakness in patients who come with sudden loss of consciousness, performing lung imaging as well as the performing brain computerized tomography can allow detection of an underlying Covid-19 infection. |
63 | August | Bagnato S | 10.1016/j.ijid.2020.07.072 | 2020 | Italy | From March to June, 2020 | To describe neurophysiological findings from a patient who developed critical illness myopathy after a long stay in ICU for COVID-19 | Descriptive: Case Report | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 1 | Diffuse and symmetrical muscle weakness (ranging from 3/5 to 4/5 on MRC) 68 days post COVID-19 onset. Deep tendon reflexes reduced in lower limb. The patient walked a few steps with assistance. | Rehabilitation program 3 h/day for 6 days/week for 2 months | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The patient had a critical illness myopathy confirmed by NCS/EMG/DMS. She underwent a rehabilitation treatment for 2 months with almost complete motor recovery. Given a large number of patients with COVID-19 who require long ICU stays, many are very likely to develop this condition in the coming months. Since rehabilitation programs can be effective, health systems must plan to provide adequate access to rehabilitative facilities for both pulmonary and motor rehabilitative treatment after COVID-19. |
64 | August | Basi S | 10.1136/bcr-2020-235920 | 2020 | UK | April 2020 | To describe a case report of a 66-year- old man with an acute ischaemic stroke in the setting of a COVID-19 infection | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | At the admission the patient showed a left-sided weakness, an incresed musle tone in his left upper limb, a mild left facial droop, and a deterioration in his speech pattern. Moreover, he required 2 L of nasal cannula oxygen to maintain his oxygen saturations between 88% and 92%. Then, his respiratory condition worsened and his levels of consciousness reduced. The patient was pronounced dead by doctors at four days after the admission. | Nasal cannula oxygen at 2 L and then Venturi mask at 8 L of oxygen; intravenous and ciprofloxacin; 300 mg of aspirin | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A 66 yrs old patient admitted with diagnosis of right frontal cerebral infarct had a concomitant COVID-19 pneumonia. In his clinical history he had atrial fibrillation and had one previous ischaemic stroke, with a consequent left-sided haemiparesis, that had completely resolved. His worsening respiratory condition and reduced levels of consciousness, present during the LOS, made it impossible to assess progression of the neurological deficit after stroke. His comatose condition persisted throughout the admission. The patient was pronounced dead by doctors at four days after the admission. |
65 | August | Belli S | 10.1183/13993003.02096-2020 | 2020 | Italy | N/A | To assess the proportion of COVID-19 patients with low physical functioning and/or impaired performance of ADLs at the time of discharge. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 115 | N/A | N/A | N/A | - 1-minute sit-to-stand test - Short Physical performance Battery - Barthel Index | N/A | N/A | N/A | N/A | N/A | N/A | 103 of 115 patients hospitalized for COVID-19 survived and were discharged at home
|
66 | August | Benger M | 10.1016/j.bbi.2020.06.005 | 2020 | UK | From 1st February 2020 to 14th May 2020 | To provide a description of clinical, radiological and laboratory characteristics of consecutive patients presenting to King’s College Hospital (KCH) with ICH in association with COVID-19 | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 5 | Case 1:
|
Case 1:
|
N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 5 relatively young patients with COVID-19 suffered from ICH with a mean age lower than expected
for
ICH
|
67 | August | Bolaji P | 10.1136/bcr-2020-236820 | 2020 | UK | N/A | To report a COVID-19 case with extensive cerebral venous sinus thrombosis with bilateral venous cortical infarcts and acute cortical haemorrhage | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 with CVST | 1 | Left-sided weakness, left-sided sensory inattention, and subsequent focal seizures, then status epilepticus and coma | Anticoagulation and antiepileptic, intubation, then inpatient rehabilitation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This case reports of a 63 yrs old man a potential association between CVST and COVID-19
infection.
|
68 | August | Chakraborty U | 10.1136/bcr-2020-238668 | 2020 | India | N/R | To report a case of acute transverse myelitis associated with COVID-19 infection in a 59-year-old female | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | Acute-onset progressive ascending flaccid paraplegia, retention of urine, constipation, and fever. No lower limbs deep tendon reflexes, a sensory level at T10 segment. After injectable steroids she did show some signs of recovery. A day later, she developed an acute- onset respiratory failure, a sudden cardiac arrest and she died despite resuscitation maneuvers. | Corticosteroids | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Considering the onset of ATM symptoms in the background of a confirmed COVID-19 test and initial improvement with steroids, ATM may be considered as an immune-mediated response to the virus. It is rare but it has severe consequences and early identification is very important to initiate appropriate treatment. |
69 | August | Cunha P | 10.1111/ene.14474 | 2020 | France | N/A | To describe a new type of delayed onset movement disorders in five patients who were admitted to ICUs for severe SARS-CoV-2 infection | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Post-acute | COVID-19 | 5 | Upper limbs postural and action-tremor was observed in 4 patients,
|
- in ICU: intubation and ventilation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
|
70 | August | D'Andrea S | 10.1038/s41394-020-0319-0 | 2020 | Italy | April 2020 | To evaluate differences in clinical features and evolution of COVID-19 between people with SCI and able-bodied individuals | Descriptive: Historical cohort | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | SCI patients developing COVID-19 | 15 | Out of 15 SCI-patients affected by COVID-19, 10 (66.7%) were symptomatic, 10 (66.7%) with fever, 9 (60.0%) with dry cough, 3 (20.0%) had dyspnea, 2 (13.4%) with diarrhea, 1 (6.7%) had anosmia, and 2 (13.4%) had fatigue. | All individuals who tested positive for SARS-CoV-2 among SCI patients (cases) and able-bodied healthcare workers (controls) were enrolled in a historic cohort study | COVID-19 able-bodied controls (n=17) | COVID-19 clinical features; COVID-19 radiological findings; COVID-19 treatment; COVID-19 evolution | N/A | N/A | N/A | N/A | N/A | N/A | Fever and dry cough were the most common symptoms of COVID-19 without significant differences between SCI patients and able-bodied controls. In conclusion, the authors showed that in their sample SCI patients had a favorable prognosis, not differing from controls. Therefore, the authors hypothesized that it is due to the early COVID-19 diagnosis, with a consequent prompt management; however, future larger studies are necessary to confirm these findings. |
71 | August | Figueiredo R | 10.1136/bcr-2020-237146 | 2020 | Portugal | N/A | To present a case of a term pregnancy diagnosed with COVID-19 after presenting with isolated peripheral facial palsy. | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | pregnant woman with COVID-19 | 1 | A 35-year-old woman, primigravida, 39-week gestation, presenting with involuntary drooling with acute peripheral facial palsy |
|
N/A | Facial palsy severity | N/A | N/A | N/A | N/A | N/A | N/A |
|
72 | August | Franco C | 10.1183/13993003.02130-2020. | 2020 | Italy | From March 1st to May 10th,2020 | To analyze the safety of the hospital staff, the feasibility, and outcomes of noninvasive respiratory support applied to patients outside the ICU. | Descriptive: Historical cohort | General postacute rehabilitation | Meso Level | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 670 | N/A | 163 HFNC, 330 CPAP, 177 NIV | N/A | Length of stay in hospital, endotracheal intubation and deaths | N/A | N/A | N/A | N/A | N/A | N/A | The majority of patients (49.3%) were treated with CPAP. The overall unadjusted 30-day
mortality
rate was 26.9% with 16%, 30%, and 30%, while the total endotracheal intubation rate was 27% with
29%, 25% and 28%, for HFNC, CPAP, and NIV, respectively, and the relative probability to die was
not
related to the NRS.
|
73 | August | Hajdu SD | 10.1161/STROKEAHA.120.030794 | 2020 | International | November 2019 - April 2020 | To determine the effect on endovascular therapy for patients with acute ischemic stroke during the COVID-19 confinement | Descriptive: Historical cohort | N/A | Epidemiology - Prevalence | N/A | N/A | Stroke Patients (treated with endovascular therapy in the COVID-19 period ) | 1600 | N/A | To compare outcome measures according to the COVID-19 confinement (dates identified for each country varying from March 9, 2020 to March 23, 2020) | Patients treated by endovascular therapy for acute ischemic stroke before COVID-19 confinement | Mean number of endovascular therapies performed and mean stroke onset-to-groin puncture time interval (minutes) per hospital and per 2-week interval | N/A | N/A | N/A | N/A | N/A | N/A | There was a significant decrease in mean number of endovascular therapies performed per hospital per 2-week interval between before and after COVID-19 confinement (9.0 vs 6.1; p<0.001). Moreover, the authors observed a significant increase in mean stroke onset-togroin puncture time between before and after COVID-19 confinement (300.3 vs 354.5 minutes; p<0.001). Less interventions might lead to a higher disability. |
74 | August | Han X | 10.1097/PHM.0000000000001535 | 2020 | China | From December 30, 2019 to February 17, 2020 | To analyze the infection features of inpatients with brain damage in one rehabilitation ward of a large general hospital with natural exposure to COVID-19 at the beginning of the outbreak | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Brain injury rehabilitation inpatients developing COVID-19 | 25 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 4 of 25 patients (16%) with brain damage admitted to this rehabilitation ward were diagnosed with COVID-19 pneumonia. COVID-19 patients were older (60.5 vs 50), with a higher prevalence rate of tracheotomy (75% vs 9.5%) and underlying pulmonary infection (100% vs 38.1%). Their modified Barthel Index scores were significantly lower than those of noninfected subjects (7.5 ± 9.6 vs 29.5 ± 26.4). Brain damage inpatients with impaired airways and low activity levels are more susceptible to COVID-19 and can easily become severely ill or even die. |
75 | August | Hemphill NM | 10.1016/j.cjca.2020.04.038 | 2020 | USA | From the beginning of 2020 to April 5th | To quantify the change in physical activity observed during the early phase of the COVID-19 pandemic in children with CHD | Analytical: Cohort study | N/A | Epidemiology - Prevalence | N/A | N/A | Children with CHD | 109 | N/A | Physical activity in the first 14 weeks of 2020 | Physical activity in the corresponding weeks in 2019 | Weekly average step counts | N/A | N/A | N/A | N/A | N/A | N/A | This paper compares the physical activity, measured as weekly average step counts, of children with CHD in the first 14 weeks of 2020 and compare it with the same period in 2019: from January through early March (week 1 to 12), 2019 and 2020 step-counts are similar and increasing, while later in March, 2020 step-counts are significantly lower than 2019 (week 13 and 14). Reduced physical activity due to COVID-19 pandemic may have negative impacts on physical, cardiovascular and mental health in children with CHD: long term impact need to be considered. |
76 | August | Hermann M | 10.1097/PHM.0000000000001549 | 2020 | Switzerland | From March to May, 2020 | To characterize COVID-19 patients referred to in- patient rehabilitation and describe performance and outcome during cardiopulmonary rehabilitation. | Analytical: Cohort study | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 28 | N/A | Multimodal 2-4 weeks inpatient CR: 25-30 therapy sessions, 5-6 days per week. | CRQ, HADS, CIRS, FIM, 6-MWT, FT | N/A | N/A | N/A | N/A | N/A | N/A | The cohort presents patients referred for CR who was divided into mechanically ventilated
patients
(n=12) or not ventilated patients (n=16) in the acute hospital setting in order to analyze the
impact of very severe COVID-19.
|
|
77 | August | Hsueh S-J | 10.1016/j.jfma.2020.07.042 | 2020 | Taiwan | March to May | To report a possible neuromuscular manifestation of SARS-CoV-2 infection | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 with quadriplegia | 1 | - 51-year-old Taiwanese woman with a history of hypertension and obesity - On admission: dyspnea - Post-extubation: quadriplegia with intact pinprick sensation intact, and mildly decreased vibratory sensation in the ankles | - intubation - rosuvastatin, cisatracurium, zithromycin, meropenem, lopinavir/ ritonavir, hydroxychloroquine, baricitinib and sedative agents | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case report of a middle-aged woman found positive to SARS-CoV-2 after a travel to Europe. Due to progressive dyspnea, she was intubated and on March 15th and extubated on April 9th. The PCR for SARS-CoV-2 became negative since April 6th. The following days she remained quadriplegic with gradual recovery which led her to be able to walk again on May 1st. Laboratory and instrumental exams were compatible with myopathy. Follow-up in late May 2020 revealed full muscle power. Authors suggest that inflammatory myopathy should be considered as a cause for persistent respiratory failure and weakness in patients with COVID-19 |
78 | August | Khare J | 10.1016/j.dsx.2020.08.012 | 2020 | India | N/A | To study the effect of lock down on glycemic control in diabetic patients and possible factor responsible for this | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | N/A | N/A | Adult patients with type 2 diabetes | 143 | N/A | N/A | Same population - pre-lock down | Fasting Blood Glucose Post Prandial Blood Glucose | N/A | N/A | N/A | N/A | N/A | N/A | This study compared assessed the effects of lock-down on blood glucose levels in adults with
type 2
diabetes.
Both fasting and postprandial blood glucose in lock down period were higher than prior to lock
down,
statistically significant
difference was seen with postprandial blood glucose only.
The most common factor worsening of hyperglycemia were:
|
79 | August | Lascano AM | 10.1111/ene.14368 | 2020 | Switzerland | From March to April 2020 | To report a series of three cases of typical GBS, preceded by classic signs and symptoms of biologically confirmed COVID-19 | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 3 | Distal paresthesias and rapidly progressive limb weakness, evolving to either moderate tetraparesis (2/3) or tetraplegia (1/3) and areflexia (3/3) within the first 5 days. Two patients presented with pain and only one with bulbar signs and facial biplegia. Neurological symptoms appeared within the first 22 days (7, 15 and 22 days) after the appearance of typical COVID-19-related symptoms. | Intravenous immunoglobulin | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Three patients presented a classic demyelinating pattern, occurring 15 (7-22) days after classic signs and symptoms of biologically confirmed COVID-19. All three patients were treated with intravenous immunoglobulin and had a favourable clinical course: one fully recovered and was discharged, another one was able to walk with assistance and the last one remained bedridden but was able to rise to standing up. |
80 | August | Le Guennec L | 10.1111/epi.16612 | 2020 | France | N/A | To report a case of status epilepticus as the first manifestation of COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | At admission: 5-day history of cough, fever, and anosmia One week after admission: verbal perseverations and imitation behavior, drowsiness | - mechanical ventilation - intravenous levetiracetam - IV-Immunoglobulins at 2g/kg | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is a case report of a 69-year-old patient admitted to ICU for status epilepticus who required endotracheal intubation. He had a medical history of diabetes mellitus, hypertension and a single seizure. The patient was treated with IV-Immunoglobulins. He improved after one week, allowing for weaning from mechanical ventilation, but he presented signs of frontal lobe syndrome. MRI at day 15 showed the persistence of a marked hyperintensity of the right caudate nucleus and a significant decrease of the hyperintensity of the prefrontal cortex, MRI at day 30 was normal. Authors hypothesized that this particular form of orbitofrontal status epilepticus might have been triggered by the passage of SARS-CoV2 through the olfactory pathway |
81 | August | Lee AJY | 10.1016/j.physio.2020.06.002 | 2020 | Singapore | N/A | To describe clinical course and physiotherapy intervention in a sample of COVID-19 patients | Descriptive: Case Series | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 9 | Out of 9 patients (median age: 66 years), one case (Case 7) with pre-existing asthma/chronic obstructive pulmonary disease overlap syndrome, showing with a dry and unproductive cough, was referred for respiratory care. All the other patients were referred for rehabilitation; of these, exertional and positional-related oxygen desaturation was a common feature in five patients (Case 1, 2, 5, 6, 8). One individual (Case 1) demonstrated severe and persistent postural hypoxaemia (oxygen saturation decreased to <90% when seated upright from a supine position and lasted beyond 4 weeks following ICU discharge). | Rehabilitative therapy sessions were organised into small interval sessions with multiple rest breaks in between exercise sets. Interval training was prescribed in the initial stages of the rehabilitation before gradually progressing to continuous training, as the patients were unable to tolerate continuous aerobic exercises. | N/A | Clinical course | N/A | N/A | N/A | N/A | N/A | N/A | Early detection of COVID-19 infection and management and recognition of this phenomenon is mandatory. A tailored rehabilitation approach should be performed in accordance with patient tolerance. A prolonged duration of rehabilitation course may be expected especially for severly ill patients |
82 | August | Longobardi Y | 10.1177/0194599820948043 | 2020 | Italy | From April 7 to May 11, 2020 | To describe a remote approach used with patients with voice prosthesis after laryngectomy during the COVID-19 pandemic and the resulting clinical outcomes in terms of voice prosthesis complications management, oncological monitoring, and psychophysical well-being. | Analytical: Cohort study | Specialized postacute rehabilitation | Meso Level | N/A | N/A | Adult laryngectomy patients who use a voice prosthesis | 73 | N/A | - semi structured interviews to inquire about the nature of the need - on the basis of the answers, telematic contact with the relevant professional figure - if needed, subsequent outpatient visit |
N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
|
83 | August | Maideniuc C | 10.1007/s00415-020-10145-6 | 2020 | USA | N/A | To describe a case of COVID 19 patient with ANM and AMAN, a rare variant of GBS, without systemic signs of infection | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 with ANM | 1 | At the admission, the 61-year-old woman showed increased tone in the lower extremities and weakness of upper and lower extremities (worse in the lower ones); reflexes were normal in the upper extremities but brisk in the lower extremities with upgoing toes bilaterally. The patient continued to progress and became quadriparetic. At 3 weeks after her initial onset of symptoms, she was areflexic in all extremities. EMG showed evidence of acute motor axonal neuropathy with normal sensory conductions | Methylprednisolone 1 g IV for 5 days without improvements. Then, at 3 weeks she received five rounds of plasma exchange and was discharged to an inpatient rehabilitation setting. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors reported the first case of COVID 19 patient who presented with GBS and ANM at the same time without any systemic manifestation. Immunotherapy seemed to have a role in immune-mediated neurological conditions associated with COVID-19. The patient started to stand up with the assistance and was able to take few steps with the walker at the rehabilitation facility after the discharge from the Neurology Unit. It is mandatory an early diagnosis and a consequent early management of immuno-mediated neurological conditions associated with COViD-19 |
84 | August | Mella-Abarca W | 10.3332/ecancer.2020.1085 | 2020 | Chile | From April to June 22nd, 2020 | To describe a model of physical therapy using telerehabilitation for people with breast cancer during the COVID-19 pandemic in Chile | Descriptive: Historical cohort | Specialized postacute rehabilitation | Meso Level | N/A | N/A | People with breast cancer | 118 | N/A | Telerehabilitation | N/A | Side effects of breast cancer surgery, including lymphedema, axillary web syndrome, limited movement in the upper limbs and reduced muscle strength | N/A | N/A | N/A | N/A | N/A | N/A | This paper describe a model of physical therapy using telerehabilitation for people with breast
cancer and report data on its implementation: during the pandemic, 226 care events have been
recorded, 142 (63%) of which correspond to tele-rehabilitation in 118 patients. Both patients
and
physiotherapists reported a high level of acceptance and satisfaction. The model can be
implemented
in the case of telerehabilitation when face-to-face appointments can not be performed and can be
facilitated by:
|
85 | August | Mooney B | 10.1007/s11420-020-09778-0 | 2020 | USA | From April 4, 2020, to May 30, 2020 | To determine the outcomes of a collaboration between PT and SLP in the treatment of COVID-19 patients who underwent tracheostomy placement | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 3 | Patient 1: A 33-year-old woman. Post-weaning, she exhibited delirium, right upper extremity
myopathy/neuropathy, anxiety. Patient 2: An 81-year-old man. Post-weaning, he produced thick, purulent secretions, a pressure ulcer, constipation, delirium, and respiratory stridor. Patient 3: An 84-year-old man. Post-weaning, he was diagnosed with toxic metabolic encephalopathy and MRI signs of a subacute stroke. Moreover, he was found to have a pulmonary embolism. |
PT interventions focused on breathing mechanics, secretion clearance, posture, sitting balance, and upper and lower extremity strengthening. SLP interventions focused on cognitive reorganization, verbal and nonverbal communication, secretion management, and swallowing function. | N/A | Achievement of PT and SLP functional milestones, including mobility, communication, and swallowing. | N/A | N/A | N/A | N/A | N/A | N/A | Three patients with COVID-19 received coordinated PT and SLP following prolonged intubation and
tracheostomy.
|
86 | August | Muhammad S | 10.1016/j.bbi.2020.05.015 | 2020 | Germany | N/A | To report the first case of COVID-19 positive patient presenting with a concomitant subarachnoid haemorrhage from an intracranial aneurysm | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | 60-year-old COVID-19 positive patient presenting with a concomitant subarachnoid haemorrhage from an intracranial aneurysm | - intubation - microsurgical clipping of intracranial aneurysm |
N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
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87 | August | Negrini S | 10.1016/j.apmr.2020.08.001 | 2020 | Italy | From January to March, 2020 | To investigate the feasibility and acceptability of telemedicine as a substitute for outpatient services in emergency situations such as COVID-19 | Descriptive: Historical cohort | Specialized outpatient rehabilitation | Meso Level | N/A | N/A | Patients with spinal disorders | 1207 | N/A | Usual consultations and physiotherapy during the control and COVID phases, only telemedicine services (telephysiotherapy and teleconsultations) during the telemed phase | Control phase of 30 working days including the usual services before the spread of COVID-19 (January 7-February 23); a COVID phase of 13 working days during which there was a surge of usual services before starting telemedicine (February 24-March 14) | number of services provided in 3 phases; continuous quality improvement questionnaires | N/A | N/A | N/A | N/A | N/A | N/A | During telemed phase, 325 teleconsulations and 882 telephysiotherapy sessions V30were provided
in 15
days.
|
88 | August | Ntaios G | 10.1161/STROKEAHA.120.031208 | 2020 | International | January 2020 - May 2020 | To assess whether stroke severity and outcomes in patients with acute ischemic stroke are different between COVID-19 and non-COVID-19 patients | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 inpatients with acute ischemic stroke | 174 | The most prevalent COVID symptoms were fever (55.2%,), cough (53.5%), and dyspnoea (43.7%). The main stroke symptoms were motor (67.8%), dysarthria (46%), and sensory (42%). The median NIHSS was 10. | Assessment of stroke severity and outcomes (assessed at discharge or at the latest assessment for those patients still hospitalized) in patients with acute ischemic stroke | Non-COVID-19 patients hospitalized with acute ischemic stroke registered in the Acute Stroke Registry and Analysis of Lausanne Registry between 2003 and 2019. | mRS | N/A | N/A | N/A | N/A | N/A | N/A | Forty-eight COVID-19 patients (27.6%) died, of which 22 were attributed to COVID-19 and 26 to stroke. Among 96 survivors, 49 (51%) had severe disability at discharge. Patients with COVID-19 resulted to have higher risk for severe disability (median mRS 4 vs 2; p<0.001) and death (OR: 4.3) compared with patients without COVID-19. |
89 | August | Peng M | 10.12998/WJCC.V8.I15.3305 | 2020 | China | January-February 2020 | To present two cases of COVID-19 who received MV and were managed successfully with a sequential weaning protocol | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 2 | Fever, cough and fatigue at admission; failed improvement after 2 hours of non-invasive ventilation, requiring MV | MV sequential weaning protocol, attentive to the timing of intubation and extubation, early prone positioning (12 hours/day during the first 5 days of MV), infection control, and sequential advancement and withdrawal of invasive ventilation | N/A | MV weaning | N/A | N/A | N/A | N/A | N/A | N/A | Two critical COVID-19 patients with respiratory failure firstly received NIV and, due to the missing improvement after two hours, were following advanced to MV. Using a sequential weaning protocol, the patients were successfully extubated and placed on NIV and, later, on high-flow nasal cannula oxygen therapy. The patients were then transferred from the ICU to the common ward. Based on the good outcomes of the patients, the proposed weaning protocol could be considered for patients with critical COVID-19. |
90 | August | Perrin P | 10.1111/ene.14491 | 2020 | France | From March 9 to April 9, 2020 | To describe the neurological manifestations of patients with COVID-19 and gain pathophysiological insights especially with respect to the CRS | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 5 | Neurological presentation included confusion (n = 5), tremor (n = 5), cerebellar ataxia (n = 5), behavioral alterations (n = 5), aphasia (n = 4), pyramidal syndrome (n = 4), coma (n = 2), cranial nerve palsy (n = 1), and central hypothyroidism (n = 3). | corticosteroids and intravenous immunoglobulins | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Neurological disturbances occurred in the second week after COVID-19 onset in 3 cases (in the others, the exact onset was not assessable because of the critical conditions). Neurological disturbances were remarkably accompanied by laboratory evidence of CRS. Brain MRI findings comprised evidence of acute leukoencephalitis (n = 3, of whom one with a hemorrhagic form), cytotoxic edema mimicking ischemic stroke (n = 1), or normal results (n = 2). Treatment with corticosteroids and/or intravenous immunoglobulins was attempted with recovery from neurological disturbances in two cases. These data indicate that corticosteroids aimed at tackling CRS and IVIg may be effective to control severe neurological disturbances in patients with COVID-19. |
91 | August | Pisano TJ | 10.1097/PHM.0000000000001578 | 2020 | USA | N/A | To report the case of acute SCI with COVID-19 that developed bilateral DVT despite chemoprophylaxis | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Acute non traumatic SCI developing COVID 19 | 1 | At the admission, 48 year old male showed urinary retention, constipation, lower extremity weakness and sensory impairment. MRI revealed multilevel degenerative disk disease with a T11-12 compressive mass of unclear etiology. He was transferred to a tertiary facility for higher level of neurosurgical care with no lower extremity motor or sensory function. Here, after surgical intervention he had T11 AIS A paraplegia. Then, patient had a diagnosis of DVT with a consequent change in his anticoagulation therapy from chemoprophylaxis dosing to therapeutic dosing using a heparin algorithm infusion (1650 units/hour) with a PTT target range of 50-70 seconds. Anticoagulation was transitioned to oral 15 mg rivaroxaban at a dose of 15 mg two times per day on hospital discharge (day 16) | The patient underwent a T10-L1 decompressive laminectomy removing of a large extruded T11-12 herniated disc and was started on VTE chemoprophylaxis with heparin 5000 units administered subcutaneously three times | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The patient presented acute nontraumatic SCI that has an inherent increased risk for VTE, and COVID-19 without significant respiratory symptoms. During hospitalization, the patient developed first extensive bilateral lower extremity deep vein thrombosis despite chemoprophylaxis, and then bilateral pulmonary embolism, despite therapeutic anticoagulation. This case highlights the need for clinicians to have elevated vigilance in regards to screening and treatment for VTE in high-risk patients, such as SCI with a concurrent diagnosis of COVID-19, because might require more aggressive management or interventions. |
92 | August | Quinn L | 10.1093/ptj/pzaa128 | 2020 | USA | N/A | to describe a physical activity coaching program for individuals newly diagnosed with Parkinson Disease and to highlight rapid modifications made to this program in response to the COVID-19 pandemic | Analytical: Cohort study | Specialized outpatient rehabilitation | Meso Level | N/A | N/A | people with early-mid stage Parkinson Disease | 27 | N/A | adaptation to telehealth delivery of a physical activity coaching program which included 1:1 coaching, goal-setting, physical activity monitoring, and use of a disease-specific workbook to promote and support safe exercise uptake | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
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93 | August | Ros-Castelló V | 10.1002/mdc3.13025 | 2020 | Spain | N/A | to report a case of a patient who developed myoclonus after a COVID-19 infection recovery | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 1 | At admission:
- 5-day history of fever and shortness of breath - tachypnea One month after admission: - progressively disabling myoclonus in upper limbs and negative myoclonus in lower limbs leading to falls |
In ICU: - high flow oxygen therapy and prone position - intubation - lopinavir/ritonavir - hydroxychloroquine - ceftriaxone, azithromycin, meropenem - corticosteroids - prophylactic doses of low-molecular-weight heparin After myoclonus onset: - low doses of clonazepam |
N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case report of a 72 years old woman who developed myoclonus after a COVID-19 infection. Two days after admission, the patient was intubated due to hypoxemia and treated with antivirals, hydroxychloroquine, antibiotics and corticosteroids an prophylactic LMWH., One month from admission and two weeks from the withdrawal of antibiotics, antivirals and corticosteroids, she developed progressively disabling myoclonus in upper limbs and negative myoclonus in lower limbs. The myoclonus almost disappeared after two days of low doses of clonazepam. Hypoxia was held responsible for myoclonus in light of normal laboratory tests and absence of concomitant medical therapy. |
94 | August | Saeki T | 10.1097/PHM.0000000000001545 | 2020 | Japan | February 2020 | To describe the rehabilitation therapy of a COVID-19 patient who received MV | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 1 | Fever and worsening of respiratory conditions, until his percutaneous oxygen saturation was < 80% while receiving 10 L/min oxygen via a non-rebreather mask | Rehabilitation therapy | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A 65-year-old man was admitted to ICU and MV started due to worsening of his respiratory condition. Six days after admission, rehabilitation therapy started but limited to positioning, postural drainage and passive mobilisation, while increased to active exercises, standing and stepping, gait and endurance training as the patient’s conditions got better. On day 19, he was extubated and, on day 34, discharged and instructed to continue home exercise. One month after discharge, muscle strength and activity of daily living returned to normal. This report highlights the importance of early rehabilitation in severe COVID-19 patients. |
95 | August | Sakai T | 10.2340/16501977-2731 | 2020 | Japan | From April 24 to May 24, 2020 | To describe the effectiveness and risk management of remote rehabilitation for COVID-19 patients | Descriptive: Case Series | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 43 | N/A | Remote rehabilitation | Direct rehabilitation | Destination after discharge, PCR results, mobility scores on level surfaces, and Barthel Index total scores | Need for intubation and rehabilitation-related complications | N/A | N/A | N/A | N/A | N/A | Eighteen COVID-19 patients underwent remote rehabilitation using a mobile terminal to minimize contact: all of them were discharged home or to a hotel and no serious adverse events were observed. Remote rehabilitation was an effective and safe modality against the transmission of infection and could facilitate rehabilitation of patients in COVID-19 wards. It should be noted that patients in the remote rehabilitation group were significantly younger than those in the direct rehabilitation group and that the most severe cases belonged to the direct rehabilitation group. |
96 | August | Sassone B | 10.1097/HCR.0000000000000539 | 2020 | Italy | From January 7 to April 6, 2020 | To investigate and quantify the reduction of PA in patients with automatic implantable cardioverter-defibrillators for primary prevention of sudden death | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | N/A | N/A | Patients with automatic ICDs | 24 | N/A | N/A | PA 40 days before the national lockdown began | Daily PA (hours/day) was estimated by processing recorded data from ICD-embedded accelerometric sensors used by the rate-responsive pacing systems. | N/A | N/A | N/A | N/A | N/A | N/A |
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97 | August | Schirinzi T | 10.1002/mdc3.13026 | 2020 | Italy | From 20th of April to 2nd of May 2020 | to remotely investigate the impact of COVID-19 emergency on daily-life of a cohort of Italian PD patients, specifically focussing on the relationship between physical activity changes and the self-perceived health. | Descriptive: Historical cohort | N/A | Epidemiology - Prevalence | N/A | N/A | people with Parkinson Disease | 74 | N/A | N/A | N/A | motor activity habits before COVID-19 emergency: - physiotherapy/rehabilitation practice, - sports practice (type and weekly frequency) motor activity habits during lockdown: - physiotherapy/rehabilitation practice - physical exercise practice (indoor/outdoor, type of activity) - a self-reported questionnaire to quantify the intensity of physical activity as Metabolic Equivalent (MET) min/week - use of technology-based tools: previous experience, frequency of current use, opinion on the usefulness - use of wearable devices - perception of own health during COVID-19 emergency - Three self-administered scales: the International Physical Activity Questionnaires – Short Form, the Parkinson’s Well-Being Map (PWBM), the Beck Depression Index |
N/A | N/A | N/A | N/A | N/A | N/A |
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98 | August | Schlachetzki F | 10.1177/1357633X20943327 | 2020 | Germany | From January to April 2020 | To evaluate the effect of the COVID-19 pandemic lockdown on stroke consultations and treatment recommendations using the acute consultant database of the telestroke network TEMPiS | Descriptive: Historical cohort | N/A | Epidemiology - Prevalence | N/A | N/A | Telemedicine consultations in the telestroke network TEMPiS | N/A | N/A | Data collected during the first four months of 2020 | Data collected during the same months in the years 2017–2019 | Data for presumed and definite ischemic stroke, recommendations for rtPA and EVT | N/A | N/A | N/A | N/A | N/A | N/A |
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99 | August | Shan MX | 10.1136/bcr-2020-237406 | 2020 | USA | N/A | To report the case of a patient receiving pulmonary rehabilitation following COVID-19 infection | Descriptive: Case Report | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 1 | At admission: - 8 days of fever, chills, cough and lethargy and positive outpatient COVID-19 test |
In acute ward: - intubation - including hydroxychloroquine, azithromycin, ceftriaxone, vancomycin, cefepime, doxycycline and tocilizumab During patient’s rehabilitation course - therapy focused on improving activity tolerance and endurance |
N/A |
functional outcome measured with multiple assessments: - the Chair Stand Test - the Timed Up & Go - the 6MWT |
N/A | N/A | N/A | N/A | N/A | N/A | This is the case report of an elderly woman who survived COVID-19 and was referred to the Acute
Rehabilitation Unit for pulmonary rehabilitation.
Patient's functional outcomes, as measured by Chair Stand Test, TImed Up & Go and 6MWT, improved
in
the 11 days she spend in the rehabilitation unit. Her gait speed, heart rate, oxygen saturation after ambulation and incentive spirometer volume showed similar improvements. She was discharged home with a prescription for a rollator as well as home and outpatient cardiopulmonary therapy for continued rehabilitation. |
100 | August | Shariyate MJ | 10.22038/abjs.2020.47626.2333 | 2020 | Iran | March 2020 | To report three cases of COVID-19 patients with fragility hip fractures | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Patients with fragility hip fractures developing COVID-19 | 3 | Patient 1: 73 year old male admitted with intertrochanteric femoral fracture, complaining
weakness.
He was transferred to PACU and was discharged from the hospital after 2 days; he returned to the
hospital 3 days after discharge with new onset fever, weakness, dyspnea, and anorexia. Patient 2: 69 year old male admitted with intertrochanteric femoral fracture, complaining weakness. Partient 3: 93 year old female admitted with femoral neck fracture; he showed a low grade fever along with cough and feeling of fatigue. |
Patient 1 underwent surgical fixation under spinal anesthesia and intravenous sedation. Patient 2 was treated in a same manner as was done for Patient 1. Patient 3: the authors urged to postpone surgery due to severe pulmonary involvement in the patient. All three patients received oseltamivir and hydroxychloroquine. One patient also received corticosteroid. |
N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Elderly patients with fragile lower extremity fractures are at high risk of COVID-19. The authors recommended careful assessment using chest CT scan and other lab tests. |
101 | August | Tan GP | 10.1016/j.resp.2020.103515 | 2020 | Singapore | From January 29 to May 29, 2020 | To describe the clinical characteristics and outcome of individuals affected by COVID-19 and Platypnea orthodeoxia syndrome-POS | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 5 | Oxygen desaturation, dyspnea and tachypnea during physiotherapy when sat up from a recumbent position | A modified physiotherapy approach including bed exercises, pre-emptive increases in supplemental oxygen in anticipation of movement and/or exercise, and interval training with multiple breaks | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | During physiotherapy when sat up from recumbent position, five out of 20 ICU survivors presented POS, a clinical syndrome characterized by orthostatic oxygen desaturation and positional dyspnea from supine to an upright position. A modified physiotherapy approach was instituted: bed exercises, pre-emptive increases in supplemental oxygen in anticipation of movement and/or exercise, and interval training with multiple breaks. POS resolved over a median (range) of 17 (6–39) days. Compared to ICU survivors without POS, patients with POS were older and had lower body mass index. POS is an under-recognized clinical feature in severe COVID-19 ARDS and should be considered by healthcare personnel. |
102 | August | Tenforde MW | 10.15585/mmwr.mm6930e1 | 2020 | USA | From April 15 to June 15, 2020 | To interview adults tested positive at an outpatient visit about symptoms present at the time of testing, whether those symptoms had resolved by the interview date, and whether they had returned to their usual state of health at the time of interview | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 outpatients | 274 | N/A | Telephone interview, 2-3 weeks after testing | N/A | Baseline chronic medical conditions, symptoms present at the time of testing, whether those symptoms had resolved by the interview date, and whether subjects had returned to their usual state of health at the time of interview | N/A | N/A | N/A | N/A | N/A | N/A |
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103 | August | Trifan G | 10.1016/j.jstrokecerebrovasdis.2020.105167 | 2020 | USA | N/A | To report the case of a young female with history of CADASIL with COVID-19 with acute ischemic stroke as the sole manifestation. | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Patients with CADASIL developing acute stroke and COVID-19 | 1 | A 37 years old African American female with a genetically proven CADASIL mutation referred to ICU presenting with left leg weakness, dysarthria and ataxia. MRI brain without contrast revealed an acute ischemic stroke in the right pons along with extensive chronic white matter signal abnormalities characteristic of CADASIL. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors reported a paradigmatic case of a woman with CADASIL and positive to SARS-CoV2 showing an acute stroke. They affirmed that CADASIL associated imaging changes have remained stable throughout the years. Thus, while it is possible that SARS-Cov-2 infection may have contributed to the etiology of the acute pontine stroke, the authors could not conclusively prove the causation. |
104 | August | Turgut A | 10.5152/j.aott.2020.20209 | 2020 | Turkey | From March 16 to May 22, 2020 | To evaluate the types and the frequency of fractures, both in the pediatric and adult population during the COVID-19 pandemic and to find out the differences in comparison to the non-pandemic period. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | N/A | N/A | Patients with a new fracture | 3996 | N/A | N/A | Patients with new fractures admitted to the hospital in the same date range in 2018 and 2019. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The frequency of fractures decreased by approximately one-third during the pandemic period compared with that in the non-pandemic period (1794, 1747, 670 fractures in 2018, 2019, and 2020, respectively). The mean age of the patients with a fracture in the pediatric group was found to have decreased also. Finger fractures in pediatric patients and metatarsal fractures in adult patients were found to have significantly decreased during the pandemic. The decreased mobility on the streets directly affects the fracture frequency. |
105 | August | Vitali M | 10.1016/j.tcr.2020.100336 | 2020 | Germany and UK | March-April 2020 | To report a case of axillary nerve palsy in a patient affected by COVID-19 who kept a wrong decubitus position while receiving CPAP therapy. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 1 | A 46 year-old Caucasian male referred to ICU with shortness of breath, body temperature 38 °C and RR=30 breaths per minute; oxygen saturation was 95% on room air. An orthopedic consult revealed that patient had left shoulder abduction and extension limited to 45° each, left deltoid muscle hyposthenia of 3⁄4 on MRC, without sensitivity disturbances. | CPAP four times a day for 3 h each time, alternating with Venturi oxygen mask with 60% FiO2 oxygen flow and a cycle of passive physical therapy | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This clinical case highlights an uncommon side effect, axillary nerve compression, that might
occur
while keeping the lateral decubitus for a long time during CPAP.
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106 | August | Weerahandi H | 10.1101/2020.08.11.20172742 | 2020 | USA | N/A | To characterize overall health, physical health and mental health of patients one month after discharge for severe COVID-19 | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 patients | 161 | N/A | N/A | N/A | - degree of residual pulmonary impairment - overall health status and mental health |
N/A | N/A | N/A | N/A | N/A | N/A |
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107 | August | Whittemore P | 10.1136/bcr-2020-236586 | 2020 | UK | N/A | To present a case of a 60-year-old man who developed extensive COVID-19 pneumonitis and was successfully managed with low-flow oxygen and awake proning | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 1 | Significant and worsening shortness of breath, COVID-19 symptoms and SpO2 of 88% | Awake proning | N/A | SpO2, need of MV | N/A | N/A | N/A | N/A | N/A | N/A | A 60-year-old man with extensive COVID-19 pneumonitis was successfully managed with low-flow oxygen therapy and awake proning, avoiding the need of increasing oxygen therapy or of invasive MV, and discharged home. Awake proning, lasting as much as possible but ideally at least 18 hours/day, could be used in mechanically ventilated as well as non-mechanically ventilated patients to improve oxygenation and avoid the need of MV. |
108 | August | Wurm H | 10.1177/1352458520943791 | 2020 | Germany and UK | April 2020 | To report the case of a MS patient who had received B-cell-depleting immunotherapy with rituximab for about 3 years and developed COVID-19 symptoms | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Patient with relapsing MS developing COVID-19 | 1 | A 59-year-old female MS patient showed mild paraparesis and paraspasticity and a limited walking distance; after 4 days she devolped dry cough, dyspnea, fatigue, headache, nausea, fever of 39°C and low oxygen saturation | Prophylactic IV antibiotic (ampicillin/sulbactam) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This MS patient, in treatment with immunotherapy for 3 years, recovered 14 days after COVID-19 symptoms onset despite having a 0% B lymphocyte count and not developing SARS-CoV-2 IgG antibodies. This case suggests that MS patients receiving B-cell-depleting therapy are not at higher risk of severe complications from primary SARS-CoV-2 infection, and demonstrates that viral clearance is possible without B-cell involvement and antiviral therapy. |
109 | August | Zha L | 10.21037/apm-20-753 | 2020 | China | From March 4, 2020 to May 5, 2020, | To present a modified version of rehabilitation exercises aimed at improving the pulmonary function of patients and easing the expectoration process with acupressure integrated into the exercises to facilitate the recovery and maintenance of pulmonary function | Analytical: Cohort study | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 60 | At baseline the prevalence for dry cough, productive cough, difficulty in expectoration and dyspnea were 41.7%, 43.3%, 35.0% and 50.0%, respectively | Modified rehabilitation exercise which is a full-body exercise retrieved from Chinese martial art Eight-section Brocade | N/A | Over time prevalence of self-reported symptoms of: - Dry cough - Productive cough - Difficulty in expectoration - Dyspnea | N/A | N/A | N/A | N/A | N/A | N/A | The current study found that pronounced improvement occurred in all four investigated
respiratory
symptoms in COVID-19 patients who performed the Modified rehabilitation exercise during both
hospitalization and quarantine period. In particular, after one month, the prevalence rates were
- 11.7% in dry cough, - 11.7% in productive cough, - 8.3% in difficulty in expectoration 15% of patients reported dyspnea as a remained symptom. |
110 | September | Anzalone N | 10.1007/s00415-020-09966-2 | 2020 | Italy | N/A | To report four cases of subacute encephalopathy occurring in patients with SARS-CoV-2 infection | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 4 | agitation and spatial disorientation | Treatment for SARS- CoV-2 infection | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study reported four cases of subacute encephalopathy occurring in COVID-19 patients.None of
the
patients had a relevant clinical history or previous treatment or hypertension.
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111 | September | Bellinghausen AL | 10.1186/s13054-020-03289-4 | 2020 | USA | N/A | To present two cases of COVID-19-associated ARDS treated with prone positioning who developed meralgia paresthetica | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Post-acute | COVID-19 | 2 | left anterior thigh numbness | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study reported two cases of meralgia paresthetica in prone positioning for COVID-19-ARDS.
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112 | September | Beom J | 10.23736/S1973-9087.20.06406-0 | 2020 | Republic of Korea | February 2020 | To report the comprehensive evaluation and inpatient rehabilitation for physical functional recovery in a critically ill COVID-19 inpatient | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patient | 1 | Severe weakness, fatigue, impossibility to sit without back support, mild tendency to aspirate when swallowing solid food | Rehabilitation intervention with 3 sessions for 5 days (day 34 to day 38), consisitng of: sitting and standing balance training, sit-up and sit-to-stand training, gait training with a low walker, and lower limb strengthening exercise starting from low intensity. | N/A | HGS, MRC sum score, itting balance, 1-min STS test, Berg balance scale, FAC, 4-meter walking speed | N/A | N/A | N/A | N/A | N/A | N/A | A 58-year-old woman with COVID-19 on day 30 after diagnosis was assessed by a physiatrist and underwent rehabilitation from days 34 to 38; as a result, lower limb muscle strength, balance function, and gait speed considerably improved and on day 39 she was discharged from hospital, with FAC=2, considering that she could walk about 100 meters using a low walker. At the 1-month follow-up, she was able to walk alone without assistance and BIA showed increased ASMM (6.35 kg/m2). Therefore, inpatient rehabilitative treatment, including pulmonary rehabilitation, has to be recommended in COVID-19 patients, taking into account the the intriguing findings of this case report |
113 | September | Blauwet CA | 10.1002/pmrj.12481 | 2020 | USA | December 2019 - April 2020 | To provide a step-by-step guide on the design and implementation of a virtual adaptive sports program | Analytical: Cross-sectional study | N/A | Meso Level | Any other body structure and function-generic (s/b) | N/A | People with disabilities | 219 | Disabilities (SCI, osteoarthritis, muskoloskeletal conditions, stroke, MS, muscular dystrophy, post-polio, brain injury and other conditions) | Virtual Adaptive Sports | Traditional Adaptive Sports | Likert scale for rating: Physical Domain (Flexibility, Strength, Endurance, Balance), Emotional Domain (Confidence, Self-esteem, Mood) Functional Domain (Self-care/ADLs, Ambulation, WC Mobility, Transfers) | N/A | N/A | N/A | N/A | N/A | N/A | Significant differences, favoring traditional programming, were noted in terms of endurance (2.99 vs 2.70; P=0.04), confidence (3.31 vs 2.74; p< 0.001), and self-esteem (3.19 vs 2.74; p=0.005). Activities that required minimal home equipment might be considered as viable options, including: yoga, meditation, dance, group and individual fitness, group drum circles, and off-season sled hockey training. Adaptive sports and recreation provide many potential benefits for persons with disabilities, including increased opportunities for physical activity and social interaction |
114 | September | Brown EJ | 10.3233/JPD-202249 | 2020 | USA | From April 23 to May 23, 2020 | To understand the symptoms and outcomes of SARS-CoV-2 infection in people with and without PD to determine how the disease may affect people with PD differently, to determine the effects of COVID-19 on motor and non-motor symptoms related to PD, to understand the effects of the pandemic and associated public health measures on people with and without PD. | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Parkinson Disease | 7209 | N/A | N/A | Healthy subjects. | Answer to Fox Insights survey. | N/A | N/A | N/A | N/A | N/A | N/A | The survey, administred to 7209 subjects (5,429 people with PD and 1,452 without PD), showed that 51 people with PD and 26 without PD were diagnosed with COVID-19. Complications were more frequent in people with longer PD duration. The vast majority of people with PD did not have COVID-19, yet most reported significant disruptions in many aspects of their daily lives. Disruptions were more common for those living alone, with lower income and non-white race. |
115 | September | Cao X | 10.2147/JPR.S274199 | 2020 | China | January-July,2020 | To describe clinical features, treatments and outcome of herpes zoster and postherpetic neuralgia in a 70-year-old woman with critical COVID- 19. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Post-acute | COVID-19 developing Herpes zoster | 1 | N/A | Intravenous and then oral acyclovir; Pregabalin and ibuprofen was used for analgesia | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is a case of 70-year-old woman who developed herpes zoster in the right 10 to 12 lumbar dermatomes in the recovery period of COVID-19 (about 7 weeks after symptoms onset) . The lesions resolved 21 days after the onset of rash but she continued to have persistent pain in the same dermatomal distribution. 4 months after herpes zoster eruption, the patient still complained intermittent pain in the dermatomes. It is reported that herpes zoster cases substantially increase during COVID-19 pandemic. For COVID-19 patients with herpes zoster, antiviral treatment should be started as early as possible and lastlonger than a typical course. The use of analgesics should be based on the dermatome involved, severity of pain and the comorbidities. |
116 | September | Carroll E | 10.1111/epi.16683 | 2020 | USA | March 2020 | To describe a case of refractory status epilepticus (RSE) after recovery from acute COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 1 | Refractory status epilepticus | Lorazepam, Levetiracetam, Clonazepam, Lacosamide, Midazolam, steroids and intravenous immunoglobulin | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The paper describe the clinical history of a 69-years-old with previous history of diabetes and consequent severe nephropathy necessitating a renal transplant. He developed COVID-19 and was admitted in ICU for severe hypoxia that needed mechanical ventilation. On day 2 of hospitalization she had a 2-minute episode of spontaneous, symmetric, tonic movements of her arms and left gaze deviation without reported head turn that resolved with Lorazepam. 6 weeks after hospiltazion, after improvement of her clinical conditions and discharge to sub-acute rehabilitation she developed refractory status epilecticus. Her clinical condition improved after therapy with steroids and intravenous immunoglobulin. |
117 | September | Cavalagli A | 10.23736/S1973-9087.20.06452-7 | 2020 | Italy | April - June 2020 | To report a case of cranial nerves impairment in post-acute oropharyngeal dysphagia after COVID-19 | Descriptive: Case Report | General postacute rehabilitation | Epidemiology - Clinical presentation | Digestive functions (b510) | Post-acute | COVID-19 patient | 1 | Involvement of both sensitivity and motor IX and X CNs components, selective sensitivity right impairment of V in lingual nerve component and impairment of right XII, resulting in mild dysphagia. | Rehabilitation program with objective to regain endurance, strength, independence and swallowing (exercises to improve base tongue strength and pharyngeal movements), coordination and coughing, until functional swallows with ice chips and airway protection exercises | N/A | POMA, MBS, IOPI, FOIS, DOSS, I&I Test | N/A | N/A | N/A | N/A | N/A | N/A | I&I test, a useful scale to detect the major deficits affecting the cranial nerves in patients with swallowing disorders, showed gradual and partial recovery after rehabilitation. Moreover, the patient was able to walk for short distances without O2 therapy after 30 days. The patient started a complete oral feeding with pureed food and water with protective maneuvers after 40 days. This case report could expand knowledge about clinical picture after COVID-19, taking into account that cranial, particularly bulbar nerves might be involved as late complications |
118 | September | Chan JL | 10.1007/s11102-020-01080-w | 2020 | USA | N/A | To report a case of a pregnant female presenting with pituitary apoplexy and simultaneous SARS-CoV-2 infection | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Acute | COVID-19 pregnant female | 1 | Blurry vision, left dilated pupil, and headache | corticosteroid administration and surgery | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case of a 28-year-old pregnant female (38weeks 1day) presenting with pituitary apoplexy and simultaneous SARS-CoV-2 infection. She presented with 4 days of blurry vision, left dilated pupil, and headache. She had central hypothyroidism and a cystic-solid lesion with a fluid level in the pituitary fossa and expansion of the sella consistent with pituitary apoplexy at MRI. Her visual symptoms improved with corticosteroid administration and surgery was delayed to two weeks after her initial COVID-19 infection and to allow for safe delivery of the child. She made a full recovery and was discharged home two days after surgery. |
119 | September | de Havenon A | 10.1136/neurintsurg-2020-016777 | 2020 | USA | April-July 2020 | To compare the outcome of acute ischemic stroke patients who received EVT with confirmed COVID-19 to those without. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | EVT-treated acute ischemic stroke patients with comorbid COVID-19 | 3165 (104 with confirmed COVID-19) | N/A | EVT-treated acute ischemic stroke patients with COVID-19. . | EVT-treated acute ischemic stroke patients without COVID-19. Moreover, as a sensitivity analysis, the authors compared COVID-19 AIS patients who did not undergo EVT to those who did, to balance potential adverse events inherent to COVID-19 infection. | in-hospital death, favorable discharge, defined as a discharge to home or acute rehabilitation | N/A | N/A | N/A | N/A | N/A | N/A | In AIS patients treated with EVT, comorbid COVID-19 infection was associated with in-hospital death and a lower odds of favorable discharge compared with patients without COVID-19. Comorbid COVID-19 infection was associated with younger age, male sex, diabetes, black race, Hispanic ethnicity, intubation, acute coronary syndrome, acute renal failure, and longer hospital and intensive care unit length of stay. However, AIS EVT patients with COVID-19 had a near-identical rate of death as 2139 AIS patients who did not undergo EVT but had COVID-19, suggesting the higher rate of adverse outcomes was inherent to COVID-19 infection. These results argue that eligible AIS patients with COVID-19 should receive EVT, given the overwhelming benefit of that intervention. |
120 | September | De Paulis M | 10.1097/INF.0000000000002834 | 2020 | Brazil | N/A | To report the case of a 4-year-old child with a post-infectious multisystem inflammatory syndrome associated with COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 1 | Somnolence and mental confusion (Glasgow coma score 11), a mild multiforme skin rash on trunk and legs, cracked lips, and swelling of palpebrae, hands, and feet. | Intubation, dobutamine, antibiotics, Acyclovir, intravenous immunoglobulin | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Thi is the case of a 4-year-old child with a post-infectious multisystem inflammatory syndrome associated with COVID-19, presenting with shock, Kawasaki-like and neurologic dysfunction (somnolence, lethargia, mental confusion) for whom a cytokine storm and decreased levels of BDNF were well documented. The girl was discharged home, fully recovered after 17 days from skin rash onset. The development of a cytokine storm, either during or following SARS-CoV-2 infection, is strongly suspected as the main feature in the pathogenesis of the multisystem inflammatory syndrome. The causal relationship between reduced BDNF and neurologic symptoms in patients with COVID-19, as well as the long- term consequences on neurocognitive function in children, remains to be elucidated and should be further explored. |
121 | September | Di Gennaro F | 10.4084/MJHID.2020.063 | 2020 | Italy | From March, 2020 | To report outcomes and clinical features of a cohort of 14 patients who had been admitted to a Neurorehabilitation Unit and subsequently found to be positive for SARS-CoV-2 infection on nasopharyngeal swabs. | Analytical: Cohort study | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Patients with severe neurological disabilities developing COVID-19 | 14 | One out of 14 patients (7%) developed severe manifestations of COVID-19 (BCRSS=3) starting with fever, cough, and dyspnea, followed by a rapidly evolving acute respiratory distress syndrome. The other 13 patients did not present fever, respiratory symptoms, or oxygen desaturation on both pulse oximetry and blood gas analysis (BCRSS=0). | Symptomatic patient: oxygen therapy, Lopinavir/Ritonavir, Hydroxychloroquine, enoxaparin. Asymptomatic patients: enoxaparin. | N/A | Clinical outcome. | N/A | N/A | N/A | N/A | N/A | N/A | The study describe 14 patients suffering from severe neurological disabilities, who tested positive for SARS-COV-2 during inpatient neurorehabilitation. Out of 14 patients, only 1 developed symptomatology and was consequently treated. However, he developed acute respiratory distress, leading to exitus. All the other patients did not develop symptomatology and consequently recovered. |
122 | September | Garnero M | 10.1016/j.jns.2020.117114 | 2020 | Italy | February - May 2020 | To report the natural history of patients with GBS, both COVID and not-COVID related, hospitalized in Liguria region, during lock down period, evaluating possible managements pitfalls due to pandemic emergency. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients with GBS | 6 | Dysphagia and dysphonia were present in 3 patients; arterial pressure instability in 1 patient; paralytic ileus in 1 patient; bradycardia in 1 patient | IVIG | 9 GBS patients without COVID-19 | MRC score, GBS-DS | N/A | N/A | N/A | N/A | N/A | N/A | Multi-organ involvement, delay in the diagnosis, incomplete work up and start of therapy, were registered in 50% of cases with a GBS-Disability scale ≥4 at follow-up evaluation. In not-COVID-19 related GBS, main problem was diagnostic delay. The Authors concluded that not only SARS-COV-2 infection can cause GBS, but it can also indirectly, due to effects of pandemic on the health organization, affect the outcome of patients with not-COVID-19 related GBS. |
123 | September | Gaspari CH | 10.1093/ptj/pzaa175 | 2020 | Brazil | From March to May, 2020 | To describe the role of physical therapists in a neurosurgical center that was converted into a COVID-19 center for critically ill patients. | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 116 | N/A | Proning, respiratory and neuromuscular rehabilitation. | N/A | Discharge setting. | N/A | N/A | N/A | N/A | N/A | N/A | During COVID-19 outbreak a brazilian public neurosurgical center was reallocated for treatment of COVID-19 patients. Physical therapists were heavily involved since acute stage of the disease, coordinating proning, and later in helping patient to regain physical function. Of the 116 patients treated, 49% of patients died, 3% were transferred to another institution, 20% were discharged home and 28% continued hospitalization. |
124 | September | Grewal P | 10.3389/fneur.2020.00910 | 2020 | USA | March - April 2020 | To report on patients with acute ischemic stroke and concomitant COVID-19 in a diverse patient population | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients with AIS | 13 | Most strokes were cortical (84.6%) and more than 50% of patients had no identifiable source, and were categorized as embolic stroke of unknown source | N/A | Historic patients with AIS without COVID-19 admitted in the same time frame in 2019 and 2020 | NIHSS, mRS | N/A | N/A | N/A | N/A | N/A | N/A | A trend toward less alteplase administration was noted in the COVID-19 stroke patients compared to the non-COVID group from 2020 and 2019 (7.1 vs. 20.7% p 0.435 and 7.1 vs. 27.2% p 0.178). Endovascular thrombectomy was performed in 3 (23%) patients. Eight patients (63.8%) were discharged home or to acute rehabilitation, and two deceased from COVID-19 complications. Five patients were discharged to Acute Rehabilitation Units |
125 | September | Hallifax RJ | 10.1136/bmjresp-2020-000678 | 2020 | UK | From March to May, 2020 | To describe the first 48 patients admitted to a respiratory HDU, requiring additional respiratory support. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 48 | N/A | Respiratory support: CPAP, HFNO, or NIV. | N/A | Discharge setting. | N/A | N/A | N/A | N/A | N/A | N/A | The study describe 48 patients admitted to a HDU because of COVID-19. Patients were transferred to HDU if there was an increasing oxygen requirement, or an absolute oxygen requirement of: either FiO2≥40% or ≥8 L/min via mask face. Of the 48 patients, 11 (22.9%) were successfully managed with respiratory support in HDU alone and were discharged home, 26 (54.2%) patients died, 11 (22.9%) required ICU admission for intubation and invasive ventilation. Awake proning was attempted in 30/48 (62.5%) patients. Successful proning was achieved in 11/30 (36.7%), and semiproning in 17 (56.7%) patients. Achievement of full proning was associated with lower mortality than failed or semiproning in the HDU setting. |
126 | September | Jiandani MP | N/A | 2020 | India | From June 5th to July 5th, 2020 | To describe how COVID-19 patients received physiotherapy interventions in acute care setup of a tertiary hospital in Mumbai. | Descriptive: Historical cohort | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 300 | N/A | Rehabilitation program in ICU and a step-down unit. | N/A | ICU Mobility Scale, Oxygen Support Needed | N/A | N/A | N/A | N/A | N/A | N/A | During ICU and step down unit stay patients underwent respiratory rehabilitation, and their clincal condition improved in the first 7 days of stay in all the outcome considered. Namely, ICU mobility scale improved in a statistical significant way, and, as far as oxygen support needed is concerned, 23.1% of patients using face mask and nasal prongs were weaned to room air, 32.8% of patients using non rebreather masks were weaned to face mask and nasal prongs, 31.3% on non invasive ventilation were weaned to non rebreather masks or face mask,while where was no change in intubated patients. However, 30.8% of patents on face mask and nasal prongs, 18.8% on non rebreather masks, 6.3% on non invasive ventilation had increased oxygen requirement. Early physiotherapy intervention seems to be beneficial for restoring ambulation and assuring early discharge in severe COVID-19 patients. |
127 | September | Johnson JK | 10.1093/ptj/pzaa181 | 2020 | USA | From beginning of pandemia to June 10, 2020 | To examine the relationship of physical therapy visit frequency and duration in the hospital with patients’ mobility status at discharge and probability of discharging home | Descriptive: Historical cohort | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Any Activity limitation and participation restriction (d) | Acute | COVID-19 | 312 | N/A | Physical therapy visit | N/A | Activity Measure for Post-Acute Care 6-Clicks basic mobility (6-Clicks mobility) and the Johns Hopkins Highest Level of Mobility (JH-HLM) scales, Discharge to home vs. to a facility | N/A | N/A | N/A | N/A | N/A | N/A | The frequency of physical therapy visits in acute care hospitals was variable with a mean of 0.5 visits per day (ie, one visit every other day), but which ranged from 0.1 to 1.5. The mean visit duration was 25.3 minutes. Patients with COVID-19 demonstrated improved mobility at hospital discharge and higher probability of discharging home with increased frequency and longer mean duration of physical therapy visits. These associations were not generally moderated by patient characteristics. Physical therapy should be an integral component of care for patients hospitalized due to COVID-19 (more frequent and longer physical therapy visits) |
128 | September | Lampe A | 10.1186/s42466-020-00066-0 | 2020 | Germany | March 2020 | To report the case of a 65-years old man infected with SARS-CoV-2 and acutely presented with typical symptoms of Guillain-Barré syndrome | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | Distally accentuated paresis of the right arm and a slight paraparesis of the lower limbs. No sensory deficits. Deep tendon reflexes reduced generally. | intravenous immunoglobulin and physioteraphy | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study described a case of a 65-years old man infected with SARS-CoV-2 with Guillain-Barré syndrome. 5 days-treatment with IVIG in combination with physiotherapy quickly led to a significant improvement in GBS symptoms. The patient was discharged from the hospital 12 days after admission without residual paresis. |
129 | September | Malik GR | 10.1016/j.bja.2020.08.045 | 2020 | USA | From April 24, 2020 to June 30, 2020, | To describe 11 patients who were diagnosed with acquired peripheral nerve injury in association with the use of prone positioning for COVID-19-related ARDS. | Descriptive: Case Series | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 with ARDS developing peripheral nerve injuries | 11 | peripheral nerve injury | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Out of 83 patients admitted to rehabilitation hospital after hospitalisation for COVID-19- related ARDS, 12 patients (14.5%) were diagnosed with peripheral nerve injury. All but one patient had a confirmed history of prone positioning in acute care (91.7%). In total, there were 21 focal peripheral nerve injury sites across these 12 patients and one newly acquired distal symmetric polyneuropathy. The majority of these peripheral nerve injuries occurred in the upper limb (76.2%). Peripheral nerve injury after prone positioning for management of severe COVID-19-related ARDS patients is surprisingly common. Physicians must be aware of an increased susceptibility to peripheral nerve injury in severe COVID-19 and refine standard protocols in order to reduce the risk. |
130 | September | McWilliams D | 10.1513/AnnalsATS.202005-560OC | 2020 | UK | March and April, 2020 | To describe the demographics, clinical status, level of rehabilitation and mobility status at ICU discharge of patients with COVID-19 | Analytical: Cohort study | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 177 | N/A | N/A | N/A | Manchester Mobility Score | N/A | N/A | N/A | N/A | N/A | N/A | The present study focused on patients admitted to ICU and mechanical ventilated for longer then 24 hours. Out of 177 patients, 110 survived to discharge. The mean time at first mobilization was 14 ± 7 days, with a median Manchester Mobility Score at ICU discharge of 5 (interquartile range: 4-6), which represents participants able to stand and step round to a chair with or without assistance. The study showed that it is possible to practice rehabilitation in ICU, but not at the time of admission because of the severity of the clinical conditions of the patients. Because of the weakness and high levels of delirium acquired during ICU stay, rehabilitation looks to be necessary in an hospital setting, and this should be taken into account in planning for the care of COVID-19 patients. |
131 | September | Nakayama A | 10.1186/s12199-020-00885-2 | 2020 | Japan | From January, 2019, to May, 2020 | To demonstrate the effectiveness of a remote cardiac rehabilitation program. | Analytical: Cohort study | Specialized postacute rehabilitation | Meso Level | Cardiovascular functions (Heart b410) | N/A | Hospitalized patients suffering from heart failure | 236 | N/A | Home-based tele cardiac rehabilitation. | Outpatient cardiac rehabilitation and non cardiac rehabilitation groups | EQD-5 at discharge and 30 days after discharge, emergency readmissions. | N/A | N/A | N/A | N/A | N/A | N/A | In this study post-hospitalization patients suffering from heart failure could choose between remote, outpatient or non cardiac rehabilitation. Patients who underwent remote rehabilitation showed better quality of life after the treatment and lower rate of emergency readmission. |
132 | September | Negrini F | 10.1016/j.apmr.2020.09.376 | 2020 | Italy | From March 3rd to April 8th, 2020 | To report the cognitive features of severe COVID-19 patients in the post- acute phase, to understand whether COVID-acute respiratory distress syndrome itself could result in long-term cognitive deficits and whether neuropsychological treatment might represent a specific rehabilitation need. | Descriptive: Case Series | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 9 | N/A | N/A | N/A | Mini-Mental State Examination Test. | N/A | N/A | N/A | N/A | N/A | N/A | A general cognitive decay was observed in three patients (33.3%) as for MMSE score. The cognitive decline was negatively correlated to the length of stay (in days) in the ICU. Some COVID-19 patients might benefit from a neuropsychological rehabilitation, especially the patients who are treated in the ICU care. | |
133 | September | Pironi L | 10.1016/j.clnu.2020.08.021 | 2020 | Italy | April 2020 | To know the prevalence of malnutrition as well as the provided nutritional therapy in COVID-19 patients | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Digestive functions (b510) | Post-acute | COVID-19 | 268 | N/A | N/A | N/A | Patient nutritional assessment | N/A | N/A | N/A | N/A | N/A | N/A | A total of 268 patients was evaluated: intermediate care units (61%), sub-intensive care units
(8%), intensive care units (17%) and rehabilitation units (14%).
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134 | September | Priftis K | 10.1007/s10072-020-04768-w | 2020 | Italy | April 2020 | To investigate the specific and focal neuropsychological consequences of SARS-CoV-2 in a patient affected by left emisphere stroke | Descriptive: Case Report | General postacute rehabilitation | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 patient with stroke | 1 | Patient presented mild interstitial pulmonary signs at chest X-ray scan and antibodies for SARS-CoV-2 at serological tests. She showed showed some signs of conduction aphasia and impairment in writing. | N/A | N/A | Language, number processing and calculation tests | N/A | N/A | N/A | N/A | N/A | N/A | The patient had a largely intact neuropsychological profile, except for the presence of severe agraphia and some signs of conduction aphasia. These deficits were fully compatible with the presence of a temporo-parieto-insular lesion documented by FLAIR MRI. The authors suggested that COVID-19 patients and stroke might not only show diffuse neurocognitive and neurobehavioural signs (e.g. confusion, agitation, psychosis), but they can also present with highly focal neuropsychological disorders, such as agraphia and conduction aphasia. |
135 | September | Ramalingam MB | 10.1097/PHM.0000000000001606 | 2020 | Singapore | From February to April, 2020 | To describe the case of a severe COVID-19 patient undergoing rehabilitation. | Descriptive: Case Report | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 1 | Respiratory insufficiency, recurrent pneumonia, proximal myopathy, post-critical illness musculoskeletal deconditioning, bilateral hand tremors from weakness, pulmonary deconditioning, poor endurance and effort tolerance, moderate oropharyngeal dysphagia, psycho-emotional issues, fatigue, poor appetite. | Respiratory and muskoloskeletal rehabilitation. | N/A | FIM, PHQ-9, 6MWT | N/A | N/A | N/A | N/A | N/A | N/A | The case study described a 64 years-old severe COVID-19 patient who needed mechanical ventilation and tracheostomy during the acute phase. He was later discharged to an inpatient rehabilitation ward where he underwent a comprehensive rehabilitation program. After 10 days of rehabilitation botrh autonomy, measured using FIM, and endurance, measured using 6MWT were improved and the patient was discharged. |
136 | September | Slessarev M | 10.1007/s12630-020-01661-0 | 2020 | Canada | N/A | To propose HFNC combined with patient self-proning in a COVID-19 patient with hypoxemia and normal work of breathing. | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 1 | Bilateral Pneumonia, hypoxemia and normal work of breathing. | HFNC combined with patient self-proning | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case of a 68-yr-old COVID-19 patient with bilateral pneumonia that rapidly worsened, who was placed in a negative pressure room, treated with HFNC and instructed to self-prone via telephone by lying with his chest down for as long as possible. Total proning time was 16–18 hr each day. The patient felt better while prone and this positioning resulted in cyclical improvements in his oxygenation. The patient was discharged to a dedicated COVID-19 ward after 4 days without requiring intubation. HFNC combined with patient self-proning can be broadly applied in COVID-19 patients with hypoxemia and normal work of breathing. In addition to preserving ventilator capacity in resource replete settings, this care approach would have important applications to resource-limited countries where sophisticated ICU techniques may not be available. |
137 | September | So H | 10.1016/j.semarthrit.2020.07.012 | 2020 | Hong Kong | From 23 January, 2020 to 27 May, 2020 | To examine the incidence and outcomes of all COVID-19 patients with rheumatologic conditions in Hong Kong. | Descriptive: Case Series | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | COVID-19 patients with underlying rheumatologic diseases | 5 | N/A | N/A | Incidence of COVID-19 in the general population in Hong Kong; clinical course | Incidence of COVID-19 in patients with rheumatologic conditions | N/A | N/A | N/A | N/A | N/A | N/A | Out of the 39,835 patients with underlying rheumatologic diseases, there were 5 PCR confirmed
COVID-19 cases with inflammatory arthropathies. The estimated incidence of COVID-19 was 0.0126%
patients with rheumatologic diseases, compared to 0.0142% in the general population.
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138 | September | Sparr SA | 10.1161/STROKEAHA.120.030434 | 2020 | USA | late April 2020 | To report cases of infarction of the Splenium of the Corpus Callosum in the Age of COVID-19 | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 4 | Encephalopathy | Three patients underwent hemodialysis and ventilator; one patient was treated with high flow oxygen, apixaban, hydroxychloroquine, and steroids | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | During a 2-week period 4 patients at Montefiore Medical Center in the Bronx were found to have ischemic lesions of the splenium of the corpus callosum, 2 with infarction isolated to the corpus callosum. All patients tested positive for COVID-19 and 3 had prolonged periods of intubation. All had cardiovascular risk factors. Clinically, all presented with encephalopathy and had evidence of coagulopathy and raised inflammatory markers. Two patients improved and were discharged to acute rehabilitation. In one patient the mental status remained depressed and the last one died. -This small series of patients with an uncommon locus of injury suggests COVID-19 as an inciting agent,with the mechanisms to be elucidated. |
139 | September | Stierli S | 10.2340/16501977-2735 | 2020 | Switzerland | N/A | To describe the case of a 62 year-old man with severe acute respiratory distress syndrome due to Covid-19 treated with dysphagia therapy and speech therapy and the use of ventilator-compatible speaking valves | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | N/A | dysphagia and speech therapy, ventilator-compatible speaking valves | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The case report describes the case of a 62 year-old man with severe acute respiratory distress syndrome due to Covid-19. He presented with critical illness polyneuromyopathy, ventilator- associated diaphragm dysfunction, weaning failure, tracheotomized from 6 weeks, and completely mechanically ventilated with inflated cuff, nasogastric tube. In close collaboration between the speech-language therapists and intensive care nurses, a ventilator-compatible valve could be inserted and the speech therapy started. This led a gradual improvement in speaking and swallowing. Four weeks after admission to the ICU, it was possible to safely remove the patient’s nasogastric and tracheostomy tubes. Early intervention with dysphagia therapy and speech therapy and ventilator-compatible speaking valves, provided within an interprofessional collaborative team, can mitigate the potentially negative consequences of prolonged intubation, long-term use of cuffed tracheostomy, and post intensive care syndrome resulting from Covid-19. |
140 | September | Ticinesi A | 10.1007/s40520-020-01699-6 | 2020 | Italy | March - April 2020 | To assess the incidence of delirium in a large number of patients hospitalized for suspect COVID-19 in Northern Italy, verify its clinical correlations and determine its impact on in-hospital mortality | Descriptive: Historical cohort | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | Patients with suspect COVID-19 presenting with delirium | 94 | Patients with delirium presented more frequently atypical symptoms such as syncope, postural instability and thoracic pain (26% vs 16%; p=0.02), lower oxygen saturation values in room air (90% vs 93%; p=0.049), and lower functional autonomy in daily activities (31% vs 63%; p=0.02) | N/A | 758 patients with suspect COVID-19 without delirium | Clinical and laboratory characteristics | N/A | N/A | N/A | N/A | N/A | N/A | Ninety-four patients (11%) developed delirium during stay. At multivariate models, delirium was independently and positively associated with age [OR 1.093, 95% CI 1.046–1.143, p < 0.001], use of antipsychotic drugs (OR 4.529, 95% CI 1.204–17.027, p=0.025) at admission. The authors concluded that delirium could represent a common complication of COVID-19 and a marker of severe disease course, especially in older patients with neuropsychiatric comorbidity. |
141 | September | Trifan G | 10.1016/j.jstrokecerebrovasdis.2020.105314 | 2020 | USA | March - May 2020 | To describe the characteristics of a diverse cohort of acute stroke patients with COVID-19 disease and determine the role of sex and vascular risk factors on outcome | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients with stroke | 83 | The most common complications were respiratory failure (59%) and septic shock (34%). Compared with females, a higher proportion of males experienced severe SARSCoV-2 symptoms requiring ICU hospitalization (73% vs. 49%; p=0.04). | N/A | N/A | Clinical characteristics, stroke onset, NIHSS, mRS | N/A | N/A | N/A | N/A | N/A | N/A | Compared with females, males had higher mortality (38% vs. 13%; p=0.02) and were less likely to be discharged home (12% vs. 33%; p=0.04). After adjustment for age, race/ethnicity, and number of VRFs, mRS was higher in males than in females (OR=1.47, 95% CI=1.03-2.09). The large majority of our patients had pre-existing VRFs and manifested changes in laboratory markers of inflammation and coagulability |
142 | September | Vadukul P | 10.1136/bcr-2020-238168 | 2020 | UK | N/A | To report the case of a 52-year-old woman with COVID-19 pneumonitis who developed an acute massive pulmonary embolism, a week after the home discharge. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 1 | Acute massive pulmonary embolism with severe respiratory and cardiac failure | intravenous thrombolysis | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | TThe COVID-19 patient (obesity and undiagnosed type 2 diabetes mellitus) required mechanical
ventilation for nearly 2 weeks.
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143 | September | Vaes AK | 10.3390/jcm9092946 | 2020 | Netherlands and Belgium | June 2020 | To explore the level of care dependency in ADLs and the need for assistance with personal care in non-hospitalized COVID-19 patients | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any Activity limitation and participation restriction (d) | Post-acute | Non-hospitalized mild COVID-19 patients | 1837 | A high proportion of patients experienced long-term symptoms, including fatigue (98%), muscle weakness (90%), sleeping problems (88%), and pain (87%). | Online questionnaire adminstered through Facebook | N/A | Clinical characteristics, USD, CDS | N/A | N/A | N/A | N/A | N/A | N/A | The care need increased significantly after COVID-19 infection (7.7% vs 52.4%; p <0.05). Patients had a median CDS score=72, and 31% of the patients were considered as care-dependent (CDS score= 68). The authors concluded that the impact of COVID-19 on patients’ daily lives is tremendous, and more attention is needed to identify optimal treatment strategies to restore patients’ independency. |
144 | September | Van Aerde N | 10.1007/s00134-020-06244-7 | 2020 | Belgium | From March 13th to June 8th, 2020 | To assess the incidence of ICU acquired weakness in critically ill COVID-19 patients, to identify factors associated with its occurrence, and to describe its short-term outcomes. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 74 | N/A | N/A | N/A | The incidence of ICUAW (MRC-sum score)at awakening, at ICU and hospital discharge; factors and short-term outcomes associated with weakness at ICU discharge | N/A | N/A | N/A | N/A | N/A | N/A | -ICU Mortality in IMV patients was 11/74. -In 50/74 (67.6%) assessed IMV patients, the incidences of ICUAW at awakening, ICU, and hospital discharge were 72%, 52% and 27%. Weak patients had prolonged ventilation, higher mean morning glycemia, more frequently received dialysis, and had higher exposure to corticosteroids, sedatives and analgesics, except for dexmedetomidine, and NMBA. Weak patients had longer ICU stays and lower mobility scores at ICU discharge. Handgrip-strength, and Barthel at hospital discharge (8 versus 10.5) remained lower in weak patients. 15/26 (57.7%) weak versus 6/24 (25%) not-weak patients were referred for in-patient rehabilitation. -The ICUAW incidence in IMV patients is high and the impact on functional status remained substantial. -These data highlight the need for follow-up of post-ICU COVID-19 patients, to offer tailored rehabilitation, hopefully reducing long-term impact. |
145 | September | Wijeratne T | 10.7759/cureus.10366 | 2020 | Australia | March-April 2020 | To describe the case of a 75-year-old man with COVID-19 complicated with severe neurological symptoms during the prolonged intensive care unit stay followed by recovery from both respiratory and neurological involvement. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | acute ischemic stroke-like symptoms and raised intracranial pressure | invasive mechanical ventilation, anticoagulation, neurorehabilitation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | -This study illustrates the case of a 75 years old patient with COVID-19 complicated with severe neurological symptoms (acute ischemic stroke-like symptoms) during the prolonged intensive care unit stay (at day 26) followed by slow neurorehabilitation and normal recovery from both respiratory and neurological involvement. -The onset of acute stroke-like symptoms appears to be closely associated with changes of neutrophil-lymphocyte ratio and in C-reactive protein, and D-dimer levels, suggesting that a COVID-19-induced hyperimmune response led to significant inflammatory injury to the brain and suspected intracranial hypertension. -This highlights the critical clinical value of regular assessment of NLR, LCRPR (Lymphocyte to CRP Ratio) and LPR (lymphocyte to platelet ratio) which are low-cost prognostic tools available in almost all health services across the world. |
146 | September | Zito A | 10.3389/fneur.2020.00909 | 2020 | Italy | N/A | To describe a case report with an axonal variant of GBS following COVID-19, and to review the available reports in the literature on other GBS cases related to SARS-CoV-2 infection | Descriptive: Case Report | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 patient with GBS | 1 | Weakness in dorsiflexion of the foot, extension of the toes, extension of hand and fingers, and gait ataxia at the baseline | IVIG cycle at 0.4 g/kg/day over 5 days; at the discharge, the patient underwent rehabilitation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | After IVIG cycle at 0.4 g/kg/day over 5 days, there was a significant improvement of the weakness in the upper limbs and the left foot but a poor benefit on the right foot and gait ataxic. After rehabilitation treatment, he slowly improved and he was able to walk without aid and was discharged at 1 month. |
147 | October | Beathe JC | 10.1177/2333721420956766 | 2020 | USA | N/A | To describe the case of a 100-year-old COVID-19 hip fracture patient undergoing spinal anesthesia for hemiarthroplasty and subsequent hydroxychloroquine therapy | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Any other body structure and function-generic (s/b) | Acute | COVID-19 patient with hip fracture | 1 | She had a baseline exercise tolerance <4 METs, complaining of a mild headache and denying shortness of breath, cough, fever, or chills. Initial oxygen saturation was 99% on 2 L/min oxygen via nasal cannula | The patient tolerated the spinal anesthesia (performed at the L4-L5 level with bupivacaine 0.5%, 2.5 mL) without complications. Prior to incision, intravenous cefazolin (1000 mg) and tranexamic acid (10 mg/kg) were administered. Ninety minutes into the 130 min-long procedure, 20 mcg of fentanyl was administered. After the intervention, the patient underwent physical therapy from POD1, progressing from transferring to the edge of bed , completing sit-to-stand transfer and marching in place (on POD 2), to walking with moderate assistance six steps to bedside (on POD 7), when she was discharged to a Rehabilitation service | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A 100-year-old COVID-19 patient with displcaed left femoral neck fracture was able to undergo hemiarthroplasty and subsequent hydroxychloroquine therapy. The authors concluded that asymptomatic or mild COVID-19 might not present a prohibitive additional risk to operative hip fracture management among patients at otherwise high risk for perioperative complications. |
148 | October | Bekelis K | 10.1161/STROKEAHA.120.031217 | 2020 | USA | From January to April 2020 | To investigate the association between COVID-19 and stroke. | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 and stroke | 24808 | N/A | N/A | COVID-19 without stroke | Occurrence of new-onset stroke, case-fatality and discharge to rehabilitation for patients presenting with acute ischemic stroke. | N/A | N/A | N/A | N/A | N/A | N/A | This study is based on 24808 discharged patients in New York State. 2513 subjects (10.1%) were diagnosed with COVID-19, and 566 (0.2%) presented with acute ischemic stroke. The authors did not observe a positive association of COVID-19 and ischemic stroke among patients of all ages. Patients with stroke with concurrent SARS-CoV-2 infection dem- onstrated increased case-fatality and a trend more discharge to rehabilitation. These findings do not support the concerns for an epidemic of stroke in young adults with COVID-19. |
149 | October | Belghmaidi S | 10.12659/AJCR.925897 | 2020 | Morocco | N/A | To report the case of a COVID-19 patient that developed incomplete unilateral palsy of the third cranial nerve during the acute phase of the disease. | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | Fever, dry cough, anosmia, strabismus and diplopia of the left eye. | Chloroquine, azitrhomycin, vitamin C, zinc. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The case-study describe a 24-year-old woman who developed exotropia, strabismus (that incresed in abduction) and diplopia of the left eye during acute phase of COVID-19 disease. After starting the therapy for COVID-19 the symptoms quickly improved, and after three days issues with the left eye were resolved. The case-study shows the possibility of transient unilateral diplopia and strabismus during COVID-19 acute phases. |
150 | October | Bourguignon A | 10.1016/j.thromres.2020.10.017 | 2020 | Canada | From March 2020 until June 27th 2020 | To investigate incidence of thrombotic outcomes for patients hospitalized and discharged after COVID-19 infection | Descriptive: Historical cohort | General postacute rehabilitation | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Late-onset | COVID-19 | 454 | N/A | N/A | N/A | Incidence of arterial and venous thrombotic complications | N/A | N/A | N/A | N/A | N/A | N/A | Of the 454 patients hospitalized with COVID-19 infection, 285 were admitted exclusively on the ward, 78 were admitted in the ICU, 91 patients were admitted to a COVID-19 rehabilitation ward. Thromboprophylaxis was administered to 91,2% of the ward population, 96,2% of the ICU population and 88% of the rehabilitation ward population. The incidence of arterial and venous thrombotic complications were 2,5% and 1,8% in the ward population, 3,9% and 21% in the ICU population. In the inpatient rehabilitation cohort, only one patient was found to have a pulmonary embolism. A cohort of 175 patients (140 patients were discharged from the medical ward and 35 from the rehabilitation ward) were assessed at follow up at 60-68,5 days. Overall, only one patient discharged from the hospital ward presented a pulmonary embolism 9 days after discharge. The incidence was 0% in patients discharged from the rehabilitation ward. Globally, this data suggests that even if acutely infected COVID-19 patients have a high incidence of thromboembolic complications, the risk diminishes quickly after the acute phase. This population should not systematically require prolonged thromboprophylaxis until prospective randomized trials are performed in this setting. |
151 | October | Busillo V | N/A | 2020 | Italy | March - April 2020 | To report a case of Guillain-Barrè syndrome in a 75-year- old female associated with SARS-CoV2 infection | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patient with GBS | 1 | The patient presented with fever and positive oropharyngeal swab for SARS-CoV-2. In ICU, after interruption of sedation, she showed tetraparesis (MRC scale 1/5 at upper and lower extremities) with generalized areflexia. | She was treated with lopinavir/ritonavir and hydroxychloroquine; then, she was transferred to ICU, where started mechanical ventilation and received tocilizumab beyond antiviral drugs. After improvement, she underwent extubation. After diagnosis of GBS, the patient started IVIG at the dosage of 400 mg/kg for 5-day course. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The patient showed a marked hyposthenia of upper and lower limbs (MRC: 1/5) with generalized areflexia. Cerebrospinal fluid examination showed normal cell count with increased protein level (130 mg/dL), suggestive of GBS, and she was treated with IVIG. The authors concluded that GBS should be considered by clinicians as possible complication of COVID-19 patient, requiring a rapid starting of IVIG or plasmapheresis. Cerebrospinal fluid examination showed normal cell count with increased protein level (130 mg/dL, normal range: 15-45 mg/dL) as in inflammatory polyneuropathy. The electromyographic test showed a severe decrease in compound muscle action potential amplitude, an increased motor distal latency with reduced conduction velocity and F waves absenceù |
152 | October | Chia KX | 10.1136/bcr-2020-237926 | 2020 | UK | March 2020 | To report the case of a young patient with COVID-19 central nervous system vasculopathy and stroke | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | Reduced Glasgow Coma Scale score, right-sided weakness with hemi- sensory loss and diplopia, paranoia, irritability, aggression, disinhibition, and cognitive impaiment | antipsychotics, rehabilitation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case of a previously fit and well 39-year-old man who presented with fever and respiratory symptoms, evolving in pneumonia with hypoxia but only requiring continuous positive airway pressure. After resolution of the respiratory disease (day 8) the patient developed focal neurology and was found to have bilateral occipital, thalamic and cerebellar infarcts. A diagnosis of COVID-19 central nervous system vasculopathy was made. He developed a florid neuropsychiatric syndrome requiring treatment with antipsychotics and transfer to neurorehabilitation. There was a fast resolution of the neuropsychiatric picture with mild residual cognitive impairment. Early brain imaging in COVID-19-positive patients with neuropsychiatric symptoms is of great importance to detect possible cerebrovascular events even in patients outside the ‘at risk’ group. Neuropsychological/neuropsychiatric evaluation in patients of working age with COVID-19 with suspected central nervous system involvement is highly desirable to facilitate access to cognitive rehabilitation and vocational therapy, and increase the chances of a successful return to employment. |
153 | October | Daher A | 10.1016/j.rmed.2020.106197 | 2020 | Germany | February - May 2020 | To investigate pulmonary impairments, as well as the prevalence of other organ dysfunctions and psychological disorders in patients with COVID-19 six weeks after discharge from hospital. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 33 | N/A | N/A | N/A | Full pulmonary function tests, blood samples, electrocardiography, transthoracic echocardiography,PHQ-9, GAD-7, SGRQ, EQ-5D-5L, 6MWT, Borg scale | N/A | N/A | N/A | N/A | N/A | N/A | Hospitalized COVID-19 patients not requiring mechanical ventilation at six weeks after discharge from hospital did not reveal pulmonary function limitations, echocardiographic impairments or thromboembolic complications. However, fatigue is a common symptom (45%) with significant limitations of mobility, which was also reflected by reduced 6MWT distance. |
154 | October | De Lorenzo R | 10.1371/journal.pone.0239570 | 2020 | Italy | From February 25, 2020, to May 7, 2020 | To investigate whether COVID-19 leaves behind residual dysfunction, and identify patients who might benefit from post-discharge monitoring. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 185 | N/A | N/A | N/A | Primary outcome: need of follow-up, defined at the presence at follow up of at least one among: RR > breaths/min, uncontrolled BP, requiring therapeutic change, moderate to very severe dyspnoea, malnutrition, or new-onset cognitive impairment, according to validated scores. Secondary outcome: PTSD. | N/A | N/A | N/A | N/A | N/A | N/A | The patients included in the study were analyzed after a median follow-up of 23 days (range 20-29) of discharge. Many patients, despite apparent clinical recovery at discharge, had clinically relevant medical problems when evaluated after approximately 3 to 4 weeks. One third of them complained of dyspnoea, and 22.2% had a RR >20 breaths/min. PaO2/FiO2 and BMI at presentation in the emergency department were the strongest independent predictors of the need of follow-up. PTSD was observed in 41 (22.2%) patients. Taken all together, more than half of the patients discharged after COVID-19 infection require follow-up evaluation, and programmes involving follow-up after hospitalization should be implemented. |
155 | October | Dhont S | 10.1007/s13760-020-01514-z | 2020 | Belgium | From April 1, 2020 to April 30‐2020 | To report the clinical course of COVID‐19 in three hospitalized patients with myotonic dystrophy type 1 | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | Myotonic dystrophy type 1 patients developing COVID-19 | 3 | N/A | oxygen therapy, antibiotics, intensive respiratory physiotherapy and non- invasive positive pressure ventilation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study described the clinical course of COVID-19 in three patients with advanced Steinert’s disease receiving non-invasive nocturnal home ventilatory support. Two patients had a limited respiratory capacity, whereas one patient had a rather preserved functional capacity but more comorbidities. Two out of three patients were obese, none of them had diabetes mellitus. Despite maximal supportive care with oxygen therapy, antibiotics, intensive respiratory physiotherapy and non- invasive positive pressure ventilation, all three patients died due to COVID-19. This study confirms that p eople with myotonic dystrophy type 1 are at high risk for severe disease and poor outcome, so the primary advice is to prevent the infection.Once infected, they should be closely monitored. |
156 | October | Ishkanian A | 10.1007/s00455-020-10205-z | 2020 | USA | N/A | To report a case of a 58-year-old woman with COVID‑19 presenting with dysphagia and progressive muscle weakness | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID‑19 with myositis | 1 | She presented with shortness of breath, cough, and fatigue, slurred speech, left upper extremity weakness, nausea/vomiting, and difficulty with ambulation. She showed hoarse and wet vocal quality and over 5 days she developed worsening dysphagia, with poor management of oropharyngeal secretions and with reduced cough strength suspected. Then, she subsequently noted to develop right eye ptosis, facial weakness, and hypernasal dysarthria | At 3 weeks post-admission, a PEG was placed because of a lack of improvement in swallow function; then, the patient underwnt a total spine MRI, bilateral thigh MRI, and a thigh biopsy. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The patient underwent a bilateral thigh biopsy and was ultimately diagnosed with COVID-19-associated myositis. Four weeks after admission, she was transferred to acute rehabilitation unit. The patient underwent dysphagia therapy (starting from incentive spirometry, swallowing exercises, and training of oral care, and then including respiratory muscle strength training, therapeutic per os trials, and exercises targeting hyolaryngeal excursion and pharyngeal muscle strength). The authors concluded that dysphagia is a common symptom of myositis and their co-existence might be a sequela of COVID-19 |
157 | October | Leigh AE | 10.1097/PHM.0000000000001614 | 2020 | USA | From March 1, 2020, to April 20, 2020 | To describe the functional status dependency in a cohort of patients admitted to a medical center for veterans during the surge of COVID-19 cases in the city of New Orleans, Louisiana | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 119 | N/A | N/A | N/A | Functional status at discharge, measured as as measured by independence in ADLs. | N/A | N/A | N/A | N/A | N/A | N/A | The study, conducted in a medical center for veterans in USA, showed a correlation between functional status at discharge, the main outcome, and older age, respiratory failure and thromboembolic complicatrions. On the other hand, pre-existing conditions (e.g. hypertension, obesity, lung disease or diabetes) were not correlated. Overall, patient age and severity of COVID-19 are the most important factor that can cause a loss in independence in ADLs in a post-acute phase of the disease. |
158 | October | Lima MA | 10.1007/s13365-020-00912-6 | 2020 | Brazil | From May to July 2020 | To report 8 cases of peripheral facial nerve palsy associated with COVID-19 | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 8 | Facial palsy | steroids,acyclovir | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | In three patients, facial palsy was the first symptom of COVID-19, while in the remaining five, it appeared from 2 to 10 days after onset of other clinical manifestations. All patients had mild respiratory and systemic COVID-19 symptoms, and none required hospitalization. According to the House-Brackmann grading system, nerve damage resulted in mild (grade 2) dysfunction in five patients and moderate (grade 3) in three. Complete recovery occurred in five patients, while the other three still had some degree of facial weakness at the last follow-up 30 days after onset of neurological symptoms. Peripheral facial palsy should be added to the spectrum of neurological manifestations associated with COVID-19. |
159 | October | Lima MS | 10.1590/2317-1782/20192020222 | 2020 | Brazil | N/A | To describe the functional development of swallowing in ICU patients with COVID-19, who underwent a speech-language treatment for swallowing | Analytical: Cohort study | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Digestive functions (b510) | Acute | COVID-19 | 77 | N/A | speech-language therapy intervention | N/A | American Speech-Language-Hearing Association National Outcome Measurement System | N/A | N/A | N/A | N/A | N/A | N/A | The results indicate that there was a significant recovery in the functional patterns of swallowing in the comparison before and after speech-language therapy intervention. 83% of patients need up to 3 interventions to recover safe swallowing patterns.Oropharyngeal dysphagia in ICU should be investigated and treated |
160 | October | Mcloughlin BC | 10.1007/s41999-020-00353-8 | 2020 | UK | April 2020 | To investigate functional and cognitive outcomes among COVID-19 patients with delirium | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 71 | N/A | N/A | N/A | all-cause mortality, modified Telephone Instrument for Cognitive Status, Barthel Index and Nottingham Extended Activities of Daily Living | N/A | N/A | N/A | N/A | N/A | N/A | In 71 patients, 31 (42%) had delirium, of which only 12 (39%) had been recognised by the clinical team. At 4-week follow-up, delirium was significantly associated with worse functional outcomes, independent of pre-morbid frailty. Cognitive outcomes were not appreciably worse. The presence of delirium is a significant factor in predicting worse functional outcomes in patients with COVID-19. |
161 | October | Meyer C | 10.1016/j.rehab.2020.09.010 | 2020 | Belgium | N/A | To present 4 cases of patients with severe COVID-19 who required mechanical ventilation and exhibited Heterotopic ossification in hips and shoulders | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 4 | Hip and shoulder pain and range of motion limitation | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This case series reported heterotopic ossification in 4 severe COVID-19 patients who required mechanical ventilation. The patients complained pain and decreased range of motion after 30-40 days, so underwent imaging that revealed HO. The etiopathogenesis of HO and the association with COVID-19 is unclear. COVID-19 global inflammation, altered acid base homeostasis and tissue hypoxia during the mechanical ventilatory period may play a role in the pathophysiology. HO should be considered in COVID-19 patients with prolonged immobilization in the presence of a painful joint. Early management aims at limiting its progression and maximizing function of the affected joint. |
162 | October | Nasuelli NA | 10.1007/s10072-020-04820-9 | 2020 | Italy | March - May 2020 | To highlight the relevance of neuromuscular involvement and its different clinical features in ICU patients with SARS-CoV-2 | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 with CINM | 4 | Case 1: Drowsiness, tetraplegia with diffuse hypotonia, and hypotrophy, mainly at shoulder girdle and to the peroneal district, with neurophysiological findings at EMG compatible with CINM. Case 2,3,4 presented with hypotrophy of the peroneal district and/or of the shoulder girdle, with neurophysiological findings at EMG compatible with CINM | Case 1: physiotherapy and cough machine therapy 4 times/day; Cases 2,3,4: invasive ventilation, pronation cycles due to respiratory distress, and physical therapy (intensive for Case 3) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Case 1 had diagnosis of CINM and started physiotherapy but her respiratory function worsened, requiring to switch back to controlled ventilation, and a progressive deterioration of the clinical conditions occurred (related to new superinfection), until death. Case 3: The only patient with a positive outcome (probably due to a younger age), even if characterized by slow recovery of motor skills (foot flexion) after intensive physical therapy. |
163 | October | Pilotto A | 10.1136/jnnp-2020-323929 | 2020 | Italy | February - April 2020 | To investigate the impact of COVID-19 by recording clinical presentations, laboratory characteristics and management/outcomes of a series of neurological patients who consecutively presented at the ED during the peak of the pandemic | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | COVID-19 patients with neurological diseases | 147 | The 29.1% of neurological patients assessed at the ED were positive for SARS-CoV-2; they presented with an increased frequency of cerebrovascular events and encephalitis | N/A | Non-COVID-19 patients with neurological diseases | Demographic, clinical, laboratory characteristics, hospitalisation rate, mRS, in-hospital mortality | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19-positive patients had higher prevalence of ischaemic stroke (n=51, 34.7% vs n=105, 29.3%), delirium (n=24, 16.3% vs n=18, 5.0%) and meningitis/encephalitis (n=14, 9.5% vs n=7, 1.9%). Furthermore, COVID-19-positive patients showed a higher rate of hospitalisation following ED triage (91.2% vs 69.3%, p<0.0001) and in-hospital mortality (29.7% vs 3.1%, p<0.0001). Lastly, COVID-19-positive patients had higher levels of disability at discharge compared with non-COVID-19 patients (mRS: 2.6 ±1.6 vs 1.6±1.4, p<0.0001) |
164 | October | Pirau L | 10.3389/fneur.2020.00964 | 2020 | USA | N/A | To describe the clinical course, radiological findings and outcome of two COVID-19 patients, initially intubated for ARDS while neurologically intact, who demonstrated prolonged unresponsiveness following discontinuation of sedation, with evidence of borderzone ischemia on cerebral MRI | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 patients with prolonged unresponsiveness off sedation | 2 | A 59-year-old man and a 53-year-old man developed worsening COVID-19 associated ARDS. Both required benzodiazepine, opioid, neuromuscular blockade, therapeutic anticoagulation and vasopressor infusions in addition to renal replacement therapy. Both demonstrated only trace flexion to pain 7-10 days following discontinuation of all sedation. | N/A | N/A | Laboratory, CT and electroencephalography findings | N/A | N/A | N/A | N/A | N/A | N/A | At 90 days after he initial presentation, the 59-year-old man was oriented, with fluent speech and able to ambulate with assistance, while the 53-year-old man was at home and independent to basic ADL. The authors concluded that critically-ill COVID-19 patients with prolonged coma following sedation discontinuation might demonstrate imaging features of ischemic injury in borderzone regions despite the absence of documented sustained hypotension or hypoxia, despite a substantial neurological recovery seems possible |
165 | October | Rajdev K | 10.1177/2324709620961198 | 2020 | USA | N/A | To highlight a rare case of GBS in a young patient with COVID-19 | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 patient with GBS | 1 | Two days after discharge at home without symptoms, the post-COVID patient began to develop numbness, tingling over his fingers, toes, and perioral region, which then progressed to weakness in legs. Two days later, he presented to the ED and was admitted for progressive and ascending weakness in his legs along with difficulty walking. He showed a decreased muscle strength in upper limbs (MRC=4) and lower limbs (MRC=3), where he presented also with hyporeflexia | IVIG therapy for five days at a dose of 0.4 mg/kg/day. Then, he received 5 plasma exchange treatments and was successfully weaned from mechanical ventilation | N/A | Motor nerve conduction study findings at EMG | N/A | N/A | N/A | N/A | N/A | N/A | The patient was diganosed with GBS and was treated by IVIG and 5 plasma exchanges. He required mechanical ventilation for a total of 13 days and then he was successfully extubated on day 19 of his LOS, when he was able to pass the spontaneous breathing trial. Following extubation, his motor strength continued to improve, and he was noted to recover muscle strength in proximal (MRC=4) and distal muscle groups (MRC=5), bilaterally before discharge. Thus, he was discharged to a rehabilitation facility for physical therapy in a stable condition without any supplemental oxygen after a hospital stay of 23 days. The authors concluded that GBS is a neurological emergency and physicians should pay close attention to neurologic complications including GBS in COVID-19 patients |
166 | October | Requena M | 10.1016/j.jstrokecerebrovasdis.2020.105225 | 2020 | Spain | March - April 2020 | To uncover the rate of acute stroke in COVID-19 patients admitted in a high-volume center and identify those cases in which a possible causative relationship could exist | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 patients with stroke | 17 | Seventeen out 25 stroke patients reported COVID-19 symptoms before stroke onset, lasting 12 days. A severe COVID-19 infection was diagnosed in 14 patients, 8 of them were admitted to the ICU. | N/A | Non-COVID-19 patients with stroke | Vascular risk factors, presence of COVID-19 prestroke symptoms, days of evolution, ICU admission, presence of severe infection | N/A | N/A | N/A | N/A | N/A | N/A | Seventeen (68.0%) patients presented COVID-19 symptoms before stroke onset with a mean duration of 12 days; 6 patients without symptoms were diagnosed at admission by screening test, the 2 others presented symptoms in the first 48 hours after hospital admission. Severe COVID-19 infection was diagnosed in 14 (56.0%) patients, 8 of them were admitted to the ICU. The study showed that the frequency of acute stroke in patients with COVID-19 requiring hospital admission is low (1%) and in most cases a usual cause of stroke was identified. |
167 | October | Steere HK | 10.1002/pmrj.12506 | 2020 | USA | May 2020 | To report the main characteristics of a cohort of US-based rehabilitation ambulatory referrals and interventions for previously hospitalized COVID- 19 patients. | Descriptive: Historical cohort | General outpatient rehabilitation | Meso Level | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 102 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Several key findings emerged: (1) teams were able to rapidly develop physiatry-run outpatient COVID-19 recovery clinics via telehealth to safely address rehabilitation-related needs of patients who had become severely ill from COVID-19, (2) institutions differed in mechanisms for patient flow and referrals to the recovery clinic, and (3) patient demographics differed among institutions. |
168 | October | Wootton SL | 10.1002/rcr2.669 | 2020 | Australia | N/A | To present COVID-19 telehealth rehabilitation programme, delivered within a pulmonary rehabilitation setting, and discuss the management of three cases | Descriptive: Case Series | Rehabilitation services at home | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 3 | N/A | The telehealth rehabilitation programme consisted of (1) a comprehensive initial rehabilitation assessment within the PR context; an initial six-week rehabilitation programme, with weekly contact by a physiotherapist with multidisciplinary team input as required; and (3) a reassessment | N/A | Outcome measures at hospital discharge, commencement and after six weeks of rehabilitation: FSS, mMRC dyspnoea scale, 5STS, 1minSTS, heart rate and oxygen saturation | N/A | N/A | N/A | N/A | N/A | N/A | This is a single-centre report of three cases undergoing rehabilitation via telehealth provided by experienced pulmonary rehabilitation clinicians. The patients ( males with a median age of 73 years) at hospital discharge ( length of stay 9-15 days) presented with persistent limitations and/or symptoms (e.g. breathlessness, fatigue, and reduced exercise capacity). Patients underwent an individualized rehabilitation programme and demonstrated improvements in exercise capacity and breathlessness; however, fatigue levels worsened in two cases and this was attributed to the difficulties of managing returning to work and/or carer responsibilities whilst trying to recover from a severe illness. The data suggested that the programme provided was feasible and acceptable to patients. |
169 | November | Akhtar N | 10.1016/j.jstrokecerebrovasdis.2020.105435 | 2020 | Qatar | March - May 2020 | To compare the types of ischemic strokes in patients with or without confirmed COVID-19 infection to a busy tertiary care hospital during the pandemic | Descriptive: Case Series | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 with stroke | 32 | N/A | N/A | 216 COVID-19 negative patients with ischemic stroke (Mar - May 2020) | Demographics and risk factors; Stroke Classification (TOAST and Banford); Prognosis At Discharge | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19 patients with ischemic stroke were younger (48.9 vs 54.9 years) and presented with significantly lower rates of hypertension, diabetes and dyslipidemia. Moreover, COVID-19 patients had more cortical strokes (34.4% vs 5.6%; p = 0.001), severediseases (NIHSS>10: 34.4% vs 16.7%; p=0.001) prolonged hospitalization and lower probability of good recovery (mRS 0-2: 28.1% vs 51.9%; p = 0.001). |
170 | November | Ballesteros Reviriego G | 10.1097/TGR.0000000000000283 | 2020 | Spain | N/A | To demonstrate the improvements in the respiratory mechanics during the weaning trial of subjects with pneumonia secondary to COVID-19 infection who underwent respiratory physiotherapy. | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 1 | Acute respiratory failure | Six sessions of lung physiotherapy, three in a pre-extubation phase and three in a post-extubation phase. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The paper describe the case of a 38-years-old asthmatic woman that presented an acute respiratory failure and needed intubation. The patient was hemodynamically stable, so early rehabilitation was performed. The patient underwent six sessions of lung physiotherapy, three in a pre-extubation phase and three in a post-extubation phase. After 12 days from admission the patient, already extubated, was discharged to a ward with low-flow oxygen support, and after 19 days from admission the patient was discharged home. |
171 | November | Bowles KH | 10.7326/M20-5206 | 2020 | USA | From April to June, 2020 | To describe characteristics of patients with COVID-19 upon admission to HHC, the home visits received, the extent of recovery among COVID-19 survivors discharged from HHC and to profile the risk factors associated with rehospitalization or death. | Descriptive: Historical cohort | Rehabilitation services at home | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 1409 | N/A | Home health care | N/A | Rate of discharge, ADL dependency, Risk of rehospitalization or death,. | N/A | N/A | N/A | N/A | N/A | N/A | The study analyzed 1409 patients discharged from hospital that underwent home health care. After 32 days most patients were discharged (94%) and achieved an improvement in symptoms and functions. Patients at discharge were much more independent in ADL. Risk of rehospitalization were higher for male patients (HR, 1.45 [CI, 1.04 to 2.03]); and patients presenting comorbidity such as heart failure (HR, 2.12 [CI, 1.41 to 3.19]) or diabetes with complications (HR, 1.71 [CI, 1.17 to 2.52]). 1% of patients died, 10% were rehospitalized and 2% remained on service. |
172 | November | Brika M | 10.1007/s42399-020-00613-5 | 2020 | France | March 3, 2020, to june 8, 2020 | To underline the global approach that is necessary in a geriatric rehabilitation context associated with the COVID-19 infection | Descriptive: Case Report | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 1 | N/A | Physical therapy (one session of 30 min per day) and nutritional monitoring | N/A | Frail’BESTest | N/A | N/A | N/A | N/A | N/A | N/A | This is the case of a 93-year-old frail patient, hospitalized after a COVID-19 infection. After one month he was transferred to the rehabilitation unit for respiratory dysfunction, subsequent effort incapacity, and postural-motor deficiencies.The assessment process of this patient has been supported by an innovative multisystemic tool developed in view of the COVID-19 clinical consequences and a systemic evaluation of motor functions by the Frail’BESTest. This process allowed a mixed clinical picture associated with significant respiratory distress and an evident motor frailty. The care plan was developed accordingly, and the patient returned home just over a month with a high level of independency. This case report illustrates the importance of a global approach and of rehabilitation in the COVID-19 context. |
173 | November | Brugliera L | 10.1016/j.apmr.2020.10.131 | 2020 | Italy | N/A | To present prone positioning-related complications from 7 critically ill COVID-19 patients intubated and mechanically ventilated in a prone position for a prolonged time at the ICU | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 7 | All COVID-19 patients showed nerve injuries after being intubated and mechanically ventilated in a prone position for a prolonged time at the ICU | N/A | N/A | Nerve injuries assessed by EMG and ENG | N/A | N/A | N/A | N/A | N/A | N/A | This case series suggested that compressive neuropathies could be considered as frequent complications of ventilation with prone position in COVID-19 patients. Risk factors as a poor BMI should be taken into account before undergoing shorter prone positioning cycles aimed to prevent nerve damage |
174 | November | Castillo-Pinto C | 10.1177/1941874420966845 | 2020 | USA | N/A | To report the case of a healthcare worker who presented with a large vessel acute ischemic stroke in setting of a mild COVID-19 infection | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | Right-sided hemiparesis, aphasia and dysarthria | thrombectomy | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case of a A 43-year-old female with minimal vascular risk factors who presented with acute ischemic stroke due to a Large Vessel Occlusion that was incidentally found to have COVID-19 on screening prior to transfer to a comprehensive stroke center for thrombectomy. At discharge, she had mild right facial droop, mild hemiparesis (4þ/5) with NIHSS 1. She was discharged home after a 6-day hospitalization with subcutaneous enoxaparin and atorvastatin for secondary stroke prevention. This case highlights suspected mechanisms of hypercoagulability in SARS-CoV-2 infection and the importance of optimizing stroke care systems during the COVID-19 pandemic. |
175 | November | Daia C | 10.1016/j.ijid.2020.11.146 | 2020 | Romania | July - September 2020 | To characterize the action of COVID 19 on muscular fibers through electrophysiology studies in post-COVID-19 patients with myalgia | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Late-onset | Post-COVID-19 | 3 | Case 1: generalized myalgia (pronounced in the calves), fatigue and dizziness; Case 2: bilateral calf myalgia and fatigue; Case 3: bilateral calf myalgia, fatigue, and exhaustion under stress. | N/A | N/A | Nerve injuries assessed by EMG and ENG | N/A | N/A | N/A | N/A | N/A | N/A | Three patients showing fatigue and myalgia of both calves , in teh recovery phase after COVID-19 infection, were submitted to nerve conduction studies (NCS) and electromyography (EMG). NCS showed signs of demyelinating polyneuropathy due to SARS-COV-2, whereas EMG supported the hypothesis of myopathy, indicating a direct action of COVID 19 on muscular fibers, especially in the lower limbs. COVID-19 related polyneuropathy and myopathy should be taken into consideration in the COVID-19 management. |
176 | November | Dawson C | 10.1017/S0022215120002443 | 2020 | UK | From 21/3/2020 until 21/5/ 2020 | To describe the dysphagia and functional swallow outcomes during recovery from COVID-19 in a large cohort of patients | Descriptive: Historical cohort | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Digestive functions (b510) | Acute | COVID-19 | 208 | N/A | Therapy and compensation strategies included: exercise prescription, postural adaptations, practice swallows, augmentation of texture or complexity of diet and or fluid if required, portion volume control, adaptations to environmental factors, and reducing distractions | N/A | length of stay on the ICU, timing of speech and language therapy assessment, timing of oral intake commencement, and swallow competence at various timepoints | N/A | N/A | N/A | N/A | N/A | N/A | The prevalence of dysphagia was high: 208 out of 736 patients (28.9 percent) admitted to the institution with SARS-CoV-2. Of the 208 patients, 102 were admitted to the intensive treatment unit for mechanical ventilation support, of which 82 were tracheostomised. -All patients were assessed by the SLT team within 24 hours of a referral as part of 7-day service. - Dysphagia was multi-factorial, and co-existed with delirium, fatigue and difficulty achieving effective breathe/swallow coordination -On average, the SLT team provided clinical interventions to patients for 8.6 days. This increased to 11.3 days for those who underwent endotracheal tube intubation alone, and was highest for those who had a tracheostomy (12.9 days). -Mean (SD) time to starting oral intake from extubation for the endotracheal tube only group was 5.3 (2.3) days. For patients with a tracheostomy, mean (SD) time to starting oral intake from the date of tracheostomy insertion was 14.8 (6.6) days. -The majority of patients regained near normal swallow function prior to discharge, regardless of intubation duration or tracheostomy status. -Dysphagia is prevalent in patients admitted either to the intensive treatment unit or the ward with COVID-19 related respiratory issues. A whole systems approach from an integrated multi-disciplinary team is required to manage COVID-19 patients. With intensive therapy, most patients can regain normal swallow function following COVID-19. |
177 | November | de Lorenzo Alvarez A | 10.1007/s13730-020-00553-y | 2020 | Spain | N/A | To describe the case of an 80-year-old male undergoing peritoneal dialysis with a moderate COVID-19 infection who developed a purpuric dermatitis and ischemic stroke after successful recovery from his bilateral pneumonia. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Late-onset | COVID-19 | 1 | Erythemato-papular lesions affecting trunk and lower limbs, right lower limb paresis and unsteadiness of gait. | corticoesteroids , heparin | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors described the case of an 80-year-old male undergoing peritoneal dialysis with a moderate COVID-19 infection who developed a purpuric dermatitis (17 days after the COVID-19 symptoms onset) and ischemic stroke (30 days after the onset of COVID-19 symptoms) after successful recovery from his bilateral pneumonia. The purpuric dermatitis was treated with corticoesteroids achieving complete resolution. Arterial thrombosis occurred 5 days after withdrawal of antithrombotic prophylaxis that the patient received from his admission until 2 weeks after discharge. He completely recovered from his paresis and continued on his regular antiaggregation therapy. The authors highlight the importance of define an appropriate length of antithrombotic prophylaxis after successful recovery from COVID-19 pneumonia in individuals with preexisting cardiovascular conditions, especially in dialysis patients. |
178 | November | Forni R | 10.4414/smw.2020.20397 | 2020 | Switzerland | From March to May, 2020 | To present the protocols developed to support the process of weaning patients from tracheotomy and the reprisal of feeding by mouth, in a tracheotomy ward, within a COVID hospital served by a interdisciplinary rehabilitation team | Descriptive: Historical cohort | N,A. | Meso Level | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 53 | N/A | N/A | N/A | Percentage of complication of tracheostomy, percentage of successful weaning from tracheostomy, length of stay in hospital | N/A | N/A | N/A | N/A | N/A | N/A | The article presents the protocols adopted by an interdisciplinary rehabilitation team for weaning COVID-19 patients from tracheotomy and recovering oral feeding and reports the outcome in 53 cases admitted to a tracheotomy ward. The authors conclude that concentrating the COVID-19 patients in one hospital and the creation of a tracheotomy ward were successful strategies, simplifying the allocation of available resources. Undertaking percutaneous tracheotomy on patients subsequently transferred to adapted subacute wards helped to free up beds in the ICU. Patients with percutaneous tracheotomy can be ventilated efficiently by means of instruments normally used for home ventilation, simpler than the conventional ventilators in use in the ICU and successfully handled by nursing staff. The positive outcome of this experience was guaranteed by excellent interprofessional cooperation. |
179 | November | Gale A | 10.1136/bcr-2020-239241 | 2020 | UK | From April 9, 2020 to June 2020 | To report aGBS before developing clinical and radiological findings of COVID-19. | Descriptive: Case Report | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 1 | Progressive ascending weakness affecting all four limbs and impaired mobility | invasive ventilation , tandard supportive intensive care management,tinzaparin,dexamethasone | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case of a 58-year-old man with features of GBS before developing clinical and radiological findings of COVID-19. He suffered from a severe form of GBS and the nasopharyngeal swab for Coronavirus was initially negative. He underwent invasive ventilation and weaned from the ventilator after about 20 days. By the 27th day of admission, he was stepped down from critical care to the respiratory ward for ongoing physiotherapy and speech and language therapy. After about 36 days he was discharged to a community rehabilitation unit to continue his recovery for 15-20 days, then he returned to his own home. Raising awareness of a possible association between GBS and COVID-19 t is important so both are considered allowing appropriate investigations to be arranged to optimise the chance of neurological recovery and survival, while also protecting staff from potentially unrecognised COVID-19. Consider doing multiple samples when radiological investigations show typical features of COVID-19. |
180 | November | Kacem I | 10.1007/s10072-020-04866-9 | 2020 | Tunisia | March-May 2020 | To describe the neurological symptoms associated with COVID-19, their main characteristics, and their evolution in the Tunisian population | Descriptive: Historical cohort | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 646 | The 72.1% showed neurological symptoms | N/A | N/A | Prevalence of neurological symptoms (headaceh, smell impairment, taste impairment, myalgia, sleep disturbance, visual loss, focal weakness, disorientation, behaviour disorders) | N/A | N/A | N/A | N/A | N/A | N/A | Out of 646, 466 patients (72.1%) had neurological symptoms. Headache was the most frequent one (n = 279, 41.1%). Smell and taste impairment were found in 37.9% (n = 245) and 36.8% (n = 238) respectively. Myalgia (n = 241, 37.3%) and sleep disturbances (n = 241, 37.3%) were also frequent. In 14.5%, neurological symptoms preceded the respiratory signs that resulted to be associated with more frequent (p=0.006) and numerous (p<0.001) neurological symptoms. |
181 | November | Kataria S | 10.1016/j.ensci.2020.100287 | 2020 | USA | N/A | To present three MS patients affected by COVID-19 an to review the existing data on this topic | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | COVID-19 with MS | 3 | Case 1: A 65-year old man with RRMS, presenting with fever, pulse oximetry 85%, fatigue, generalized weakness and shortness of breath, concerning for worsening MS symptoms. Case 2: A 52-year old man with RRMS, presenting with constant nagging cough, generalized weakness, fever, and increasing shortness of breath, as a pseudoexacerbation of MS. Case 3: A 69-year female with RRMS, presenting with fever and cough | Case 1: hydroxychloroquine and azithromycin for 5 days, and glatiramer acetate as DMT. Case 2: CPAP and hydroxychloroquine and anti-viral ritonavir for a week, and dimethyl fumarate as DMT. Case 3: non-steroidal anti-inflammatory agents, advising to quarantine, and ocrelizumab as DMT. | N/A | EDSS | N/A | N/A | N/A | N/A | N/A | N/A | Case 1: Symptoms improved after 4 days of treatment and no additional oxygen supplementation was required; the clinical course of COVID-19 lasted approximately 2.5 weeks. His EDSS was 2.0 at the admission and at the discharge. Case 2: Symptoms resolved within a week of treatment. His EDSS was 4.0 at the admission and 3.0 at the discharge. Case 3: The patient was advised to quarantine herself and recommended to follow up in the neurology clinic. |
182 | November | Levin SR | 10.1016/j.apmr.2020.10.104 | 2020 | USA | by June 3, 2020 | To present the challenges and opportunities involved in adapting to a pandemic surge as well as some of the operational considerations in moving patients throughout the continuum of acute and postacute care. | Descriptive: Historical cohort | General postacute rehabilitation | Meso Level | Health services, systems and policies (e580) | Post-acute | COVID-19 | 300 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The challenge faced required the adaptation and modification of options within the health system’s continuum of care, both regarding clinical assessment (electronic consultation service was created) and discharge pathways: to home care, to inpatient rehabilitation facilities, or to a skilled nursing setting. For transitions of care, they created a new set of screening criteria for postacute care with social work and the acute medical teams, which included both review of laboratory and respiratory care needs but also rapid social clearance. In the final tally, Montefiore Medical Center admitted 5691 patients with COVID-19 by June 3, 2020. Out of them, 1291 (22.7%) died and 4400 (77.3%) were discharged as follows: approximately 300 (6.8%) to inpatient rehabilitation facilities, 450 (10.2%) to home care, 220 (5.0%) to skilled nursing facility, while 3400 (77.3%) were discharged home without services. The intrahospital transfers were less than 45.The framework for the pathways success is because of the expertise and relationships Rehabilitation Medicine has within the hospital system and with postacute care providers. |
183 | November | Li L | 10.1093/ptj/pzaa198 | 2020 | China | From January 31 to March 8, 2020 | To report on a physical therapy service, commissioned to manage COVID-19 during patients‘ stay in the ICU | Analytical: Cohort study | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 16 | Severe and critical COVID-19 | Neuromuscolar and respiratory rehabilitation | N/A | PaO2/FiO2, PEFR, MIP, MBDS, Medical Research Council Sum Score for muscle strength, Physical Function in Intensive Care Test, De Morton Mobility Index, MBI | N/A | N/A | N/A | N/A | N/A | N/A | Most of the patients admitted to the ICU and treated with neuromuscolar and respiratory rehabilitation achieved outcomes in the range of normality at the time of discharge. However, 61% of the discharge patients had PEFR below 80%, 31% had MIP below 80% and 46% of the patients had De Morton Mobility Index values below the normative value. These findings point out that many ICU patients need rehabilitation even after discharge. |
184 | November | Lowery MM | 10.2478/jccm-2020-0038 | 2020 | USA | N/A | To present a case of an atypical variant of GBS in COVID-19 patient | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 with GBS | 1 | A 45-year-old man complaining gait ataxia and weakness self-referred to the Hospital and presented with left facial and bilateral lower extremity numbness and dysgeusia. A nasopharyngeal swab was positive for COVID-19 PCR. His neurological symptoms worsened progressing to dysphagia and quadriparesis. | IVIG, mechanical ventilation, and tracheostomy (on Day 26 ost-admission) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The patient had a spine MRI consistent with GBS, but clinical symptoms and positivity of anti-GQ1B antibodies were consistent with Miller Fisher Syndrome and GBS overlap. After a 5-week hospitalization, the patient was transferred to a long-term acute care hospital for ventilator weaning and physical therapy. At five and half months after diagnosis the patient was able to control his head, right thumb, left foot, right toe, and had extraocular and tongue movements. Thus, this case highlighted the severity of neurological symptoms and the prolonged course of COVID-19 patients with overlapping Miller Fisher Syndrome and GBS |
185 | November | Lyadov KV | 10.18093/0869-0189-2020-30-5-569-576 | 2020 | Russia | March - April, 2020 | To create the protocol for the first stage rehabilita tion of patients with the COVID-19 infection under the conditions of respiratory failure based on literature data and clinical experience, to select the treatment group from among patients who meet the inclusion and exclusion criteria and received an appropriate early rehabilitation according to the protocol, to form the comparison group using the pseudo-randomization method from the number of patients who meet the inclusion and exclusion criteria, but have not received an appropriate early rehabilitation according to the protocol, to compare clinical results in the two groups. | Non randomised controlled trial | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 146 (73 treatment group + 73 control group) | N/A | Respiratory rehabilitation | Retrospective control group | Required time of continuous oxygen support, Frequency of transferring patients to artificial lung ventilation, Dynamics of the oxygenation index measurement, Evaluation of subjective general state according to SF-36, Break-in exercise therapy for 2 or more days, Patient survival rate at 10 days from starting exercise therapy. | N/A | N/A | N/A | N/A | N/A | N/A | The study propose a respiratory rehabilitation program for acute patients in ICU setting undergoing continuous oxygen support. Control group was selected retrospectively with a pseudo-randomization method. The primary outcome considered was the required time of continuous oxygen support and resulted significantly lower in treatment group vs control group (5.1 ± 3.3 vs 8.0 ± 4.6 days). This result suggest that a respiratory rehabilitation protocol is feasible and likely efficacious in the acute setting. |
186 | November | Mandal S | 10.1136/thoraxjnl-2020-215818 | 2020 | UK | N/A | To follow-up COVID-19 patients fout to six weeks after discharge | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Chronic | COVID-19 | 384 | N/A | N/A | N/A | Phone or in-person interview. Severity of symptoms was graded by a 11-point scale | N/A | N/A | N/A | N/A | N/A | N/A | In 384 patients (mean age 59.9 years; 62% male) followed a median 54 days post-discharge, 53% reported persistent breathlessness, 34% cough, and 69% fatigue. 14.6% had depression. In those discharged with elevated biomarkers, 30.1% and 9.5% had persistently elevated d-dimer and C reactive protein, respectively. 38% of chest radiographs remained abnormal with 9% deteriorating. Systematic follow-up after hospitalization with COVID-19 identifies the trajectory of physical and psychological symptom burden, recovery of blood biomarkers, and imaging which could be used to inform the need for rehabilitation and/or further investigation. |
187 | November | Meshcheryakova NN | 10.18093/0869-0189-2020-30-5-715-722 | 2020 | Russia | From February 28 to June 4, 2020 | To present the data of two clinical cases of patients with different types of pulmonary rehabilitation. | Descriptive: Case Series | Specialized outpatient rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 2 | Fever, dry cough, shortness of breath, weakeness | Respiratory rehabilitation | N/A | CT scan, clinical blood tests, spirometry. | N/A | N/A | N/A | N/A | N/A | N/A | The study present two clinical cases of patients with COVID-19 that underwent outpatient respiratory rehabilitation. Both patients suffered from COVID-19 related pneumonia. After the acute phase they underwent 10 sessions of high-frequency oscillation of the chest, and inspiratory muscle training, with subjective benefit, and reduction of the symptoms, especially coughing. However, in the first patient that underwent a control spirometry after the treatment, there was no improvement in bronchial patency. |
188 | November | Moradian ST | 10.18502/ijph.v49i11.4729 | 2020 | Iran | February - April 2020 | To assess the frequency of delayed symptoms at 6 weeks after discharge in post-COVID-19 patients | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Late-onset | Post-COVID-19 | 200 | At the admission the study population showed: dyspnoea in the 59.5% of cases, weakness in the 55.5%, myalgia in the 53.5%, and shivering in the 1.5% | N/A | N/A | Clinical symptoms | N/A | N/A | N/A | N/A | N/A | N/A | At 6 weeks after the discharge, 94 patients (42%) were asymptomatic. On the other hand, fatigue was the most frequent delayed symptom (19.5%) and then dyspnea (18.5%), weakness (18%), and activity intolerance (14.5%). The authors concluded that follow-up evaluation are needed in COVID-19 patients and rehabilitation might be helpful even in a late phase. |
189 | November | Murat S | 10.1007/s11845-020-02433-x | 2020 | Turkey | March - June 2020 | To evaluate the frequency, localization, and severity of pain among the presenting signs and symptoms in COVID-19 patients | Descriptive: Historical cohort | N/A | Epidemiology - Clinical presentation | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 193 | Main complaints of the COVID-19 patients were: fatigue (76.6%), pain (69.3%), fever (62%), cough (45.3%), and loss of taste and/or smell (43.5%) | N/A | N/A | General symptoms at the first admission to the hospital; presence of pain at admission; localization, severity, and persistence of pain | N/A | N/A | N/A | N/A | N/A | N/A | Pain was the chief complaint in of 46.61% of the patients and started on 2.2±2.8 days before admission. Among 133 patients reporting pain, the most common pain symptoms were myalgia/arthralgia (69.2%) and headache (50.4%). Therefore, pain is one of the most common complaints of admission to the hospital in COVID-19 patients ans dhoeld be adequately assessed |
190 | November | Paneroni M | 10.1097/PHM.0000000000001641 | 2020 | Italy | April 2020 | To describe muscle strength and performance at discharge from a post-acute COVID-19 Department in COVID-19 patients without pre-existing locomotor disabilites | Analytical: Cross-sectional study | Specialized postacute rehabilitation | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 41 | N/A | N/A | N/A | MVC, 1min-STS, SPPB, Modified Borg Scale | N/A | N/A | N/A | N/A | N/A | N/A | At discharge from post-acute COVID-19 Department, patients presented with a mean MVC of 18.9 Kg for quadriceps and of 15.0 Kg for biceps, mean number of chair rises in the 1min-STS was 22.1, while the mean SPPB score was 7.9. Therefore, the authors concluded that the high prevalence of impairment in muscle strength and performance in hospitalized patients recovering from COVID-19 suggested the need for rehabilitation even after their discharge. |
191 | November | Petersen MS | 10.1093/cid/ciaa1792 | 2020 | Denmark | From April to August 2020 | To describe symptoms in the acute phase and especially long COVID in mainly non-hospitalized patients from the Faroe Islands. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Chronic | COVID-19 | 180 | N/A | N/A | N/A | Phone interview, The fatigue impact scale . The number of interviews was dependent on how long symptoms persisted, and the time from onset of symptoms to first interview. | N/A | N/A | N/A | N/A | N/A | N/A | Of the 180 participants (96.3% of the 187 eligible COVID-19 patients), only eight individuals were hospitalized. During the acute phase of COVID-19, 4.4% (n=8) were asymptomatic and 7.2% (n=13) reported one or two symptoms while more than 30% had nine or more symptoms. 53.1% reported persistence of at least one symptom after a mean of 125 days after symptoms onset, 33.3% reported one or two symptoms, and 19.4% three or more symptoms. The most prevalent symptoms during the acute phase were fatigue, fever, headache, chills, and loss of smell and taste, while the most persistent symptoms were fatigue, loss of smell and taste, and arthralgias. The results show it might take months for symptoms to resolve, even among non-hospitalized persons with milder illness course in the acute phase. |
192 | November | Picchi G | 10.12659/AJCR.926921 | 2020 | Italy | March and April, 2020 | To describe three cases of pulmonary fibrosis developed after SARS-CoV-2 infection in patients who had not received high-flow oxygen support. | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Late-onset | COVID-19 | 3 | All three patients: cough, fever, shortness of breath. | Corticosteroids and Oxygen support. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The three patients described in the case series were all female with no history of respiratory diseases and that did not smoke in the past. They had mild respiratory symptoms, that not needed high-flow oxygen support. Nevertheless, in all three cases, a follow-up CT around one month after symptom onset showed lung fibrosis. The findings suggest that a clinical and radiographic follow-up to assess the possibility of late onset of pulmunary fibrosis might be needed in all patients that developed pneumonia, and not only in severe cases. |
193 | November | Prasad A | 10.1016/j.clinimag.2020.09.010 | 2020 | USA | N/A | To present a case of multifocal ischemic stroke in a patient with COVID-19. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 1 | encephalopathy and dysarthria | aspirin and high-intensity atorvastatin | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This is the case of a 51-year-old man with COVID-19 who had persistent encephalopathy and dysarthria after recovering from hypoxic respiratory failure and subsequently he developed ischemic stroke in multiple vascular territories during hospital admission (at day 23 of admission by MRI, the CT did not show abnormalities). The patient was started on aspirin and high-intensity atorvastatin. The patient was then discharged to the acute rehabilitation unit with a cardiac event monitor for 30 days. When suspecting stroke timely performing MRI brain imaging could be very essential in all critically ill COVID-19 patients. Though there is lagging data on the use of anticoagulants to prevent stroke in COVID-19 patients, therapeutic anticoagulation should be kept under consideration especially in patients with a high risk for hypercoagulopathy. |
194 | November | Sangare A | 10.3390/brainsci10110845. | 2020 | France | N/A | To describe a case of a patient suffering from COVID-19 related encephalitis, who recovered after immunotherapy. | Descriptive: Case Report | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Acute | COVID-19 | 1 | Fever, cough, dyspnea, acute respiratory distress syndrome, encephalitis. | Mechanical ventilation, corticosteroids, Therapeutic Plasma Exchange with Albumin, neuromotor rehabilitation. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The case study describe a patient who suffered from severe COVID-19 causing an acute respiratory distress symptoms that required mechanical ventilation. The patient became unresponsive, even after weaning from sedation, and did not recover until day 65. At day 65 as a last resort a course of corticosteroids infusion and therapeutic plasma exchange with albumin was administred. The patient quickly recovered from day 68 and at day 88 it was possible to extubate him. At day 116 he was transferred to a rehabilitation facility where he was treated with neuromotor rehabilitation for a critical illness polyneuropathy. After 5.5 months he was discharged home with only mild cognitive and motor symptoms. | 195 | November | Senthil P | 10.36295/ASRO.2020.231510 | 2020 | India | N/A | To report the case of a 72-year-old male with COVID-19 infection and respiratory difficulties who underwent structured exercises protocol and tele-counseling | Descriptive: Case Report | General outpatient rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 1 | N/A | Chest percussion techniques, deep breathing and thorax mobility exercises, incentive spirometry exercise, performed daily twice a week, 30 min each session, for 3 weeks. Tele-counselling was given by the experts through the telephone conversation thrice a week for 15 minutes session to improve his mental health. | N/A | Oxygen saturation level (digital pulse oximeter)and rate of perceived exertion rate (Modified Borg’s Scale) | N/A | N/A | N/A | N/A | N/A | N/A | The present case is that of a 72-year-old male, with respiratory difficulties due to COVID-19, who underwent structured exercises and tele-counseling for 3 weeks. The Pre and Post–test of the patient demonstrated significantly greater improvements in oxygen saturation level and rate of perceived exertion also. This case study provides a promising exercise intervention and tele-counseling that may improve chest compliance and improved activities in older men with COVID 19 respiratory issues. | 196 | November | Townsend L | 10.1371/journal.pone.0240784. | 2020 | Ireland | N/A | To establish whether patients recovering from SARS-CoV-2 infection remained fatigued after their physical recovery, and to investigate whether there was a relationship between severe fatigue and a variety of clinicopathological parameters. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 128 | N/A | N/A | N/A | Demographic and clinical information, routine laboratory parameters, CFQ-11 | N/A | N/A | N/A | N/A | N/A | N/A | The 55.5% of COVID 19 patients required hospitalization, while the others were managed at home as outpatients. At a median follow up of 10 weeks after discharge (hospitalized patients), or after the last day of acute COVID 19 symptoms (outpatients), most patients included in the study complained of fatigue, with half of the patients reporting severe fatigue. The 51.6% of the patients were healthcare workers, of which 31% were still not back at work at followup. Fatigue did not seem to be related to initial disease severity. From the data collected, fatigue seems to play an important role in post-acute recovery from COVID-19, and intervention targetting this symptom could potentially speed up the process. | 197 | November | Yang SS | 10.9778/cmajo.20200159. | 2020 | Canada | From March to August, 2020 | To describe the characteristics, outcomes and management of critically ill patients with COVID-19 pneumonia in the ICU of a designated pandemic centre. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 106 | N/A | N/A | N/A | Demographic information, comorbidities, initial vital signies, laboratory results, severity of COVID-19, therapy administered, linical outcomes including lenght of stay, morbidity and mortality. | N/A | N/A | N/A | N/A | N/A | N/A | The study described a series of critically ill patients, their clinical course and outcomes. Out of 106 patients, 21 died during hospital stay (19.8%), 18 of them during ICU stay (17.0%). 65 patients required mechanical ventilation, and prone positioning was used in 29 patients, including 10 who were spontaneusly breathing. Acute kidney injury was the most common complications (20 patients, 18.9%). All the survivors were discharged from ICU at the time of the writing of the paper, strenghening data about ICU mortality (17.0%). The author suggest that the relatively low mortality rate can be linked to the fact that the ICU were put under heavy stress but not overwhelmed by the large number of COVID-19 patients. |
198 | December | Arnold DT | 10.1136/thoraxjnl-2020-216086 | 2020 | UK | N/A | To report a prospectively recruited UK cohort of hospitalised patients with COVID-19. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 163 | N/A | N/A | N/A | Baseline demographics, comorbidities, blood test results, chest radiograph, pulmonary function testing, clinical data. | N/A | N/A | N/A | N/A | N/A | N/A | In the present study 163 COVID-19 patients consecutively admitted to hospital were enrolled. At 8–12 weeks postadmission, survivors were invited to a systematic clinical and radiological follow-up. At the follow up 74% patients reported at least one ongoing symptom: 39% breathlessness, 39% fatigue and 24% insomnia. Fourteen percent of the patients had a abnormal radiograph follow-up. Eleven patients had restrictive spirometry and 15 had a significant desaturation on the 1 minute STS test. SF-36 scores demonstrated a reduction in reported health status across all domains compared with age-matched population norms. Overall, the study show persistency of clinical and radiological abnormalities at 8-12 weeks postadmission in COVID-19 patients. |
199 | December | Arzani P | 10.34171/mjiri.34.106 | 2020 | Iran | March 2020 | To show the effects of pulmonary rehabilitation and exercise therapy in a patient with COVID-19. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 1 | Fever and dyspnea. | Pulmonary rehabilitation and physical activity. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The case study reports of 49-year-old female COVID-19 patients. Because of COVID-19 related pneumonia she needed hospitalization and suffered from severa dyspnea. On the third day of admission pulmonary rehabilitation was started. Pulmonary rehabilitation involved, in the first phase, when the patient was inconscious, mainly passive mobilization, in a second phase a combination of active and passive mobilization and breathing exercises. She continued rehabilitation for a week after discharge, using telerehabilitation with a smartphone. As soon as the patient was able to move autonoumously she was encouraged to walk 50 meters every day. She underwent a total of 42 physical training sessions in 3 weeks. At the end of the program the patient scored better in all the outcome considered, including modified Borg scale, Saint George’s Respiratory Questionnaire, SF36. |
200 | December | Battaglini D | 10.3389/fneur.2020.602114 | 2020 | Italy | From February 28 to June 30, 2020. | To describe the type and the frequency of neurological complications in a cohort of critically ill patients with COVID-19 receiving invasive mechanical ventilation in an intensive care unit (ICU) and the effects of these complications on outcome. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 94 | N/A | N/A | N/A | Clinical data, rate of neurological complications, invasive and non-invasive neuromonitoring (e.g. transcranial Doppler, ONSD, and automated pupillometry). | N/A | N/A | N/A | N/A | N/A | N/A | The study described a cohort of 94 patients referred to an ICU. Neurological complications were detected in 50% of patients, and delirium was the most common manifestation. Patients with neurological complications did not have an incresead ICU mortaliy, but had longer hospital (36.8 ± 25.1 vs. 19.4 ± 16.9 days) and ICU (31.5 ± 22.6 vs. 11.5±10.1 days) stay. 53 patients underwent noninvasive neuromonitoring. Patients with increased intracranial pressure measured using ONSD (19%) had longer ICU stays. Overall, patients with neurological complications needed longer ICU and hospital stays. |
201 | December | Cabrera Muras A | 10.1111/ene.14561 | 2020 | Spain | N/A | To report a case of Bilateral Facial Nerve Palsy associated with COVID-19 and Epstein-Barr Virus co-infection | Descriptive: Case Report | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 with Epstein-Barr Virus co-infection | 1 | He presented with significant asthenia with headache, myalgia, nausea, and vomiting; after a week he presented right facial weakness; 2 weeks later he had diagnosis of bilateral facial paresis | Levofloxacin 500mg for 7 days; prednisone 60 mg/24h with a tapering schedule | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The patient referred to a an Emergency Room underwent a neurological examination that diagnosed a bilateral facial palsy. The RT-PCR performed for SARS-CoV-2 showed positive results. Moreover, he also had a positive heterophile test indicating a recent Epstein-Barr virus infection. Brain MRI raised the diagnosis of bilateral facial neuritis. He was treated with prednisone and at a follow-up examination 3 weeks later showed an almost complete facial palsy recovery |
202 | December | Cardoso ER | 10.12659/AJCR.927011 | 2020 | USA | N/A | To describe a case of superficial cerebral venous thrombosis and intracerebral hematoma in a 48-year-old man weeks after recovering from the acute phase of SARSCoV-2 infection | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Late-onset | COVID-19 | 1 | Left upper-limb numbness, weakness, and impairment of positional sensation. | Enoxaparin anticoagulation therapy. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The 48-year-old male patient included in this case-study, 36 days after being diagnosed for SARS-COV2 infection and 19 days after recovering from the infection and coming back to work, presented sudden onset of left upper-limb numbness, weakness, and impairment of positional sensation. CT scan showed a small acute cortical hemorrhage in the right parietal lobe, with a rim of surrounding vasogenic edema. The patient remained neurologically stable during hospitalization. He was treated with enoxaparin anticoagulation therapy with benefit, and he slowly improved. At 4 and 8 weeks follow-up after the stroke, the only residual deficit was a mild numbness of the left pointer finger. |
203 | December | Fayed I | 10.1016/j.jocn.2020.08.026 | 2020 | USA | N/A | To report three cases of spontaneous intracranial hemorrhage in COVID-19 patients | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 3 | Persistent Encephalopathy, Fixed and Dilated Pupils | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study reports a spontaneous intracranial hemorrhage (including intracerebral and subarachnoid hemorrhages, ) in three severe COVID-19 patients (two females of 57 and 54-year-old, and a 71-year-old man) who required intubation and ventilatory support. The hospital stays prior to hemorrhage was 20 days in two cases and 8 in the remainder. The 57-year-old woman was subsequently discharged to an acute rehabilitation facility one week later, the 54-year-old female progressed to brain death and expired due to asystole four days later, while the man succumbed to multi-system organ failure one week later. These cases support the predisposition of COVID-19 patients to the development of intracranial hemorrhage during critical illness, maybe for the tropism of SARS-CoV-2 to the endothelial lining of the cerebral vasculature via their angiotensin-converting enzyme (ACE) II receptors. These cases highlighted the need for heightened vigilance for intracerebral hemorrhage events and scanning when practicable, in COVID-19 patients which have prolonged ventilatory support and depressed neurologic examinations. |
204 | December | Ferraro F | 10.1002/jmv.26717 | 2020 | Italy | April - June 2020 | To characterize the COVID-19 late consequences and to investigate the role of rehabilitation in reducing COVID-19 related fatigue and improving functional outcome in a case series of post-COVID-19 inpatients. | Descriptive: Case Series | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 7 | The 85.7% showed a COVID-19 related fatigue, but only Case 2, that needed ICU in the acute phase, presented a severe perception of exertion (Borg CR10 scale=7). | Rehabilitation plan (1-2 session per day of 30 minutes each for 6 days/week), consisting of a progressively increased intensity physical exercises: a) posture changes; b) breathing control exercises; c) passive mobilization of upper and lower limbs; d) passive muscle stretching; e) muscle strengthening exercises of upper and lower limbs, trunk, and gluteus muscles, aimed at reaching the control of sitting position and standing; f) balance and coordination exercises. | N/A | Borg CR10 scale; HGS; 6MWT; SPPB; BI dyspnoea; FIM | N/A | N/A | N/A | N/A | N/A | N/A | After the rehabilitation treatment the 71.4% showed no fatigue and the other 2 cases reported only a very light perception of exertion. We evidenced a considerably improvement of functional outcome after rehabilitation, particularly showed by two patients: Case 2 (6MWT=306 vs 120 m; 10MWT=6 vs 15 sec; SPPB=9 vs 2) and Case 3 (6MWT=330 vs 100 m; SPPB=9 vs 2). The Authors concluded that that a patient-tailored rehabilitation is mandatory for reducing fatigue and improving functional outcome in ADL. |
205 | December | Galván-Tejada CE | 10.3390/ijerph17249367 | 2020 | Mexico | From 25 July to 20 September 2020. | To identify the risk of presenting persistent symptoms in recovered from COVID-19 | Analytical: Case-control study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 141 | N/A | N/A | 78 controls: people who do not meet clinical and laboratory criteria to diagnose SARS-CoV2 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A total of 219 participants were studied: 141 recovered (at least 14 days since the appearance of symptoms) and 78 controls (without diagnosis of COVID-19). Fifty-one controls were free of COVID-19 associated symptoms at the time of the interview (Symptom Questionnaire), while 27 had at least one of the most significant symptom, which means that the risk of symptoms in the controls is 0.3461, that is 34.61%. For the recovered population, 22 had no symptoms and 119 had at least one symptom, that is, a risk of 0.8439 (84.39%). All symptoms show an associated risk of persisting in people recovered from COVID19. The relative risk of the selected symptoms in the recovered patients goes from 3 to 22 times, being infinite for the case of dyspnea, due to the fact that there is no control that presents this symptom at the moment of the interview, followed by nausea and the anosmia with a RR of 8.5. Therefore, public health strategies must be rethought, to treat or rehabilitate, avoiding chronic problems in patients recovered from COVID-19 |
206 | December | Kanjwal K | 10.19102/icrm.2020.111102 | 2020 | USA | N/A | To report a case of POTS in an otherwise healthy female after COVID-19 infection. | Descriptive: Case Report | N/A | Epidemiology - Natural history/Determining and modifying factors | Cardiovascular functions (Heart b410) | Late-onset | COVID-19 | 1 | Fatigue, headache, dizziness, chest pain, and palpitations, espe cially while getting up from the sitting position. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A patient recovered from a mild form of COVID-19, three to four weeks after diagnosis presented fatigue, headache, dizziness, chest pain, and palpitations, especially while getting up from the sitting position. Electrocardiography was negative for acute events. Physical examination revealed a sitting heart rate of 86 bpm and blood pressure of 115/65 mmHg; after standing up, however, her heart rate was 115 bpm and her blood pressure was 105/70 mmHg. Because of her orthostatic increase in heart rate, she underwent head-up tilt-table testing and findings of the test were suggestive of POTS. She was treated with Ivabradine with improvement of the symptoms both subjectively and objectively at follow-up visit. |
207 | December | Livingston T | 10.1093/ptj/pzaa204 | 2020 | USA | N/A | To illustrate how the technology and COVID-19 specific decision-making frameworks were used to deliver acute rehabilitation. | Descriptive: Case Series | Rehabilitation in acute care | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 2 | N/A | In-room video communication system and PT/OT co-treatment strategies. 1 case: For acute care rehabilitation sessions co-treatments PT/OT of 30 minutes; on rehabilitation unit, session of 40-60-minute separate sessions per physical therapy and occupational therapy ; 2 case: 30 co-treatment minutes with a physical therapist and occupational therapist | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The two case reports (A 65-year-old and a 40-year-old, males) highlight a model of care that used technology and two COVID-19 specific decision-making processes to provide safe and patient-centered care. The use of in-room video communication system and PT/OT co-treatment strategies enabled patients to receive both PT and OT services, while concurrently conserving PPE and reducing provider contact. Furthermore, the capability for virtual rehabilitation following hospital discharge allowed the rehabilitation team and patient to comfortably make an informed decision to discharge the patient from the hospital to home. The authors developed also two decision-making models regarding care delivery and discharge planning in the context of the challenges to delivering care. Both patients with COVID-19 demonstrated functional gains after 2-4 weeks of acute rehabilitation (length of stays: 7 days in acute care, 17 days in COVID-19 acute rehabilitation unit; 17 days including 11 days in ICU) and discharged home. The use of technology and decision-making models allows for delivery of safe acute rehabilitation care that minimizes contact, conserves personal protective equipment, and prepares for COVID-19 surges. |
208 | December | Meys R | 10.3390/jcm9123993 | 2020 | The Netherlands and Belgium | N/A | To assess the respiratory-specific quality of life in addition to generic quality of life in non-hospitalized COVID-19 patients | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Chronic | COVID-19 | 210 | N/A | N/A | The subjects were also categozied as Confirmed COVID-19, Symptom-Based COVID-19, and Suspected COVID-19 | The EQ-5D-5L, Clinical COPD Questionnaire | N/A | N/A | N/A | N/A | N/A | N/A | 210 non-hospitalized patients (79 ± 17 days after symptom onset) were included in the study. Both generic (EQ-5D) and respiratory-specific quality of life (CCQ) was affected in these patients, approximately three months after the onset of symptoms. The combined use of the EQ-5D and the CCQ could identify the broad impact of COVID-19 on quality of life. The correlation between EQ-5D index score/EQ-VAS score and CCQ total score was moderate. Given the moderate association and limited discriminative ability of both questionnaires, the combined usage of the EQ-5D and the CCQ can be regarded as a promising approach to best describe the quality of life in patients with COVID-19. This will help to reveal patients’ needs in order to identify relevant rehabilitative interventions to effectively restore health and quality of life. |
209 | December | Mizrahi B | 10.1038/s41467-020-20053-y | 2020 | Israel | From 1/3/2020 to 07/06/2020 | To assess the longitudinal dynamics of symptoms prior to and throughout SARS-CoV-2 infection. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | COVID-19 | 2471 | N/A | N/A | 6,227 negative cases and 147,679 individuals who had no record of a PCR test for SARS-CoV-2 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | The authors extracted data from primary-care electronic health records and nationwide distributed surveys to assess the longitudinal dynamics of symptoms prior to and throughout SARS-CoV-2 infection. Information was available for 206,377 individuals, including 2471 positive cases. The two data sources were discordant, with survey data capturing most of the symptoms more sensitively. The most prevalent symptoms included fever, cough, and fatigue. Conjunctivitis, rash, sore throat, dyspnea and/or shortness of breath and speech disturbance, had a higher prevalence in children who were positive to COVID-19 compared to positive adults. Loss of taste and smell 3 weeks prior to testing, either self-reported or recorded by physicians, were the most discriminative symptoms for COVID-19. Additional discriminative symptoms included self-reported headache and fatigue and documentation of syncope, rhinorrhea, and fever. Children had a significantly shorter disease duration. Long duration of symptoms, specifically fatigue, myalgia, runny nose and shortness of breath was observed weeks after recovery. This study highlights the power of survey derived data to enhance understanding of the evolving COVID-19 pandemic. The study provides additional information on the natural history of mostly mild cases of COVID-19 and may alert physicians for the possibility of infec- tion and direct the need for testing and self-isolation. | |
210 | December | Ortelli P | 10.1016/j.jns.2020.117271 | 2020 | Italy | April and May, 2020 | To provide a comprehensive clinical, neurophysiological, and neuropsychological profile of fatigued patients suffering from neurological manifestations related to SARSCoV-2, who recovered from the acute phase of COVID-19. | Analytical: Cross-sectional study | Specialized postacute rehabilitation | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 12 | N/A | N/A | 12 healthy controls | Neuropsychological assessment and neurophysiological evaluation. | N/A | N/A | N/A | N/A | N/A | N/A | The 12 patients included in the study were all post-acute COVID-19 patients who suffered from neurological complications, and were still suffering from fatigue. All patients met the World Health Organization criteria defining the state of recovery from COVID-19. Neuropsychological and neurophysiological examination were collected in both patients and healthy controls. Neurophysiological examination was assessed before (PRE) and 2 min after (POST) a 1-min fatiguing isometric pinching task and included: CMAP amplitude in FDI following ulnar nerve stimulation, resting motor threshold, MEP amplitude and silent period duration in right FDI following transcranial magnetic stimulation of the left motor cortex . Patients manifested fatigue, apathy, executive deficits, impaired cognitive control, and reduction in global cognition. Perceived exertion was higher in patients. CMAP and MEP were smaller in patients both PRE and POST. Silent period duration did not differ between groups PRE, increased in controls but decreased in patients POST. Taken all together, the study demonstrated the presence, in post COVID-19 patients who suffered from neurological complications, of central neuromotor and cognitive fatigue, apathy, and executive dysfunction. |
211 | December | Pancera S | 10.1097/MRR.0000000000000450 | 2020 | Italy | March - April 2020 | To evaluate the feasibility of a subacute rehabilitation program for mechanically ventilated patients with severe consequences of COVID-19 infection | Descriptive: Case Series | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 7 | Seven male COVID-19 patients (age 37–61 years) referred for inpatient rehabilitation after ICU stay (14–22 days) | Pulmonary and physical rehabilitation, consisting of 11–24 treatment sessions for the duration of rehabilitation stay (13–27 days), including 6–20 sessions in the COVID unit. | N/A | BI, BID, MRC, SPPB | N/A | N/A | N/A | N/A | N/A | N/A | The 6 mechanically ventilated patients were successfully weaned off before transfer to a COVIDfree unit where they stayed for 7–19 days. At discharge, all patients increased limb muscle strength and thigh circumference, reduced activity-related dyspnea, regained functional independence and reported better quality of life. The Authors concluded that rehabilitation might play a crucial role in the recovery of seriously ill post-COVID-19 patients. |
212 | December | Roberts P | 10.1016/j.apmr.2020.11.005 | 2020 | USA | from January 1 to April 30, 2020. | To identify functional limitations in relation to demographic, medical, encounter characteristics; and discharge destination, in COVID-19 patients admitted to acute care hospitals | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 230 | N/A | N/A | Discharge Home (51) VS discharge institution (51) | Demographic, encounter, medical, and functional variables were tested against the dependent variable of discharge destination (discharge home vs discharge institution). | N/A | N/A | N/A | N/A | N/A | N/A | This is a cross-sectional, retrospective study of 230 adult patients with COVID-19 who were discharged from 2 different types of hospitals within 1 health care system, from January 1 to April 30, 2020: 165 were discharged home and 65 to an institution. In the group of people discharged home, 88.2% had functional physical health deficits, 72.5% had functional mental health deficits, and 17.6% experienced sensory deficits. In the matched cohort, individuals discharged to an institution experienced greater physical (62.7% vs 25.5%) and mental health (49.0% vs 23.5%, deficits than patients discharged home. Marital status and physical function deficits were associated with an increase odds ratio of discharge to an institution. This research highlights that functional status is a strong predictor for discharge destination to an institution for patients with COVID-19. Patients who were older, in the acute care hospital longer, and with comorbidities were more likely to be discharged to an institution. Rehabilitation is a significant aspect of the health care system for these vulnerable patients. |
213 | December | Sabayan B | 10.1016/j.jstrokecerebrovasdis.2020.105454 | 2020 | Iran | February - March 2020 | To present data on patients who initially presented with COVID-19 respiratory symptoms, but subsequently developed ischemic stroke or subarachnoid hemorrhage | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 15 | Fever, cough, dyspnea, myalgia, and COVID-19 respiratory symptoms | N/A | N/A | Type of stroke, NIHSS, mRS | N/A | N/A | N/A | N/A | N/A | N/A | Interval time between systemic COVID-19 manifestations and neurological symptoms ranged from one to 16 days (median: 7 days). Out of 15 COVID-19 patients, 14 had acute ischemic stroke and 1 patient had subarachnoid hemorrhage. Stroke severity in 2 patients (13%) was mild (NIHSS 6), in 6 patients (40%) was moderate (NIHSS: 7-12) and in 7 patients (47%) was severe (NIHSS 13). Six patients (40%) died. In those who survived, significant disability (mRS>2) was seen in all but one patient. The Authors concluded that there is a need for further investigation of the links between COVID-19 and cerebrovascular events. |
214 | December | Scelfo C | 10.2147/TCRM.S275779 | 2020 | Italy | March 2020 | To report two cases of early lung fibrosis following COVID-19 pneumonia | Descriptive: Case Series | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Late-onset | COVID-19 | 2 | Both patients showed fever, cough, and dyspnoea. | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | At one month later the onset of COVID-19 symptoms, Case 1 showed at the new contrast-enhanced CT scan signs of reticular interstitial thickening; instead, after discharge, Case 2 showed the presence of sub-pleural consolidations and reticular thickening involving the upper lobes. Thus, the Authors concluded that these cases represent two examples of early lung fibrosis in patients with COVID-19 pneumonia with different severity disease evolution and highlight the need for long-term follow-up strategies. |
215 | December | Sinha RK | 10.26452/ijrps.v11iSPL1.3608 | 2020 | India | N/A | To investigate the effectiveness of structured exercise protocol on functional performance in COVID-19 patients | Non randomised controlled trial | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 150 | Functional impairment assessed by FIM (72.4±21.7) and POMA (11.9±3.6) | Exercise protocol consisting of three satgaes: Stage I, during ICU stay (deep breathing exercises, bed mobility exercises, functional mobility in and around the bed); Stage II, during Recovery Ward stay (Stage 1 exercises continuation, graded upper limb and lower limb, strengthening exercises, and graded spinal exercises); Stage III, during isolation at home (Stage I and II exercises continuation, aerobic exercises) | N/A | FIM, POMA | N/A | N/A | N/A | N/A | N/A | N/A | There was a significant improvement in both FIM (72.4±21.7 vs 91.2±25.2, p<0.05) and POMA (11.9±3.6 vs 21.9±5.5, p<0.05). The authors suggest that the structured exercise protocol helped in maintaining the physical functional performance of the subjects through-out the hospital stay and also after discharge during follow up |
216 | December | Sonnweber T | 10.1183/13993003.03481-2020 | 2020 | Austria | April 2020 | To systematically evaluate the persisting cardiopulmonary damage of COVID-19 patients 60 days and 100 days after COVID-19 onset | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Chronic | COVID-19 | 145 | N/A | N/A | N/A | At 60 and 100 days after the COVID-19 onset, the following outcomes were assessed: cardiorespiratory, gastrointestinal, and neurological symptoms, mMRC dyspnoea score, lung function testing, low-dose CT scan of the chest | N/A | N/A | N/A | N/A | N/A | N/A | At the second follow-up visit (100 days after the onset), a relevant number of patients still reported an impaired performance status and persisting symptoms including dyspnea (36%), night sweat (24%), sleep disorders (22%), or hyposmia/anosmia (19%). Notably, severe symptoms, such as a severely impaired performance status or severe dyspnea (mMRC 3-4) were only found in 2% and 4%, respectively. The authors concluded that relevant percentage of post-COVID-19 patients presented with persisting symptoms and lung function impairment along with pulmonary abnormalities more than 100 days after the diagnosis of COVID-19. |
217 | December | van der Sar S | 10.1016/j.rmed.2020.106272 | 2020 | Netherlands | From March 16 to April 15, 2020 | To examine the impact of COVID-19 pneumonia on pulmonary function and HRQoL. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 101 | N/A | N/A | N/A | Pulmonary function testing, SF-36, Borg, mMRC, HADS. | N/A | N/A | N/A | N/A | N/A | N/A | In this study, the majority of COVID-19 pneumonia survivors had abnormal diffusion capacity six weeks after discharge. Namely, in a sample composed of 28 (27.7%) moderate cases of COVID-19 pneumonia and 73 (72.3%) severe cases, diffusion limitation was found in 71.7% of cases, obstruction in 25.7% of cases, and restriction in 21.2% of cases. Clinical anxiety and depression was still present after 6 weeks from discharge in respectively 12.5% and 16.6% of patients. SF-36 was defcitary in all domains, except for bodily pain. Overall, in COVID-19 pulmonary function and health related quality of life after 6 weeks are still impaired. |
218 | December | Vilches-Moraga A | 10.1186/s12916-020-01856-8 | 2020 | UK, Italy | From 27 February to 10 June 2020. | To investigate the association between pre-admission frailty and change in the level of care needs on discharge from hospital in patients admitted with COVID-19 | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 831 | N/A | N/A | N/A | Clinical Frailty Scale, increased care needs at discharge | N/A | N/A | N/A | N/A | N/A | N/A | Of the 831 patients who were discharged (the median length of hospital stay was 12 days, IQR 6-24), 438 (47.0%) were already living with frailty prior to COVID 19 infection (≥ CFS 5), and 193 (23.2%) required an increase in the level of care provided. Multivariable analysis showed that frailty was associated with an increase in care needs compared to patients without frailty (CFS 1–3). So, around a quarter of COVID-19 patients had increased care needs at discharge, and the pre-admission frailty was strongly associated with the need for an increased level of care at discharge. These results have implications for service planning and public health policy as well as a person's functional outcome, suggesting that frailty screening should be utilized for predictive modeling and early individualized discharge planning. |
219 | December | Woo MS | 10.1093/braincomms/fcaa205 | 2020 | Germany | until 14 July 2020 | To establish a screening approach fto detect cognitive deficits in patients who suffered from mild and moderate COVID-19 | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Chronic | COVID-19 | 18 | N/A | N/A | 10 Healthy controls | The interviews were either conducted by phone or directly with the patient: TICS-M, Fatigue Assessment Scale, Patient Health Questionnaire-9 Depression Scale | N/A | N/A | N/A | N/A | N/A | N/A | In this cross-sectional study, the authors recruited mostly young patients 20– 105days (median, 85days) after recovery from mild to moderate disease. Out of them, 14 (78%) reported sustained mild cognitive deficits and performed worse in the TICS-M for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention, and concentration were particularly affected by COVID-19, screening results did not correlate with hospitalization, treatment, viremia, or acute inflammation. Additionally, TICS-M scores did not correlate with depressed mood or fatigue. The results demonstrate that young patients who recovered from uncomplicated COVID-19 can have sustained neuropsychologic deficits that can be unmasked by targeted screening. |
220 | December | Yang ZL | 10.3389/fmed.2020.605088 | 2020 | China | January - February 2020 | To analyze follow-up CTs of patients recovering from COVID-19 in Wuhan, focusing on fibrotic change and its relevant risk factors | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 patients | 166 | N/A | N/A | N/A | Chest CT exam | N/A | N/A | N/A | N/A | N/A | N/A | Of the 166 COVID-19 patients included, at the follow-up CTs (obtained on 56 days after symptom onset), the 46% (76/166) showed CT evidence of fibrotic change and 77% (127/166) were severe or critical cases. Among patients with fibrotic change on CT, 84% (64/76) got a minimal or mild score of fibrosis. The Authors concluded that an extended follow up by CT imaging and pulmonary function testing is necessary to fully assess the sequela of COVID-19. |
221 | December | Zhang X | 10.7189/jogh-10-020514 | 2020 | UK | From March 16 to June 29, 2020 | To analyse whether PA influences the risk of COVID-19. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | COVID-19 | 1746 | N/A | N/A | 415,596 healthy controls | Self-reported moderate-to-vigourous PA, AMPA, Clinical outcomes | N/A | N/A | N/A | N/A | N/A | N/A | The study analyzed the data from The UK Biobank, a prospective cohort study including more than 500000 participants aged from 40 to 69 years in the United Kingdom. In this study, participants who have not been tested positive for SARS-CoV-2 and not died of COVID-19 were taken as controls. Using multivariate logistic regression, AMPA is associated with a decreased probability of both overall (OR 0.80, 95% CI.69 - 0.93) and outpatient (OR 0.74, 95% CI.58 - 0.95) COVID-19. on the other hand, no association was found between self-reported PA and COVID-19 related outcomes. The author tested causality by using Mendelian randomisation analyses that did not support casuality, possibly due to insufficient power. The results indicate a protective effect of objectively measured PA and COVID-19 outcomes. | |
222 | December | Zhu S | 10.1371/journal.pone.0243883 | 2020 | China | From February 21 to April 7, 2020 | To estimate the prevalence of disability and anxiety in Covid-19 survivors from eight Provinces/centrally governed municipalities of the PR China at discharge from acute inpatient treatment, and investigate relative risk of adverse outcomes by various determinants including gender, age, comorbidity,setting, ethnicity and disease severity. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 432 | N/A | N/A | N/A | IADL, BI, Zung’s self-reported anxiety scale, clinical outcomes, demographical data, comorbidity, setting. | N/A | N/A | N/A | N/A | N/A | N/A | In this multi-center study patients were analyzed at discharge from different Chinese hospitals after the acute phase. At discharge, 36.81% of patients presented at least one IADL problem, 16.44% had at least moderate-dependence measured using BI, and 28.70% resulted positive for clinical anxiety at Zung’s self-reported anxiety scale. Severe COVID-19 patients had eleveted adjusted risk ratio of IADL limitations, ADL dependency and probable clinical anxiety. Overall, a singificative number of discharged patients suffered from limitation in IADL, ADL dependency and clinical anxiety. |
223 | January-February | Fisher et al. | 10.1111/irv.12832 | 2020 | USA | July 2020 | To compare symptom prevalence and recovery among adults with and without COVID-19 who were tested at outpatient health facilities for SARS-CoV-2 infection during July 2020. | Analytical: Case-control study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 157 | N/A | N/A | 163 healthy controls | Frequency and duration of reported symptoms | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19 patients were more likely than controls to have experienced fever, body aches, weakness, or fatigue during illness, and to report ≥1 persistent symptom more than 14 days after symptom onset (50% vs 32%, P<0.001). Cases reported significantly more days of poor physical health during the past 14 days than controls (P<0.01). |
224 | January-February | Huang C et al. | 10.1016/S0140-6736(20)32656-8 | 2021 | China | January 2020 - May 2020 | To describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Chronic | COVID-19 | 1733 | N/A | N/A | N/A | Disease severity scale, mMRC dyspnoea scale, EQ-5D-5L, EQ-VAS, symptom questionnaire, 6MWT | N/A | N/A | N/A | N/A | N/A | N/A | At 6 months after COVID-19 onset, fatigue or muscle weakness (63%) and sleep difficulties (26%) were the most common symptoms. The proportions of median distance AT 6MWT less than the lower limit of the normal range were: 24% for Those at severity scale 3, 22% for severity scale 4, and 29% for severity scale 5–6. The authors concluded that patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and might be considered as the main target population for intervention of long-term recovery. |
225 | January-February | Puchner B et al. | 10.23736/S1973-9087.21.06549-7 | 2021 | Austria | April - July | To explore the dysfunctions and outcome of COVID-19 survivors after early post-acute rehabilitation. | Analytical: Cohort study | Specialized postacute rehabilitation | Micro - Outcome Measures | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 23 | N/A | An individualized, multi-professional treatment plan lasting at least 3 weeks, which focused on respiratory function, mobilization, and psychosocial management | N/A | FVC, FEV1, FEV1/FVC, TLC, RV, DLCO, blood gas analysis (pH, pO2, and pCO2), 6MWT, MIP, and BI | N/A | N/A | N/A | N/A | N/A | N/A | Rehabilitative intervention resulted in a significant improvement in lung function, as reflected by an increase of FVC (p=0.007) and FEV1 (p=0.014), TLC (p=0.003), and diffusion capacity for carbon monoxide (p=0.002). Accordingly, physical performance status significantly improved as reflected by a mean increase of 6MWT distance by 176±137 meters. However, the 83% of patients still had limited diffusion capacity. |
226 | January-February | Tuzun S et al. | 10.23736/S1973-9087.20.06563-6 | 2021 | Turkey | May - June 2020 | To reveal musculoskeletal symptoms in COVID-19 patients, to evaluate myalgia, arthralgia, fatigue, muscle strength, and to examine the relationship of these parameters with the severity and laboratory findings of the disease | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 150 | 103 patients (68.7%) were non-severe, and 47 (31.3%) were severe according to ATS guidelines. | N/A | N/A | Myalgia severity, assessed by a NRS scale; fatigue severity, assessed by Chalder Fatigue Scale were used for fatigue severity; muscle strength, assessed by HGS | N/A | N/A | N/A | N/A | N/A | N/A | The mean value of NRS for myalgia was 7.20 (6.76–7.64), 120 patients (80%) showed fatigue at the Chalder Fatigue Scale. There was a muscle weakness in both female (HGS: 21.83 kg) and male (HGS: 36.93 kg). The authors concluded that muscle involvement in COVID-19 seemed to be related to hypoxia leading to ischemic myalgia and physical fatigue. Although there is muscle weakness in all patients, the loss of muscle function is related to the disease activity, especially in women. |
227 | January-February | Cerillo AG et al. | 10.1111/jocs.15326 | 2021 | Italy | From March 23 to April 14, 2020, | To describe the benign course of the COVID‐19 in cardiac surgical patients | Descriptive: Historical cohort | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 18 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study described a cohort of 18 patients who contracted the SARS‐CoV2 infection in a rehabilitation clinic (after a median period of 9 days) while recovering from cardiac surgery. This was a group of critically ill, elderly patients (mean age was 70 years) with multiple severe comorbidities and high surgical risk scores. Seven patients had a fever and were hospitalized, and only one patient needed admission to the COVID‐19 ICU for dyspnea and mild hypoxemia, which was treated by continuous positive airway pressure. The remaining 11 asymptomatic or mildly symptomatic patients ( 6 and 5, respectively) were discharged home or to a COVID‐19 hotel. At the latest follow‐up (after 6 months), all patients had been discharged home. The patients, despite having all the risk factors for the development of severe symptoms and death (older age, obesity, arterial hypertension, chronic obstructive pulmonary disease, and cardiovascular diseases), had a benign course. The hypothesis is 1) the low rate of symptoms and complications was simply due to chance; 2)all patients received low‐ molecular‐weight heparin during the perioperative period, and all except one were discharged on oral anticoagulants that might have exerted a protective effect; 3) the cardiac surgery promoting a strong systemic inflammatory response caused a secondary immunodeficiency in these patients, resulting in a blunted immune response to the SARS‐CoV2 infection. Further studies are needed to investigate the relationship between the surgery‐induced inflammatory response, some potentially protective therapies (e.g., anticoagulants), and severity of COVID‐19. |
228 | January-February | Spielmanns M et al. | 10.1097/PHM.0000000000001686 | 2021 | Switzerland | From March to May 2020 | To analyzed a cohort of nosocomial infected COVID-19 patients in a single center inpatient rehabilitation clinic and describe performance and outcome. | Descriptive: Historical cohort | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 27 | N/A | N/A | 786 Neuro-musculoskeletal rehabilitation inpatients of 2019 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19 patients were mostly male (66.7%) with an age of 71.5 ±12.3 years. Age, sex, and cumulated comorbidities were not different between groups (COVID-19 vs non-COVID-19). 92.6% of COVID-19 patients had a mild or moderate course and two patients had to be referred to acute hospital due to respiratory failure and one of these patients died in the acute hospital. The rehabilitation duration was significantly longer in the COVID-19 group, 54.2±23.6 days versus 32.1±17.7 days. Daily therapy duration was lower during COVID-19. However, after discontinuation of isolation measures, therapy duration increased significantly. The baseline FIM score was higher in the COVID-19 group and FIM improvements were lower in COVID-19 patients than in the 2019 comparison group. In conclusion, COVID-19 infection itself had a strong negative impact on FIM change reducing the FIM at discharge by 8.9 points after correction for FIM at admission, age, sex, and morbidity index at admission. |
229 | January-February | Loerinc LB et al. | 10.1016/j.hjdsi.2020.100512 | 2021 | USA | From March 26 to April 21, 2020 | To describe the demographics, baseline comorbidities, hospital course, and post-discharge care plans of patients with COVID- 19 discharged from hospitals within an academic healthcare system | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 310 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | A total of 310 patients were included (median age 58, range: 23–99; 51.0% female; 69.0% African American) with a median length of hospitalization was 5 days (range: 0–33). The analysis was stratified into four groups: (1) all patients who survived to discharge (N=310), (2) patients with no ED visit or readmission after discharge (N=284), (3) patients with ED treat and release after discharge (N=10), and (4) patients who were readmitted (N=16). The most common complications recorded in discharge documentation for all patients were electrolyte abnormalities, acute kidney injury, and sepsis. 31 of 310 patients had a neurological complication: delirium (N=27), cerebral vascular accident (N=3), and seizure (N=1). Patients who were readmitted had overall similar hospital course in duration, treatments received, intensive care requirements, and complications recorded compared to the overall population. The majority of patients (281, 90.6%) were discharged directly home. Twenty-five patients (8.1%) were discharged to a skilled nursing facility (SNF) and four patients (1.3%) were discharged to a quarantine facility. Seventy-five patients (24.2%) required any home service at discharge, including physical or occupational therapy (42, 13.5%), nursing (16, 5.2%), and new home oxygen therapy (41, 13.2%). Only 162 patients (52.3%) had a caregiver or family support identified in the medical record. Two hundred thirteen patients (68.7%) were documented to have at least one ongoing symptom at discharge with the most common being cough (44.5%) and shortness of breath (44.2%). The post-discharge ED visit rate was 7.7% with 54.2% of these attributable to COVID-19. The post- discharge readmission rate was 5.2% with 68.8% of these attributable to COVID-19. The most common COVID-19 related reason for readmission was worsening pneumonia or bacterial superinfection, noted in four patients (1.3%). Only one patient (0.3%) was suspected to have a pulmonary embolism. Two patients (0.6%) died during rehospitalization, and both had sepsis present on readmission. One patient (0.3%) was placed on hospice after discharge. The patients have significant recommended post- discharge care in the outpatient setting. There are specific transitions of care that must be anticipated and addressed by healthcare systems and the primary care community including post-hospital visits, home health supervision, monitoring of medications, discontinuation of isolation, and follow-up laboratory and radiology needs. |
230 | January-February | Li X et al. | 10.1148/radiol.2021203998 | 2021 | China | From May to September 2020 | To evaluate cardiac involvement in participants recovered from COVID-19 without clinical evidence of cardiac involvement using cardiac MRI | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Cardiovascular functions (Heart b410) | Chronic | COVID-19 | 40 | N/A | N/A | 25 healthy controls matched for age and sex | Cardiac MRI | N/A | N/A | N/A | N/A | N/A | N/A | Forty participants (54±12 years; 24 men) who recovered from COVID- 19 with moderate(n=24) or severe(n=16) pneumonia and without clinical evidence of cardiac involvement, were enrolled with a mean time between admission and cardiac MRI of 158 ±18 days and discharge and examination of 124 ±17 days. Cardiac MRI revealed extracellular volume fraction (ECV) was elevated in 24 of 40 participants (60%) recovered from COVID-19 compared to healthy controls. Moreover, 28 of 40 participants (70%) had subclinical changes of myocardial dysfunction demonstrated by a reduction in left ventricle 2D-global longitudinal strain compared with healthy controls, regardless of the severity of pneumonia. Long-term cardiovascular consequences of COVID-19 need to be investigated, and cardiac MRI can be a sensitive imaging tool. The clinical significance of these results is unknown, and this work highlights the need for longitudinal follow-up to understand the importance and progression of subclinical myocardial findings in COVID-19 participants. |
231 | January-February | Curci C et al. | 10.23736/S1973-9087.20.06660-5 | 2021 | Italy | From March 10th to April 30th, 2020 | To describe the role of a patient-tailored rehabilitation plan on functional outcome in hospitalized COVID-19 patients. | Descriptive: Historical cohort | General postacute rehabilitation | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 41 | N/A | Rehabilitation protocol according to patients baseline FiO2 (30 minutes/set, 2 times/day), aimed to improve gas exchanges, reducing dyspnoea, and improving muscle function. | N/A | BI, mMRC Dyspnoea Scale, 6-MWT, Borg RPE scale, length of stay in Rehabilitation Unit. | N/A | N/A | N/A | N/A | N/A | N/A | 41 post-acute COVID-19 patients (25 male and 19 female), mean aged 72.15±11.07 years were included in the study. Their mean LOS was 31.97±9.06 days, as 39 successfully completed the rehabilitation treatment and 2 deceased (pulmonary thromboembolism in a case and spontaneous pneumothorax with acute respiratory failure in the other one). After rehabilitative treatment, the patients' disability was significantly reduced as described by the improvement in BI scale. Moreover, there was an improvement in resistance ( 6-MWT) and fatigue ( Borg RPE scale). These findings suggest that post-acute COVID-19 patients might beneficiate from a motor and respiratory rehabilitation treatment. |
232 | January-February | Wright EV et al. | doi: 10.1186/s13037-020-00279-x | 2021 | UK | From March 11, 2020 to April 30, 2020 | To compare the established mortality of patients presenting with femoral neck fractures during the COVID-19 pandemic to the equivalent period in 2018 | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | Patients presenting with femoral neck fractures | 68 | N/A | N/A | N/A | 30-day mortality | N/A | N/A | N/A | N/A | N/A | N/A | 68 patients presenting with femoral neck fractures were included in the study at hospital arrival. Mean age was 81 years old and 73% of patients where females. 25% of the patients resulted positive for SARS-CoV-2 at arrival or during hospital stay. The average length of stay of COVID-19 positive patients were 17 days, and they had a 30-day mortality of 11.76%. 30-day mortality was significantly different from that of the equivalent 2018 period (6%, p=0.045). No data were presented about the severity of COVID-19 presentation in these patients. Orthogeriatrics reviews were conducted in 71% of the cases within 72 hours, while in 2018 the percentage was 88%. Thirty-two patients (47%) required increased packages of care on discharge or rehabilitation. The authors conclude that the augmented mortality is possibly due both to the COVID-19 pneumonia, and the reorganisation of orthogeriatric care due to the pandemic. |
233 | January-February | Bellan M et al. | doi: 10.1001/jamanetworkopen.2020.36142 | 2021 | Italy | From March 1, 2020 to June 29, 2020 | To investigate prevalence and clinical associations of functional and psychological impairment 4 months after recovery from COVID-19. | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 238 | N/A | N/A | N/A | Clinical and demographical data, Pulmonary function testing, SPPB, IES-R | N/A | N/A | N/A | N/A | N/A | N/A | Seven hundred sixty seven consecutive post-acute COVID-19 patients were contacted by telephone 3 to 4 months after hospitalization. 4.6% of the patients died after discharge, and only 238 (35.6%) agreed to partecipate. Out of 219 patients that were able to perform pulmonary function testing, 51.6% patients (113) presented a diffusing lung capacity for carbon monoxide reduced to less than 80% of estimated value, and in 15.5% (34) of patients was reduced of less than 60%. SPBB score was reduced (score <11) in 22.3% of patients (53). Posttraumatic stress symptoms were reported in a total of 41 patients (17.2%). The study suggest that a significative percentage of hospitalized patients still suffer from respiratory, physical and psychological sequelae 3-4 months after discharge. |
234 | January-February | Guler SA et al. | doi: 10.1183/13993003.03690-2020 | 2021 | Switzerland | From May 1, 2020 to September 15, 2020 | To assess pulmonary sequela of COVID-19. | Analytical: Cross-sectional study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 113 | 47 patients mild/moderate, 66 patients severe/critical COVID-19 | N/A | N/A | Clinical and demographical data, Pulmonary function testing, CT scan. | N/A | N/A | N/A | N/A | N/A | N/A | One hundred thirteen COVID-19 patients were indagated 4 months after COVID-19 symptoms onset (median: 128 days). Patients were divided in two groups: mild/moderate (47 patients) and severe/critical COVID-19 (66 patients). Severe/critical disease was associated with impaired lung function, reduced percentage of diffusing lung capacity for carbon monoxide predicted, exercise-induced oxygen desaturation. Percentage of diffusing lung capacity for carbon monoxide predicted was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD, and minimal SpO2 at exercise, were included in the multivariable model. Abnormalities for CT scan at follow up were also associated with severe/critical COVID-19 |
235 | January-February | Mandora E et al. | doi: 10.1111/jocn.15637 | 2021 | Italy | From March 10, 2020 to June 10, 2020 | To evaluate the level of frailty in a large cohort of COVID-19 patients with acute respiratory failure admitted to a subacute unit to stabilise their clinical condition after discharge from acute care. | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 271 | N/A | N/A | N/A | Clinical and demographical data, respiratory support needed, SPPB, BRASS | N/A | N/A | N/A | N/A | N/A | N/A | In the present study COVID-19 patients were investigated at admission in sub-acute care, during recovery from acute respiratory failure. 236 patients were recruited in the study, with a median age of 77. All patients were administred BRASS and classified into three different levels of frailty risk. Furthermore, SPPB was collected together with clinical data. The median BRASS index was 14.0 (interquartile range 9.0–20.0). On the whole, the patients presented mostly intermediate frailty (32.2%, 41.1%, 26.7% of patients exhibited low, intermediate and high frailty, respectively). The author concluded that the majority of COVID-19 patients recovering from acute respiratory failure presented lintermidiate or high risk of frailty and require a continuity of care. |
236 | January-February | Ozyemisci T et al. | doi: 10.23736/S1973-9087.21.06551-5 | 2021 | Turkey | From March 15, 2020 to May 11, 2020 | To evaluate the effects of physical rehabilitation in ICU on the overall muscle strength in patients with COVID-19 following discharge. | Analytical: Case-control study | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 35 | N/A | Rehabilitation group (N=18) underwent passive, active assisted and active joint mobilization, and, if possible, sit to stand and walking exercises. Neurmuscular electrical stimulation was performed on quadriceps and tibialis anterior. | Control group who did not perform rehabilitation in ICU (N=17). | Clinical and demographical data, handgrip strength, manual muscle strength using MRC scale in 3 muscle groups in each limb (arm abduction, forearm flexion, wrist extension, hip flexion, knee extension and ankle dorsiflexion), ROM, SF-36 | N/A | N/A | N/A | N/A | N/A | N/A | In the study 35 patients with acute respiratory distress syndrome due to COVID-19 were enrolled in ICU. The first 17 patients did not undergo a rehabilitation program, while the last 18 were treated during ICU stay with mobilization and strenghtening exercises and neurmuscolar electrical stimulation on quadriceps and tibialis anterior. Of the rehabilitation group only 11 patients were stable enough during ICU stay to perform rehabilitation. At ICU discharge patients in the rehabilitation group showed no difference in no difference in hand grip or manual muscle strength compared to control group. No adverse event was found. Authors noted that the present study do not support early rehabilitation on improving muscle strength; however rehabilitation was performed safely, and the short follow-up do not allow to understand the possible medium and long term effect of the rehabilitation programme. |
237 | January-February | Townsend L et al. | doi: 10.1513/AnnalsATS.202009-1175OC | 2021 | Ireland | March - May, 2020 | To evaluate medium-term respiratory complications following SARS-CoV-2 infection. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 153 | N/A | N/A | N/A | Clinical and demographical data, Brixia score for chest radiography, 6-MWT, Rockwood’s Clinical Frailty Scale. | N/A | N/A | N/A | N/A | N/A | N/A | At a median of 75 days after diagnosis, 153 patients were re-evaluated as outpatients and investigated for respiratory and functional sequalae. Almost half of the patients (48%) needed hospital admission during acute phase of the disease and 12% needed ICU stay. More than half (62%) of patients felt that they had not returned to full health. The median distance covered during 6-MWT was 460 m, and a shorter distance was associated with frailty (measured using Rockwood Clinical Frailty Scale) and lenght of inpatients stay. Only 4% of the patients had persistent abnormality at chest x-ray. Overall, after 2 to 3 months after diagnosis, most patients still presented objective and subjective signs of COVID-19. |
238 | January-February | Bertolucci et al. | doi: 10.23736/S1973-9087.21.06674-0 | 2021 | Italy | March - August 2020 | To describe the baseline characteristics and rehabilitative outcomes of patients with complex disabilities related to pneumoniae due to COVID 19 referring to a Rehabilitation Unit | Analytical: Cohort study | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 39 | N/A | N/A | N/A | BI, FAC, CIRS, nonrespiratory manifestations; dysphagia, mental confusion; PaO2/FiO2 | N/A | N/A | N/A | N/A | N/A | N/A | BI score increased significantly (p<0.001) from 7.5 at admission to 65 at discharge. Even FAC score increased signifcantly (p<0.001), from 0 at admission to 3 at discharge. Thirty-eight patients were discharged at their home. The authors concluded that the activation of comprehensive rehabilitation settings able to assist subacute COVID-19 patients would be desirable to counteract this pandemic. |
239 | January-February | Cortes Telles et al. | doi: 10.1016/j.resp.2021.103644. | 2021 | Mexico | N/A | To compare spirometry, diffusing capacity of the lungs for carbon monoxide (DLCO), and 6-minute walk distance (6MWD) in Mexican survivors of COVID-19 with and without persistent dyspnoea. | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 with dyspnoea | 70 | Study participants showed mild COVID-19 in the 27%, moderate COVID-19 in the 14%, and severe COVID-19 in the 59%. | N/A | COVID-19 with no dyspnoea (n=116) | FVC, FEV1, FEV1/FVC, DLCO, 6MWT, Borg 0-10 Dyspnoea, Borg 0-10 Fatigue | N/A | N/A | N/A | N/A | N/A | N/A | Patients with persistent dyspnoea had significantly lower FVC (p=0.03), FEV1 (p=0.04), and DLCO (p=0.01), with 47 % having a restrictive ventilatory pattern compared to 33% in the non-dyspnoea group. Patients with persistent dyspnoea also had significantly lower 6MWT (p=0.03) and significantly higher Borg 0-10 dyspnoea (p<0.001) and fatigue (p<0.001) compared to those without dyspnoea. |
240 | January-February | Paneroni et al. | doi: 10.1016/j.apmr.2020.12.021 | 2021 | Italy | March - April 2020 | To report the level of physical function in COVID-19 patients after acute respiratory failure admitted to a subacute Rehabilitation Unit. The secondary aim was to investigate which clinical characteristics during hospitalization could predict physical function. | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 184 | N/A | N/A | N/A | SPPB score and ins sub-items: standing balance, 4-MGS, and sit-to-stand test. | N/A | N/A | N/A | N/A | N/A | N/A | The total SPPB score was 3.1±3.9, with 64% of patients exhibiting SPPB≤3. Patients with a better functional status (SPPB>3) was inversely related to previous disability (p<0.001), age (p<.0001), invasive mechanical ventilation (p<0.001), use of NIV or CPAP (p=0.001). The Authors concluded that the majority of COVID-19 patients experienced acute respiratory failure could exhibit substantial physical dysfunction. |
241 | January-February | Pant et al. | doi: 10.31729/jnma.5980. | 2021 | Nepal | December 2020 | To determine the prevalence of functional limitation in COVID-19 recovered patients using the PCFS | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other environmental factors - generic (e) | Chronic | Post-COVID-19 | 106 | N/A | N/A | N/A | PCFS | N/A | N/A | N/A | N/A | N/A | N/A | More than half of the POST-COVID-19 patients (56.6%) reported having no functional limitation (PCFS=0), while the prevalence of some degree of functional limitation was observed in 46 (43.4%) patients. The majority of patients (89.6%) had at least one of the pulmonary or extra-pulmonary symptoms during COVID-19 infection. The 45.3% showed fatigue and 9.4% showed myalgia. |
242 | January-February | RIch et al. | doi: 10.1177/1751143721991060 | 2021 | UK | April - May 2020 | To collect the incidence and frequency of physiotherapy interventions performed during the COVID-19 pandemic in a critical care setting. | Descriptive: Historical cohort | Rehabilitation in acute care | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 163 | N/A | N/A | COVID-19 patients (n=50) | Physiotherapy interventions for example, endotracheal suctioning, functional rehabilitation for every patient in the critical care setting, CPAx | N/A | N/A | N/A | N/A | N/A | N/A | The most frequent critical care physiotherapy interventions resulted to be: suctioning (430 occasions), followed by positioning (101 occasions), assisted cough (140 occasions), ventilator hyperinflation (67) and manual techniques (83 occasions); weaning interventions were completed on 271 patients. Seventy-six COVID-19 patients completed both an initial and discharge CPAx reporting a mean admission CPAx=9.1 in COVID-19 positive and a mean CPAx=10.5 in COVID-19 negative patients. On discharge. COVID-19 positive patients demonstrated a mean CPAx=24.3 versus a mean score of 28.9 in COVID-19 negative patients. |
243 | January-February | Tay et al. | doi: 10.3389/fmed.2020.615997 | 2021 | SIngapore | January - May 2020 | To describe the acute functional outcomes and associations of dependence in walking in critically ill COVID-19 patients after ICU stay; to describe the cardiopulmonary and neurological sequelae of critical illness contributing to functional dependence. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other environmental factors - generic (e) | Post-acute | COVID-19 | 51 | N/A | N/A | N/A | FAC, Charlson Comorbidity Index, PaO2/FiO2 ratio at the admission to ICU, length of ICU stay, the ICU therapies received, number of patients with continuous supplementary oxygen required, dependent in walking, dependent in 1 or more basic ADLs | N/A | N/A | N/A | N/A | N/A | N/A | The 47.1% of patients were dependent ambulators upon transferring out of ICU. On multivariate analysis, we found that a Charlson Comorbidity Index of 1 or more (OR: 14.02; p=0.039) and a longer length of ICU stay (OR: 1.50; p=0.029) were associated with dependent ambulation upon discharge from ICU. |
244 | January-February | Turcinovic et al. | doi: 10.1016/j.arrct.2021.100113. | 2021 | USA | April - June 2020 | To optimize the ability of hospitalized patients isolated due to COVID-19 to participate in physical therapy | Analytical: Cohort study | Community-based rehabilitation (CBR) | Epidemiology - Natural history/Determining and modifying factors | Any other environmental factors - generic (e) | Post-acute | COVID-19 | 39 | N/A | Hybrid approach to delivery of physical therapy, with a combination of in-person and tele-rehabilitation visits, consisted of therapeutic exercise in supine, sitting and/or standing positions (depending on the patient’s functional ability determined from the in-person sessions). Tele-rehabilitation exercises are focused on deep breathing, balance and strengthening and were tailored to patient’s current abilities. | N/A | AM-PAC 6 | N/A | N/A | N/A | N/A | N/A | N/A | There was an improvement from admission to discharge in terms of AM-PAC 6 (19.0±4.8 vs 21.8±3.3). The authors concluded that this pilot quality improvement project showed the feasibility of a hybrid combination of in-person and tele-rehabilitation sessions for hospitalized patients isolated with COVID-19 |
245 | January-February | Udina et al. | doi: 10.14283/jfa.2021.1. | 2021 | Spain | N/A | To describe the pre-post impact on physical performance of multi-component therapeutic exercise for post-COVID-19 rehabilitation | Analytical: Cohort study | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Chronic | Post-COVID-19 | 20 | N/A | The 30-minute 7 days/week multi-component therapeutic exercise intervention consisted of: a) resistance training (1-2 sets with 8-10 repetitions each with an intensity between 30-80% of the Repetition Maximum); b) endurance training (up to 15-minutes aerobic training with a cycle ergometer, steps or walking); c) balance training (walking with obstacles, changing directions or on unstable surfaces). | Post-COVID-19 patients not referred to ICU previously (n=13) | BI; SPPB score and its sub-items (standing balance, 4-MGS, and sit-to-stand test), single leg stance test, unassisted gait, 6MWT | N/A | N/A | N/A | N/A | N/A | N/A | Furthermore, post-ICU patients experienced a greater improvement compared to non-ICU in terms of SPPB (4.4±2.1 vs 2.5±1.7, p<0.01) and gait speed (0.4±0.2 vs 0.2±0.1, p<0.01). None of the patients died during the intervention and all were discharged home. Moreover, mean 6MWT walked distance improved from 158.7±154.1 to 346.3±111.5 m (p<0.001) in a subsample of 22 participants. |
246 | January-February | Alemanno F et al. | 10.1371/journal.pone.0246590 | 2021 | Italy | From March 27th to June 20th, 2020 | To investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit | Analytical: Cohort study | General postacute rehabilitation | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 87 | N/A | N/A | N/A | MMSE, MoCA, FIM, Hamilton Rating Scale for Depression | N/A | N/A | N/A | N/A | N/A | N/A | 87 patients, about 10 days after symptoms onset, were included and they were separated in 4 different groups according to the type of respiratory assistance they benefited in the acute phase: Group1 (orotracheal intubation), Group2 (B-PAP), Group3 (Venturi Masks), Group4 (no oxygen therapy). Out of the 87 patients, 80% had neuropsychological deficits and 40% showed mild-to-moderate depression. Group1, the most young, had higher scores than Group3 for visuospatial/executive functions, naming, short- and long-term memory, abstraction, and orientation. Cognitive impairments correlated with patients’ age. FIM (<100) did not differ between groups. Patients partly recovered at one-month follow-up and 43% showed signs of post-traumatic stress disorder. Patients with severe functional impairments had important cognitive and emotional deficits which might have been influenced by the choice of ventilatory therapy, but mostly appeared to be related to aging, independently of FIM scores. These findings should be integrated for correct neuropsychiatric assistance of COVID-19 patients in the subacute phase, and show the need for long-term psychological support and treatment of post-COVID- 19 patients. |
247 | January-February | Wiertz CMH et al. | 10.1016/j.arrct.2021.100108 | 2021 | The Netherlands | From April 2 to May 13, 2020 | To describe clinical characteristics of post-ICU COVID-19 patients, admitted for inpatient rehabilitation. | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 60 | N/A | N/A | N/A | ICU-stay parameters, Muscle strength, sensory neuropathy and range of motion , BI, NRS (fear, fatigue or dyspnoea) | N/A | N/A | N/A | N/A | N/A | N/A | This study included 60 patients, mean age of 59.9, 75% of them were men. In the first week after discharge to the rehabilitation centre 38.3% of all patients experienced exercise-induced oxygen desaturation, in 72.7% muscle weakness was present in all major muscle groups and 21.7% had a reduced mobility in one or both shoulders. Furthermore 40% suffered from dysphagia and 39.2% reported symptoms of anxiety. These data confirm the importance of being aware of PICS in post-ICU COVID 19 patients and support the need for an early and effective multidisciplinary rehabilitation program that is adapted to the specific needs of COVID-19 patients. |
248 | January-February | Xu F et al. | 10.1016/j.sleep.2021.02.002 | 2021 | China | From February to April 2020. | To investigate sleep and mood status, and detect the influencing factors of the psychological status of the COVID-19 patients after recovery. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Chronic | COVID-19 | 125 | N/A | N/A | N/A | Insomnia Severity Index (ISI), Center for Epidemiology Scale for Depression (CES-D) | N/A | N/A | N/A | N/A | N/A | N/A | This study included 121 COVID-19 patients, mean age 41.72 and 69 males (57.02%) at two weeks after hospital discharge. The patients had a high prevalence (26.45%) of insomnia and a relatively low percentage of depression (9.92%). There were significant differences in physical, mental impairment, and the need for psycho- logical assistance between the COVID-19 recovered patients with depression and the patients without depression. Age and health status may be the influencing factors for insomnia. Caring about the views of others may be the influencing factors of depression. We need to pay more attention to their sleep condition than mood status |
249 | January-February | Piquet V et al. | 10.1016/j.apmr.2021.01.069 | 2021 | France | From March 25, 2020. | To determine the benefits associated with brief inpatient rehabilitation for COVID-19 patients | Descriptive: Historical cohort | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 100 | N/A | Overall motor strengthening with body weight exercises, elastics, and weights, respiratory rehabilitation exercises, aerobic work included bicycle ergometer sessions at submaximal intensity | N/A | Barthel Activities of Daily Living Index, 10 sit-to-stands with associated cardiorespiratory changes, and grip strength (dynamometry), ICU lenght of stay | N/A | N/A | N/A | N/A | N/A | N/A | In this retrospective study on the first 100 patients (mean age 66 years, 66%men) with COVID-19 infection admitted to a specialized rehabilitation unit (mean delay from symptom onset was 20.4 day), inpatient therapy (mean length of rehabilitation stay was 9.8 days) was associated with substantial functional, motor, and cardiorespiratory improvement, particularly in patients who had undergone severe acute disease: Barthel index increased from 77.3 to 88.8 without recovering baseline values, there was a 37% improvement in sit-to-stand frequency, a 13% decrease in post-test respiratory rate, and a 15% increase in grip strength. Nonetheless, loss of autonomy and motor weakness persisted at discharge, which occurred approximately a month after the onset of COVID-19. After acute stages, COVID-19, primarily a respiratory disease, might convert into a motor impairment correlated with the time spent in intensive care. |
250 | January-February | Simioli F et al. | 10.5152/TurkThoracJ.2021.20158 | 2021 | Italy | From mid-March to April 2020 | To investigate the effects and feasibility of PP on COVID-19-associated awake patients with ARDS in a subintensive setting of care | Analytical: Case-control study | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 29 | N/A | Prone positioning | No Prone positioning | artery blood gases | N/A | N/A | N/A | N/A | N/A | N/A | A total of 29 patients (25 men, mean age 64 years) underwent noninvasive ventilation, and PP was initiated 12 h from admission; 18 patients tolerated prone and side positioning for at least 10 h/d and cycled their position every 2 h, and 11 patients had no complaints with PP. The data demonstrated that the Severity of gas exchange impairment in COVID-19 is not correlated to inflammatory status. PP may be an effective adjunctive therapy in patients with COVID-19-related ARDS. Oxygenation improves when PP is initiated early and performed for more than 10 h/d. The patient’s compliance is crucial, and several attempts should be made to find the best interface to fit every patient. |
251 | January-February | Nikam PP et al. | 10.18311/jeoh/2020/25676 | 2021 | India | N/A | To study the effect of twist and raise walking technique on ICU-acquired Weakness | Analytical: Cohort study | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 32 | N/A | twist and raise walking technique for a period of 7 days | N/A | inspiratory hold duration and forced expiratory volume | N/A | N/A | N/A | N/A | N/A | N/A | The aim of the twist and raise walking technique was to facilitate chest expansion along with initiation of early ambulation in order to reduce the possible complications of ICU acquired weakness in 32 COVID-19 subjects. Clinically significant results were seen in post-test scores of all the subjects in terms of Inspiratory Hold Capacity as well as Forced Expiration Volume This technique can be advocated as a effective rehabilitation intervention especially in COVID-19 patients to minimize the possible complications of ICU-acquired weakness. |
252 | January-February | Al Chikhanie Y et al. | 10.1016/j.resp.2021.103639 | 2021 | France | From 2019 to 2022 | To evaluate the effects of pulmonary rehabilitation post-ICU in COVID-19 patients | Analytical: Cohort study | General postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 21 | N/A | Pulmonary rehabilitation: respiratory exercises, muscle strengthening, balance and walking when possible, cycling and gymnastic | Non-COVID-19 Respiratory failure post-ICU (N=21) | 6MWT | N/A | N/A | N/A | N/A | N/A | N/A | Twenty-one COVID-19 patients were evaluated pre- and post-polmunary rehabilitation and compared retrospectively to a non− COVID-19 group of 21 patients rehabilitated after ICU admission due to respiratory failure. Polmunary rehabilitation induced greater 6-min walking distance improvement in COVID-19 patients than in other respiratory failure patients post-ICU. The sooner Polmunary rehabilitation was performed post-ICU, the better patients recovered. This treatment induced large functional improvements in COVID-19 patients post-ICU although significant physical and psychosocial impairments remained. |
253 | January-February | Jaywant A et al. | 10.1101/2020.10.28.20221887 | 2020 | USA | From April-July 2020 | To evaluate the frequency, severity, and profile of cognitive dysfunction in hospitalized patients recovering from COVID-19. | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 57 | N/A | N/A | N/A | Brief Memory and Executive Test | N/A | N/A | N/A | N/A | N/A | N/A | This study included a cohort of 57 patients participating in inpatient rehabilitation (75% male, mean age 64.5 years). Patients were evaluated at a mean of 43.2 days post-admission. 81% of patients had cognitive impairment, ranging from mild to severe. Deficits were most common in working memory (55% of patients impaired), set-shifting (47%), divided attention (46%), and processing speed (40%). Medically stable inpatients recovering from COVID-19 commonly have deficits in attention and executive functions. These deficits were not significantly correlated with length of intubation or time since extubation. Findings suggest that easy to disseminate interventions that remediate attention and executive dysfunctions may be important in this population. |
254 | January-February | Hall J et al. | 10.1136/thoraxjnl-2020-215861 | 2021 | UK | Until the end of May, 2020 | To understand outcome of post COVID-19 patients at 4 weeks follow-up. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 200 | N/A | N/A | N/A | Persistence of symptoms, radiological follow-up (dual energy CT or high-resolution CT), 6-MWT. | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19 patients that needed hospitalization in a UK hospital where interviewed telephonically 4 weeks after discharge. If there was a persistance of symptoms a clinical and radiological follow up was offered. More than a third of 1,272 patients interviewed (321, 34%) reported persistance of symptoms and were invited to a follow-up; the study reports the firs 200 cases. Of those 200, 170 were able to perform 6-MWT. In 80/200 (40%) patients it was possible to find at follow up a cardiorespiratory cause for breathlessness: 64 patients had persistent parenchymal abnormality, 4 had pulmonary embolism, 8 cardiac complications, 2 lung infarcts and 2 bacterial infections. Due to these findings, the authors suggest symptoms screening in the following weeks after COVID-19. |
255 | January-February | Baricich A et al | 10.23736/S1973-9087.21.06699-5 | 2021 | Italy | From March 1 to May 30, 2020 | To assess the physical and functional mid-term sequelae in COVID-19 survivors. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 204 | N/A | N/A | N/A | SPPB | N/A | N/A | N/A | N/A | N/A | N/A | The study analyzed 204 COVID-19 patients 6 to 3 months after discharge from hospitalization. Enrolled patients had a mean age of 57.9 years. Almost a third of recruited patients presented a SPPB score <=10 (32%, 66) indicating physical impairment. Those patients presented longer median hospitalization than patients with SPPB score>10 (14 vs 8 days, p=0.01). Furthermore, the authors observed a significant correlation between ICU hospitalization and mechanical ventilation and physical impairment. |
256 | January-February | Hameed F et al | 10.1002/pmrj.12578 | 2021 | USA | April - July, 2020 | To provide clinical care to patients who were suffering from persistent symptoms of COVID-19. | Analytical: Case-control study | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 106 | N/A | Virtual Physical Therapy | Home Physical Therapy, Independent Exercise Program, No therapy | 30SSTS, 2MST | N/A | N/A | N/A | N/A | N/A | N/A | The authors of the study recruited 106 patients still presenting symptoms such as weakness, fatigue, shortness of breath. After virtual assessment, based on physical tests such as 30SSTS and 2MST, and on the mini-MOCA test, patients were assigned either on a virtual physical therapy program, an independent exercise program, or, in case the patient was already undergoing home physical therapy, he was asked to continue the current program. Virtual physical therapy program consisted in one to two sessions per week, each lasting from 30 to 60 minutes, where the patients were given guidelines of how frequently to perform their exercise program independently at home, outside of therapy sessions. Out of 106 patients, 44 patients performed virtual physical therapy, 25 patients performed home physical therapy, seventeen patients performed independent unsupervised exercise, and 20 patients were referred to virtual or home physical therapy but did not perform any therapy. At two weeks follow-up, 65% of patients in the virtual physical therapy group and 88% of patients in the home physical therapy group met the clinically meaningful difference for improvement in sit-to-stand scores, compared with 50% and 17% of those in the independent exercise group and no-exercise group (p=0.056). 74% of patients in the virtual physical therapy group and 50% of patients in the home physical therapy group, independent exercise and no-exercise groups met the clinically meaningful difference for improvement in the step test (p=0.12). |
257 | January-February | Archer SK et al | 10.1016/j.apmr.2021.01.063 | 2021 | UK | From April 1 to May 31, 2020 | To evaluate the presentations and outcomes of inpatients with coronavirus disease 2019 (COVID-19) presenting with dysphonia and dysphagia to investigate trends and inform potential pathways for ongoing care. | Analytical: Cohort study | Rehabilitation in acute care | Epidemiology - Clinical presentation | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 164 | N/A | N/A | N/A | Clinical and demographical data, percentage of patients with dysphonia or dysphagia at discharge, percentage of patients decannulated. | N/A | N/A | N/A | N/A | N/A | N/A | The authors present the data gathered by the Speech and Language Therapy about hospitalized COVID-19 patients. The majority of the 164 patients included were men (106). More than half (70.9%) of the 86 tracheostomized patients were decannulated during the study, with no failed decannulations. Patients were followed by the Speech and Language Therapist by a median of 11 days (range 6-20). Baseline assessments showed marked impairments in dysphagia and voice, but there was significant improvement in all during the study (P<.0001). Most of the patients were eating and drinking normally on discharge, but 29.3% of those with dysphagia and 56.1% of those with dysphonia remained impaired at hospital discharge. |
258 | January-February | Blair P et al | 10.1093/ofid/ofab007 | 2021 | USA | From April 21 to July 23, 2020 | To determine the progression of COVID-19 and determinants of hospitalization. | Analytical: Cohort study | N/A | Epidemiology - Clinical presentation | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 118 | N/A | N/A | N/A | Clinical and demographical data, symptoms progression | N/A | N/A | N/A | N/A | N/A | N/A | Patients resulted positive for SARS-COV-2 were recruited by phone. COVID-19 cases who needed hospitalization were excluded. Out of 475 patients assessed for eligibility, 118 were enrolled and were sent a kit containing a thermometer, a pulse oximeter, and supplies for self-testing. The day they received the kit was considered day 0 and patients were tested by phone. The other timepoints were day 3, 7, 14, 21. Finally, participants attended an in-person follow-up visit between day 28 and 60 if they were asymptomatic at the time. The median age of the selected patients was 56 (interquartile range 50-63). The patients at enrollment presented symptoms from a median of 8 days. Participants returned to their usual health a median of 20 days from symptom onset, and 66.0% of enrolled patients were at their usual health during the fourth week of illness. In day 28 of observation, only 7.6% patients required hospitalization. |
259 | January-February | Núñez-Cortès et al | 10.1177/1479973121999205 | 2021 | Chile | From August 4 to September 11, 2020 | To evaluate the physical capacity and exertional desaturation one month after discharge in a sample of patients who survived COVID-19 pneumonia. | Analytical: Cross-sectional study | N/A | Epidemiology - Clinical presentation | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 50 | N/A | N/A | N/A | 1STST, percentage of patients with decrease of oxygen saturation < 4% during the execution of the test. | N/A | N/A | N/A | N/A | N/A | N/A | COVID-19 patients were recruited for this study 4 weeks after hospital discharge. A total of 50 partecipants were tested with 1STST, and were divided in two groups depending on the length of stay: 14 patients had an hospital stay of 10 days or under, while 36 patients had an hospital stay of more than 10 days. Patients were able, on average, to have 20.9 ± 4.8 repetitions; 42% were under the 2.5th percentile of predicted value, and 90% were under the 25th percentile. The group of patients who had a prolonged hospital stay had significant increase in exertional desaturation and dyspnea compared to patients with shorter hospital stay. Overall, the vast majority of hospitalized COVID-19 patients had decreased performance at 1STST after 4 weeks from discharge. |
260 | March-April | Abodonya AM et al. | 10.1097/MD.0000000000025339 | 2021 | Saudi Arabia | N/A | To assess the efficacy of IMT on COVID-19 following mechanical ventilation. | Pilot controlled trial | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 42 | N/A | 2-week IMT | No treatment | FVC%, FEV1%, DSI, 6-MWT, EQ-5D-3L. | N/A | N/A | N/A | N/A | N/A | N/A | In this study patients were recruited after weaning from intubation. Half of the patients (21) were allocated in the IMT group, and half in the control group. The two groups were not different at baseline regarding their clinical characteristics. Patients that received a 2-weeks IMT program showed, at the 2 weeks time point, an improvement in pulmonary functions (FVC%, FEV1), dyspnea (DSI), functional performance (6-MWT), and QOL (EQ-5D-3L). |
261 | March-April | Adly AS et al. | 10.2196/23446 | 2021 | Egypt | N/A | To compare two nonpharmacological respiratory treatment methods for home-isolated COVID-19 patients using a newly developed telemanagement health care system | Randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 60 | N/A | Osteopathic manipulative respiratory and physical therapy techniques | Oxygen therapy with B-PAP | Primary outcome: Time needed to reach normal levels of both pO2 and pCO2, which were assessed every 48 hours. Secondary outcome measures were temperature, respiratory rate, oxygen saturation, heart rate, and blood pressure, which were evaluated every 24 hours. | N/A | N/A | N/A | N/A | N/A | N/A | In the present study patients were recruited during acute stage of COVID-19, and were divided in two groups of 30 patients each, one treated with oxygen therapy with B-PAP and one with osteopathic manipulative respiratory and physical therapy techniques. Since patients were isolated at their respective home, all the patients where monitored using telemedicine. A real-time videoconference was established between the patient and the physiotherapist for training, directing, and supervising the patient during self-application of osteopathic and physical therapy treatments. The results of the study show that home-based oxygen therapy with B-PAP can be a more effective prophylactic treatment approach than osteopathic manipulative respiratory and physical therapy techniques, as it can impede exacerbation of early-stage COVID-19 pneumonia. Telemanagement health care systems are promising methods to help in the pandemic-related shortage of hospital beds, as they showed reasonable effectiveness and reliability in the monitoring and management of patients with early-stage COVID-19 pneumonia |
262 | March-April | Ahmed I et al. | 10.1080/21679169.2021.1909649 | 2021 | Pakistan | N/A | To determine the effect of moderate to high-intensity aerobic and breathing exercise on cardiorespiratory fitness and health-related Quality of Life in post-discharge COVID-19 patients | Analytical: Cohort study | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 20 | N/A | Five weeks (3 sessions/week) of aerobic training (20–60 min/session) and breathing exercise training (10 min/session). | N/A | 6-minute walking test, SF36, Modified Borg dyspnoea | N/A | N/A | N/A | N/A | N/A | N/A | This study reports 20 post-discharge COVID-19 patients (13 males, mean age 39.6, mean 26.1 post-COVID-19 days) underwent five weeks of aerobic training and breathing exercise training. Sub-group analysis according to inpatient ventilatory support used in the active course of the disease was also performed (10 subjects per group). Cardiorespiratory fitness, dyspnoea, and quality of life significantly improved after training. Both subgroups improved over time in measures of endurance, dyspnoea, and quality of life. An increase in exercise tolerance was observed in subjects who did not use inpatient ventilatory support. The same subjects showed a trend towards greater improvement in General health and Body pain domains of health-related quality of life and dyspnoea. This study suggests that rehabilitation training may further functional recovery in post-discharge COVID-19 patients. |
263 | March-April | Betschart M et al. | 10.3390/ijerph18083978 | 2021 | Switzerland | From March 2020 to June 2020 | To present feasibility data of outpatient pulmonary rehabilitation and to provide preliminary data on the outcomes of outpatient pulmonary rehabilitation with specific information on dose and training intensities. | Analytical: Cohort study | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 12 | N/A | Pulmonary Rehabilitation program :twice weekly, interval-based aerobic cycle endurance training, followed by resistance training; 60–90 min per session at intensities of 50% peak work rate; education and physical activity coaching were also provided. | N/A | Dropouts, number of training sessions undertaken, tolerability for dose and training mode, 6MWT, Medical Research Council Dyspnea Scale, EQ-5D-5L VAS , Post-COVID-19 Functional Status scale, FSS | N/A | N/A | N/A | N/A | N/A | N/A | This study reports 12 patients underwent a rehabilitation program at 41,5 days from COVID-19 diagnosis. Three dropouts (25%) were reported after 11–19 sessions. Tolerability of interval-based training was 83% and 100% for exercise duration of aerobic cycle endurance and resistance training, respectively; 92% for training intensity, 83% progressive increase of intensity, and 83% mode in aerobic cycle endurance . The authors suggest from these preliminary findings that the protocol used may be feasible, and confer benefits to a small subgroup of patients recovering from COVID-19. |
264 | March-April | Blanco et al. | 10.1016/j.cmi.2021.02.019 | 2021 | Spain | N/A | To describe lung function in patients recovering from COVID-19 hospitalization and to identify biomarkers in serum and induced sputum samples from these patients. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 100 | N/A | N/A | N/A | Clinical and laboratory parameters, pulmonary function tests, 6-MWT and chest CT. | N/A | N/A | N/A | N/A | N/A | N/A | Patients hospitalized for COVID-19 were studied at a median time of 104 days after symptoms onset. Almost half of them (47%) had severe COVID-19. Thorax CT scan were normal in 48% of patients. DLCO was =>80% in just 48% of patients. DLCO < 80% and a lower serum lactate dehydrogenase level were associated with the severe disease. Patients with DLCO<80% were able to walk a significantly lower distance during 6-MWT than patients with DLCO=>80% (513 vs 577 meters on average). Furthermore, only 39.2% of patients with DLCO<80% were able to walk more than 550 meters at 6-MWT, compared to 66% of patients with DLCO=>80%. In total, 51 out of 100 patients were able to walk more than 550 meters at 6-MWT. |
265 | March-April | Buccafusca M | 10.1007/s10072-020-05001-4 | 2021 | Italy | From 08 March 2020 to 30 May 2020 | To describe the natural history of PD patients hospidalized for COVID-19 infection | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | COVID-19 with PD | 12 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study reports 12 patients affected by PD who became infected with SARS-Cov-2 in a care residency, and thus hospitalised in a COVID hospital. Most PD patients had a long disease duration and multiple comorbidities. Despite lung conditions, most PD patients in this study had mild symptoms: 7 patients were clinically asymptomatic (58.3%); 3 patients had fever, cough, and myalgia (25%) and 2 patients had dyspnoea (16%) that needed high-flow oxygen therapy. All patients were discharged after a mean hospitalisation period of 30 days. The mortality rate during hospitalization was zero. SARS-CoV-2 infection did not have a poor prognosis in this cohort of PD patients. |
266 | March-April | Cao J et al. | 10.1177/ 17534666211009410 | 2021 | China | From January 22 to March 7, 2020 | To evaluate the outcomes of patients with COVID-19 at 1 and 3 months after discharge using: clinical features, blood tests, chest CT, pulmonary function, exercise capacity, and SF-36. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 81 | N/A | N/A | N/A | Chest CT abnormalities, pulmonary function test, 6-MWT, SF36 | N/A | N/A | N/A | N/A | N/A | N/A | At 3 months follow-up, chest CT abnormalities were present in more than half of COVID-19 survivors (54%) and worse chest CT scores were independently associated with older age and steroid administration during hospitalization. Residual pulmonary function impairments were modest, whereas exercise capacity and SF-36 scores were significantly lower than the general population. Support program and further follow-up evaluations may be needed. |
267 | March-April | Chiu M | 10.1016/j.jcjq.2021.02.007 | 2021 | USA | From March 30, 2020, to May, 22, 2020 | To outline the development and implementation of an efficient interdisciplinary team dedicated to the critical need of PP interventions. | Analytical: Cohort study | Rehabilitation in acute care | Meso Level | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 100 | N/A | Development of a Prone Team during the pandemic | N/A | number of daily interventions provided by the Prone Team, adverse events | N/A | N/A | N/A | N/A | N/A | N/A | During the COVID-19 pandemic, the Prone Team was developed to respond to the rapidly growing number of patients with respiratory distress. A group of physical therapists and occupational therapists (PT/OTs) with ICU experience was redeployed from their regular roles to receive intensive training in PP from an experienced medical ICU registered nurses. As the workload increased, additional PT/OTs were recruited to the team. A coordinating structure comprising attending pulmonologists screened and advised on appropriate patients. A communication and feedback structure was also implemented. Over a period of seven weeks, the team provided PP to more than 100 patients, with 577 individual interventions in a total of 14 ICUs and one emergency department. The patients remained prone for a median of 19 hours per session.There were no major airway or central venous access complications, and only one anterior pressure injury was recorded.The rapid implementation of an interdisciplinary PP team in a crisis situation is feasible. It can provide a safe and efficient alternative to adding to the workload of an overloaded nursing staff. |
268 | March-April | Darley et al. | 10.5694/mja2.50963 | 2021 | Australia | May - July 2020 | To assess the prevalence and nature of persistent symptoms; to evaluate lung function, health- related quality of life, neurocognitive and olfactory abnormalities during the recovery period, and to characterise the longitudinal immune response to infection. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 78 | N/A | N/A | N/A | Complex lung function testing, computerised CogState Cognitive Test Battery, NIH Toolbox Odor Identification test,Depression in the Medically Ill questionnaire (DMI- 10), post COVID-19 maniefestations | N/A | N/A | N/A | N/A | N/A | N/A | Seventy-eight patients were assessed at a median 69 days after diagnosis. Thirty-one patients had persistent symptoms, including fatigue (n: 17), shortness of breath (n: 15), and chest tightness (n: 14). Sixty- five patients underwent complex lung function testing at a median of 113 days after COVID-19 diagnosis. Total lung capacity was abnormal in 18 patients, hospitalised patients have a significantly lower median total lung capacity compared to community-treated patients (P = 0.023). Eight patients were cognitively impaired, while five patients had mild and three had moderate cognitive impairment. Sixteen patients reported symptoms of depression. |
269 | March-April | Daunter AK et al. | 10.1002/pmrj.12624 | 2021 | USA | From March 4, 2020 and May 1, 2020. | To examine the prevalence of functional decline and related rehabilitation needs at hospital discharge | Analytical: Case-control study | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 288 | N/A | N/A | N/A | Discharge location; need for outpatient physical, occupational, or speech therapy; need for durable medical equipment at discharge; presence of dysphagia at discharge; functional decline measured by ?????. | N/A | N/A | N/A | N/A | N/A | N/A | This study included 288 COVID-19 subjects (mean age 66.80±15.31 years, males 57.6%; Length of stay 13.40±12.84). 17% were deceased at the time of discharge, 63,5 % of COVID-19 survivors were discharged to home, 12,8 % to subacute rehabilitation or Skilled Nursing Facility, 1.7% were transferred to another acute care hospital or field hospital, 1.7% were transferred to a Long Term Acute Care Hospital. Additionally, 1.4% transferred to an unaffiliated acute inpatient rehabilitation hospital. 45% percent of survivors experienced functional decline impacting their discharge, as they required additional physical, occupational, or speech therapy at discharge (80.6%); new durable medical equipment needs (67.6%); or diet modifications for dysphagia (at least 26.7%). 40.6% of the survivors were never assessed by a PM&R physician, physical therapist, occupational therapist, or speech language pathologist during their hospitalization. Length of stay as well as days on ventilator differed significantly between those who did and did not show functional declines: Those who showed functional decline had significantly longer length of stay (21.70±14.64 vs 6.21±5.61) and were mechanically ventilated longer (mean =6.96±9.69). The authors conclude that the results support the need for rehabilitative services during and after hospitalization for COVID-19. |
270 | March-April | Debeaumont D et al. | 10.1093/ptj/pzab099 | 2021 | France | Up to November 2020 | To assess physical fitness and its relationship with functional dyspnea in in COVID-19 survivors at 6 months after their discharge from hospital | Descriptive: Historical cohort | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Chronic | COVID-19 | 23 | N/A | N/A | N/A | mMRC dyspnea score, pulmonary function testing, respiratory muscle testing, arterial blood gas measurements and cardiopulmonary exercise testing, thorugh an electromagnetic ergometer, dyspnoea Borg scale, muscle fatigue Borg scale | N/A | N/A | N/A | N/A | N/A | N/A | At 6 months after discharge from hospital, dyspnoea was the most frequent persistent symptom (78%) in post-COVID-19 patients. The mean mMRC dyspnea score was 1 and was significantly associated with VO2peak (%) (rho = -0.49; P = 0.019). Considering the hospitalization of study participants, the ones previously hospitalized in general ward had a slightly reduced VO2peak (87%), whereas the ones previously hospitalized in ICUs had a moderately reduced VO2peak (77%). |
271 | March-April | Erben Y et al. | 10.1016/j.jvsv.2021.03.009 | 2021 | USA | From March 11, 2020 to September 4, 2020. | To assess the incidence of DVT and PE in hospitalized COVID-19 patients and to compare the incidence with that in a non-COVID-19 cohort, matched for cardiovascular risk factors. Secondary aim was to study the effects of DVT/PE on the hospital course and early outcomes. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 915 | N/A | N/A | N/A | Primary: incidence of DVT and PE | N/A | N/A | N/A | N/A | N/A | N/A | This is a retrospective review of data from 915 hospitalized COVID-19 patients ( mean age was 60.8, 43.3% were women). The incidence of DVT and pulmonary embolism in 915 hospitalized patients with COVID- 19 was 9.0% at a mean point after admission of 13.1 (+-19.9 days) greater than the 0.6% incidence in the matched non-COVID-19 cohort. Patients with COVID-19 who developed DVT/PE had greater mortality, more ICU admissions, a longer ICU stay, and longer hospitalization compared with hospitalized COVID-19 patients without DVT/PE. The vascular risk factors were not different between the COVID-19 patients with and without DVT/PE. IL-6 was associated with a greater risk of rehabilitation placement after discharge. Advancements in DVT/PE prevention are needed for patients hospitalized for COVID-19 infection. |
272 | March-April | Fayol A et al. | 10.1002/ehf2.13315 | 2021 | France | March - April 2020 | To report the presence and quantify the extent of myocardial functional alterations in patients hospitalized 6 months earlier for COVID-19 infection | Analytical: Case-control study | N/A | Epidemiology - Natural history/Determining and modifying factors | Cardiovascular functions (Heart b410) | Chronic | COVID-19 | 48 | N/A | N/A | N/A | Rest and low-level exercise transthoracic echocardiography, presenc of chest pain, dyspnoea, asthenia, and cough | N/A | N/A | N/A | N/A | N/A | N/A | At 6 months after discharge from hospital, 60.4% of post-COVID-19 patients still reported clinical symptoms including exercise dyspnoea for 56% and asthenia for 21%. Dividing the cohort in two sub-groups according to the occurrence of myocardial injury (MI) during COVID-19 hospitalization, a low-level exercise induced a significant increase in the average septal-lateral E/e′ ratio (10.1±4.3 vs. 7.3±11.5; p=0.01) and the systolic pulmonary artery pressure (33.4±7.8 vs. 25.6±5.3 mmHg; p=0.02) in patients that previously had a myocardial injury. However, in spite of increased cardiac diastolic abnormalities observed in patients who experienced MI, no significant differences were observed in the rate of the most prevalent symptoms between subgroups: dyspnoea was present in 62% cases with MI vs 53% in cases without MI, asthenia in 25% with MI vs 19% without MI. |
273 | March-April | Gianella et al. | 10.1186/s12890-021-01509-3 | 2021 | Switzerland | March - April 2020 | To describe clinical, radiological, lung function parameters and self-reported quality of life (QoL) of patients with SARS-CoV-2 pneumonia, both at diagnosis and at three-month follow-up. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 39 | N/A | N/A | N/A | abnormalities on CT scans, complex lung function testing, St. George’s Respiratory Questionnaire, SF-12 | N/A | N/A | N/A | N/A | N/A | N/A | Thirtynine patients were enrolled in the study. At three months, 82% of the cohort had persisting abnormalities on CT scans, while a statistically significant reduction in the CT score were recorded. Reduced DLCO and/or restriction were found in 64.1% of patients. In addition, SpO 2 impairment during 6MWT was reported (91.3% ± 3.5). Abnormal total score on the St. George’s Respiratory Questionnaire was reported in 79.5% of patients, while all patients reported an abnormal SF-12 score. |
274 | March-April | González et al. | 10.1016/j.chest.2021.02.062 | 2021 | Spain | Between March and June, 2020 | To report a descriptive observational cohort of patients with COVID-19 admitted to ICU . | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 62 | N/A | N/A | N/A | Pulmonary function tests, 6-MWT, chest CT, HADS, SF-12. | N/A | N/A | N/A | N/A | N/A | N/A | The study reports an observational cohort of post ICU COVID-19 patients including 62 patients, who were tested at 3-months follow-up. Pulmonary function testing showed a DLCO < 80% in 82% of patients. The median distance convered in the 6MWT was 400 m. CT scans showed abnormal results in 70.2% of patients, associated with decresead pulmonary function. Three months after hospital discharge, pulmonary structural abnormalities and functional impairment were highly prevalent in patients with ARDS secondary to COVID-19 who required an ICU stay. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months after discharge. |
275 | March-April | Hoyois A et al. | 10.1002/jpen.2101 | 2021 | Belgium | From 15 April to 1 June, 2020. | To assess the nutritional status of critical COVID-19 patients when discharged from the ICU, evaluate if and how the nutritional recommendations (30 kcal/kg/day and 1,5g of proteins/kg/day) are met during the rehabilitation period and measure the evolution of nutrition parameters such as weight, body mass index and muscular strength (hand grip and mid-arm circumference). | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Digestive functions (b510) | Post-acute | COVID-19 | 15 | N/A | N/A | N/A | Anthropometric measurements, handgrip strength. | N/A | N/A | N/A | N/A | N/A | N/A | Fifteen patients were studied at ICU discharge and 15,30 and 60 days later. Inclusion criteria included previous mechanical ventilation and at least 14 days of stay in ICU. After ICU discharge all the patients presented malnutrition. All the patients underwent inpatient rehabilitation and nutritional supplement after ICU discharge (median stay 38 days, range 26-51). Dysphagia was present in 60% of patients, who needed enteral nutrition. After 2 months, a signfiicant improvement in handgrip strength and weight was observed |
276 | March-April | Iqbal A et al. | 10.7759/cureus.13080 | 2021 | Pakistan | September - December 2020 | To investigate the stigma associated with being a COVID-19 survivor and explore probable post-COVID-19 rehabilitation strategies for the hospital- and home-treated COVID-19 patients. I MAIN FINDINGS NON PARLANO DISTIGMA MA DI ALTRE MISURE DI OUTOME | Analytical: Cross-sectional study | Specialized postacute rehabilitation | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 158 | N/A | N/A | N/A | Sociodemographic data, post-COVID-19 manifestations, questions relating to the stigma, EQ5D5L | N/A | N/A | N/A | N/A | N/A | N/A | Almost all patients (94.9%) experienced at least one post-COVID-19 symptom. Fatigue (82.9%) was the most prevalent post-discharge manifestation. The patients affirmed to have dypnoea in 50% of cases and joint pain in 47.5%. There was a statistically significant relation of age with the presence of post-COVID-19 manifestations such as dyspnea (p=0.007) and joint pain (p<0.001). A significantly higher number of females suffered from persistent COVID-19-associated symptoms, as fatigue (58.8%), anxiety (66.7%), and joint pain (64%). |
277 | March-April | Jain E et al. | 10.1002/pmrj.12607 | 2021 | USA | From April 9th to September 1st, 2020 | To determine the functional outcomes and utilization of follow up medical care 90 days following discharge from acute inpatient rehabilitation, as compared to rehabilitation impairment in age matched controls. | Analytical: Cohort study | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 18 | N/A | N/A | 18 Matched Control Patients were selected based on having the same admitting impairment group category and similar age | Functional outcomes(GG Self-Care and Mobility Activities items), hospital readmissions, and follow- up care sought by patients | N/A | N/A | N/A | N/A | N/A | N/A | Patients with COVID-19 compared to the control group had a significantly longer acute hospitalization length of stay of 18 days as compared to 9 days, respectively .More patients with COVID-19 required oxygen during acute hospitalization as compared to controls. The COVID-19 patient group had similar improvements in functional outcomes as compared to controls. All patients were discharged home, with the majority of patients in both cohorts receiving home care services such as visiting nurses or therapy. Patients with COVID-19 required fewer readmissions than their matched controls in the 30-90-day periods and required fewer follow up visits with specialists after discharge from the Inpatient Rehabilitation Facility .The functional outcome data suggest that COVID-19 patient group recovered with similar rehabilitation efficiencies to their controls. Patients with functional deficits as a result of COVID-19, requiring multiple therapy disciplines should be considered for acute inpatient rehabilitation as this study demonstrates their ability to participate in and benefit from Inpatient Rehabilitation Facility level care. |
278 | March-April | Journeay et al. | 10.2340/20030711-1000053 | 2021 | Canada | April-June 2020 | To describe the sociodemographic features, impairments, and functional changes of COVID-19-positive individuals who underwent inpatient rehabilitation | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Prevalence | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 41 | N/A | N/A | N/A | LOS in rehabilitation hospital, admission and discharge total FIM score; admission Montreal Cognitive Assessment (MoCA) score, number of readmissions to acute care | N/A | N/A | N/A | N/A | N/A | N/A | Forty-one patients were assessed after 19 days from COVID-19 diagnosis at admission to a rehabilitation hospital. 9.8% of patients were already disabled before COVID-19. The most commonly affected body functions were: neuromusculoskeletal (73.2%), cardiovascular, hematological, immunological, and respiratory (65.9%), and mental functions (29.3%). The median rehabilitation LOS was 16 days (IQR 13–22), with an admission total FIM of 85 (IQR 75–97) and discharge total FIM of 108.5 (IQR 103–118). |
279 | March-April | Kikutani T | 10.3390/nu13041113 | 2021 | Japan | May -June 2020 | To examine the relationship between eating/swallowing function and COVID-19 infection in schizophrenic patients | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Digestive functions (b510) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | COVID-19 with schizophrenia | 44 | N/A | N/A | N/A | Food Intake Level Scale | N/A | N/A | N/A | N/A | N/A | N/A | This study included 44 patients (mean age of 68.86 years) with confirmed COVID-19 who were admitted to the psychiatric ward to treat schizophrenia. The mean duration of hospitalization for COVID-19 infection was 32.1 ± 19.1 days (range: 8–83 days). Pre-infection, 20 subjects had a FILS score of 7–9 (presence of eating/swallowing disorder) and 24 subjects had a score of 10 (normal). Eating function after infection resolution showed decreasing FILS score in 14 subjects. Six subjects transitioned from oral feeding to parenteral feeding. A ≥ 10% weight loss during infection treatment was significantly associated with decreased eating function and a transition to parenteral feeding. In schizophrenic patients, who are already prone to experiencing decreased swallowing function, weight loss due to COVID-19 infection is a major risk factor for further decrease in eating/swallowing function. Preventing malnutrition during treatment for COVID-19 is important to improve post-infection prognosis and maintain quality of life. |
280 | March-April | Leite et al. | 10.1016/j.apmr.2021.03.001. | 2021 | Brazil | From March 15 to August 27, 2020 | To report symptoms, disability and rehabilitation referral rates after COVID-19 hospitalization in a large, predominantly elderly population. | Analytical: Cross-sectional study | Rehabilitation services at home | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 1696 | N/A | N/A | N/A | Clinical history and actual clinical data, independece measured using BI and IADLs scale. | N/A | N/A | N/A | N/A | N/A | N/A | In this cross-sectional study a total of 1,733 individuals were screened, and 1,696 were included in the study, 3 months after COVID-19 onset. Out of all the patients, 21.0% were admitted to the ICU at any point during their hospitalization. Patients who were admitted to ICU presented worse post-discharge outcomes, including higher incidence of symptoms like shortness of breath, and lower independence in ADLs and IADLs. A rehabilitation plan, consisting in an exercise booklets, was offered to 65.5% of patients. Post-discharge patients at 3-month follow up presented high levels of disability and dependance, especially patients who needed ICU stay. |
281 | March-April | Liu K et al. | 10.1016/j.ctcp.2020.101166 | 2020 | China | From January 1 to February 6, 2020 | To investigate the effects of 6-week respiratory rehabilitation training on respiratory function, QoL, mobility and psychological function in elderly patients with COVID-19. | Randomised controlled trial | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 72 | N/A | Respiratory rehabilitation (36 cases) | No rehabilitation (36 cases) | pulmonary function tests including plethysmography and DLCO, functional tests (6-MWT), QoL assessments (SF-36), ADL (FIM), and mental status tests (anxiety and depression). | N/A | N/A | N/A | N/A | N/A | N/A | Seventy-two COVID-19 patients aged 65 years old or more with no cognitive impairment were recruited for this study. Patients were randomized to receive respiratory rehabilitation, including respiratory muscle training, cough exercises, diaphragmatic training, stretching exercises, and home exercises (intervention group) or no treatment. The results of the study show that the six-week respiratory rehabilitation program can improve respiratory function (FEV1, FVC%), endurance (6-MWT), QoL (SF-36) and anxiety of elderly patients with COVID-19, but it provides little benefit on depression in the elderly |
282 | March-April | Liu M | 10.3389/fmed.2021.636298 | 2021 | China | From February 10, 2020 to March 23, 2020. | To verify the existence of long-term pulmonary sequelae in COVID-19 survivors | Analytical: Case-control study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Chronic | COVID-19 | 41 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 41 COVID-19 patients performed follow-up chest CT and cardiopulmonary exercise testing at 7 months after discharge. Patients were divided into fibrosis group (12 cases) and non-fibrosis group (29 cases) according to the evidence of fibrosis on follow-up CT. The predominant CT patterns of abnormalities observed at 7 months after discharge were parenchymal band (41%), interlobular septal thickening (32%), and traction bronchiectasis (29%). Sixty-one percent of the patients achieved complete radiological resolution, and 29% of patients developed pulmonary fibrosis. Compared with the patients in the non-fibrosis group, the patients in the fibrosis group were older, with a longer hospital stay, a higher rate of steroid and mechanical ventilation therapy, lower levels of lymphocyte and T cell count, higher levels of D-dimer and lactic dehydrogenase, and higher quantitative CT parameters at discharge. Age, steroid therapy, presence of traction bronchiectasis on chest CT at discharge, and opacity score at discharge, were independent risk factors for developing pulmonary fibrosis at 7 months after discharge. The combined clinical-radiological model may predict the formation of pulmonary fibrosis early. |
283 | March-April | Liu Y et al. | 10.1080/13548506.2021.1916956 | 2021 | China | From March 2020 | To assess the effects of a psychological intervention combined with pulmonary rehabilitation exercises on anxiety and sleep disorders in patients with mild COVID-19 | Randomised controlled trial | General postacute rehabilitation | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 140 | N/A | Group psychological intervention and pulmonary rehabilitation exercises (70 cases) | Standard care according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (National Administration of Traditional Chinese Medicine, National Health Commission of China, 2020), which included monitoring body temperature, pulse and heart rate; effective oxygen therapy and aerosol inhalation; instructing patients to rest in bed, drink more warm water and eat nutritious and light meals. (70 cases) | State Anxiety Inventory, Pittsburgh Sleep Quality Index | N/A | N/A | N/A | N/A | N/A | N/A | The patients were enrolled in hospitals built to treat a huge number of mild COVID-19 patients to reduce ‘run-on-hospital’ phenomena. Through group psychological intervention combined with pulmonary rehabilitation exercises, anxiety and sleep disorders of the hospitalized patients with mild COVID-19 infections were significantly less than those of the control treated with conventional nursing methods . Many factors, e.g., gender, educational background, and underlying disease status, etc., were revealed at some extent to be related to the effects of the intervention and exercises. Since the COVID-19 disease has not been eliminated yet, this study could provide a nursing framework by establishing efficient social platforms and multiple interaction mechanisms among medical staff and patients. |
284 | March-April | Mallia P et al. | 10.1136/ bmjresp-2021-000908 | 2021 | United Kindom | From May 1 to July 21, 2020 | To collect symptomatic, radiographic, biochemical and healthcare utilisation data from patients with COVID-19 who attended a follow-up clinic after discharge from hospital in order to describe the recovery times for these parameters, examine the factors associated with symptomatic and radiographic recovery and record unscheduled healthcare use in these patients. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 401 | N/A | N/A | N/A | Time to clinic from discharge; Time to clinic from illness onset; Abnormal chest radiograph; Symptoms; C reactive protein; Ferritine; D-dimer | N/A | N/A | N/A | N/A | N/A | N/A | Most patients (75.1%) were symptomatic at a median 53 days post discharge and 72 days after symptom onset and chest radiographs were abnormal in 47.4%. Symptoms and radiographic abnormalities were similar in PCR-positive and PCR-negative patients. Severity of COVID-19 was significantly associated with persistent radiographic abnormalities and breathlessness. Almost 20% of patients (18.5%) had unscheduled healthcare visits in the 30 days post discharge. |
285 | March-April | Mateo S et al. | 10.1016/j.rehab.2021.101516 | 2021 | France | From April 20, 2020 to July 16, 2020 | To assess if FES-cycling used in combination with physiotherapy early after ICU discharge in patients with critical COVID-19 is safe to favour erectus position restoration and spontaneous walking resumption more rapidly than rehabilitation without FES-cycling. | Pilot controlled trial | General postacute rehabilitation | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 14 | N/A | functional electrical stimulation with cycling (n=8): 20 days for a total of 4 weeks, 2 sessions of physiotherapy (30 min each) and one 30-min session of cycling per day with FES | cycling alone (n=6) | Actimetry: Time spent in different posture/activities during daytime (min/day), manual muscle test using the MRC score , FEV1, FVC | N/A | N/A | N/A | N/A | N/A | N/A | This study included 14 patients admitted to the rehabilitation department after hospitalisation in the ICU for a critical form of COVID-19 (Intubation duration days: 14.5 for FES-cycling group and 20.5 for controls). As compared with cycling alone, FES-cycling was associated with greater beneficial decline in the daytime spent sedentary (e.g. lying, reclining or sitting), a higher increase in time spending walking or running. All patients progressively improved across rehabilitation weeks but patients who benefitted from FES-cycling had a significantly greater daily-life physical activity recovery profile as compared with the control group. These preliminary results suggest the interest of offering rehabilitation enriched by FES- cycling to patients with critical COVID-19 as soon as they leave the ICU even though the risk of contagion requires rehabilitation under conditions of strict isolation. Nevertheless, the effect of FES-cycling on this improved physical activity recovery profile remains to be understood because it was neither explained by nor associated with an increase in muscle strength or cardiorespiratory adaptation. |
286 | March-April | Medrinal C et al. | 10.1186/s12871-021-01274-0 | 2021 | France | Between March 16 and May 15, 2020 | To report the prevalence of limb and respiratory muscle weakness in COVID-19 ICU survivors and to analyse variables associated with muscle weakness. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-acute | COVID-19 | 23 | N/A | N/A | N/A | MIP, MRC, IMS | N/A | N/A | N/A | N/A | N/A | N/A | 23 patients with severe COVID-19 requiring intubation were evaluated at three timepoints: at extubation, at discharge from ICU and telephonically 30 days after discharge. All patients underwent rehabilitation in the ICU. Most patients (69%) had limb muscle weakness at extubation, and 26% of patients had both limb and respiratory muscle weakness. The number of sessions of physiotherapy was not associated with higher muscle strength. At the 30-days follow-up almost half of patients (44%) were not able to walk autonomously for 100 meters. |
287 | March-April | Milovancev et al. | 10.3390/ijerph18084059 | 2021 | Serbia | N/A | To assess the effects of COVID-19 in detraining on the cardiorespiratory status of volleyball athletes after COVID-19 infection | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 16 | N/A | N/A | N/A | Body composition, FVC, FEV1, FEV1/FVC, MVV, cardiopulmonary exercise testing (CPET), cardiorespiratory fitness, WE (W), VE, VO2, VCO2 (L/min), RER, VE/VCO2, O2 pulse, HR, VE/VO2 | N/A | N/A | N/A | N/A | N/A | N/A | Sixteen sixteen male Serbian first division volleyball players, aged 24 4.5 years, had a recent mild COVID-19 infection (symptom duration : one week on average; return to everyday sports activities: 3 weeks after symptom onset). They were assessed after 20 days of re-training. FVC, FEV1/FVC and MVV values were over 80% of predicted values [FVC(L)=5.3±2.2; FEV-1(L)=4.7±1.9; FEV1/FVC (%)=90.5±8.2; MVV=147.7±64.8(L/min)], while ECG testing revealed no cardiac abnormalities. VE, VCO2, RER and oxygen pulse increased, heart rate exceeded 90% of predicted values, and peak VO2 values were typical for this level of athlete (44.1 ± 3.4 mL/kg). VT1 (73%) and VT2 (92.5%) were above-average values. |
288 | March-April | Monti G et al. | 10.1111/aas.13812 | 2021 | Italy | February - April 2020 | To assess the quality of life of invasively ventilated COVID-19 ARDS survivors at the follow-up evaluation after ICU discharge | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 39 | N/A | N/A | N/A | GOSe, FAC, Borg CR-10 scale, MNA-SF, EQ-5D-3L, HADS, PTSD Checklist for DSM-5, ISI, Itel-MMSE | N/A | N/A | N/A | N/A | N/A | N/A | Thirty-nine patients were assessed at a median 61 (51-71) days after ICU discharge, reporting no difficulty in walking (82%), self-care (85%), and usual activities (78%). All patients were either malnourished (38%) or at risk for malnutrition (62%). Thus, the authors concluded that Invasively ventilated COVID-19 ARDS survivors have an overall good recovery at 2 months after discharge. |
289 | March-April | Musheyev B | 10.1186/s40560-021-00542-y | 2021 | USA | From 15 March 2020 to 29 June 2020 | To investigate the functional status of COVID-19 IMV survivors at ICU and hospital discharge, and to correlate it with some clinical variables. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 118 | N/A | N/A | N/A | The modified “Mental Status”, ICU Mobility, and Barthel Index scores at ICU and hospital discharge | N/A | N/A | N/A | N/A | N/A | N/A | This study investigated the functional status of 118 COVID- 19 IMV survivors at ICU and hospital discharge. The major findings were (i) the majority of patients (94%) were functionally independent prior to COVID-19 illness, but not at hospital discharge (22% discharged with a cane or rolling walker, 49% discharged with durable medical equipment, and 14% admitted to a rehabilitation facility), (ii) half of patients were discharged with supplemental oxygen equipment, (iii) the most prevalent medical follow-up recommendations were cardiology, vascular medicine, pulmonology, endocrinology, and neurology with many patients receiving multiple medical follow-up recommendations (iv) Functional status improved from ICU discharge to hospital discharge (v) worse functional status at hospital discharge was associated with longer IMV duration, older age, male sex, higher number of comorbidities, hypertension, diabetes, chronic obstructive pulmonary disease, and immunosuppression. The data suggested that most patients were not functionally independent, and many still had significant unresolved medical issues at hospital discharge. Follow-up studies are important to ascertain long-term outcomes and anticipate healthcare needs for COVID-19 survivors |
290 | March-April | Olezene CS | 10.1371/ journal.pone.0248824 | 2021 | USA | From April 29 to May 22, 2020 | To characterize the functional impairments of a cohort of patients undergoing inpatient rehabilitation after surviving severe COVID-19 illness, in order to better understand the ongoing needs of this patient population | Descriptive: Historical cohort | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 29 | N/A | N/A | N/A | BBS, 6MWT, 10MWT, FCM | N/A | N/A | N/A | N/A | N/A | N/A | This study described the clinical characteristics of a cohort of 29 patients (mean age of 59.5) who underwent inpatient rehabilitation following hospitalization for severe COVID-19. The mean length of acute hospitalization was 32.2 days with a mean of 18.7 days intubated. Dysphagia (86.2%), weight loss (79.3%), and delirium (69%) were the most common complications. 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. At discharge, a significant portion of the population continued to deficits in cognition (attention 37%; memory 28%; problem-solving 28%), balance (55%), and gait speed (97%). These data highlight the post-acute care needs of this patient population. |
291 | March-April | Ordinola Navarro A et al. | 10.1016/j.rmed.2021.106391 | 2021 | Mexico | From April 01 to July 30, 2020. | To evaluate the changes in quality-of-life and spirometric alterations in the convalescent phase of 115 patients with at least 30 days post-COVID-19. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 115 | N/A | N/A | N/A | Spirometry, EQ-5D-5L | N/A | N/A | N/A | N/A | N/A | N/A | 115 patients (median age: 40 years, 57% women, 70% with mild or moderate COVID-19; 27% hospitalized for a median 10 days, IQR: 6-12) were assessed at 58±18 days of symptom onset. The persistence of symptoms was present in 63% cases, of whom 19% had at least two symptoms. There was a severe decrease in QOL up to 56%. Alterations in usual activities and anxiety/depression were present in 59% of patients with a severe decrease in QOL. The persistence of symptoms was present in 63% cases. Restrictive lung impairment was the most common spirometric alteration in 17%(20/115), of which 65%(13/20) had mild COVID-19. Spirometric alterations are present even in mild COVID-19, and more remarkably, there is a high rate of alterations in quality of life after the recovery of this disease. |
292 | March-April | Paneroni M et al. | 10.1016/j.pulmoe.2021.03.009 | 2021 | Italy | From April 1 to June 30, 2020 | To investigate the safety, feasibility, and efficacy of a 1- month Telerehabilitation program in individuals discharged after recovery from COVID-19 pneumonia | Analytical: Cohort study | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 25 | N/A | One-month telerehabilitation program consisting of aerobic reconditioning , muscle strengthening and healthy lifestyle education one hour/day. Twice a week, a physiotherapist contacted the patient-by video-call via a dedicated platform-to monitor progress. | N/A | 6MWT, 1 min Sit-to-Stand, and Barthel Dyspnoea Index, nd (1MSTS), Program adherence (i.e. number of performed/scheduled video-calls) | N/A | N/A | N/A | N/A | N/A | N/A | Out of 25 consecutive patients, 24 completed the program. Patients attended 7.2±1.7 out of 8 video-calls scheduled and nurses made 13.4 ± 2.1 phone calls. Patients reported fatigue (70.8%), muscle pain (50.0%), exercise induced dyspnoea (50.0%), and sleep disorders (41.7%). After one month of TR, patients improved exercise tolerance and dyspnoea. However, approximately 20% of patients were non-responders. No adverse events were found. This preliminary report, although limited by the small sample size and absence of a control group, confirms the feasibility and safety of a dedicated telerehabilitation program for survivors of COVID-19 pneumonia.. As with chronic cardiopulmonary diseases, telerehabilitation may help to avoid a gap in service delivery following hospital discharge of COVID- 19 patients and should be integrated into their follow-up. |
293 | March-April | Qureshi A et al. | 10.1161/STROKEAHA.120.031786 | 2021 | USA | December 2019 - April 2020 | To identify risk factors, comorbidities, treatment strategies, and outcomes in patients with ischemic stroke derived from a large cohort of COVID-19 patients | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 7709 (103 with stroke, 7606 without stroke) | N/A | N/A | N/A | Demographic and clinical characteristics, discharge at home, discharge to other destionations different from home, in-hospital death | N/A | N/A | N/A | N/A | N/A | N/A | 103 out of 7709 COVID-19 patients suffered an acute ischemic stroke. Mean age in this subroup was significantly higher compared with those without stroke (68.8±15.1 vs 54.4±20.3; P<0.0001). The in-hospital mortality (19.4% vs 6.2%; P<0.0001) and discharge to destination other than home (62.1% vs 29.1%; P<0.0001) were significantly higher in COVID-19 patients with acute ischemic stroke compared with those without stroke. |
294 | March-April | Rass V et al. | 10.1111/ene.14803 | 2021 | Austria | Between April and September, 2020 | To investigate the prevalence of neurological manifestations in COVID-19 patients at 3-months follow-up. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 135 | N/A | N/A | N/A | Prevalence of neurological symptoms at 3-months follow-up, 16-item Sniffin-Sticks-test, MoCA, SF-36, PCL-5, HADS. | N/A | N/A | N/A | N/A | N/A | N/A | At 3-months follow-up after COVID-19 of various degree of intensity (from severe to mild), 125 consecutve patients were tested for prevalence of neurological and psychological symptoms. Overall, 15% of patients presented neurological symptoms who were not evident before COVID-19, including poly-neuro/myopathy (n=16, 12%), mild encephalopathy (n=2, 2%), parkinsonism (n=1, 1%), orthostatic hypotension (n=1, 1%), Guillain-Barré-Syndrome (n=1, 1%) and ischemic stroke (n=1, 1%). At the 3-months follow-up, cognitive impairment, decrease in QoL, depression, anxiety and post-traumatic stress disorders were all present in different percentage of patients, 23%, 31%, 11, 25% and 11% respectively. |
295 | March-April | Rinaldo RF et al. | 10.1183/13993003.00870-2021 | 2021 | Italy | May-August 2020 | To evaluate the sequelae of COVID-19 assessing the exercise performance during incremental Cardiopulmonary exercise test | Descriptive: Historical cohort | Specialized outpatient rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Chronic | COVID-19 | 75 | N/A | N/A | N/A | Cardiopulmonary exercise test | N/A | N/A | N/A | N/A | N/A | N/A | Seventy-five (43, 57% males) patients were studied at 97 +/- 26 days of hospital discharge . Thirty-nine patients had a critical, 18 a severe, and 18 a mild-moderate disease. Forty- three (63%) patients showed a residual parenchymal involvement at CT. Spirometry showed normal values. Compared to subjects with normal exercise capacity (n=34), the patients with a reduced capacity (n=41) showed an early anaerobic threshold, indicating a higher degree of deconditioning; they reached lower levels of performance and earlier termination, with a lower work, a lower peak oxygen pulse, a higher Heart rate reserve, and a wider breathing reserve. Deconditioning might be related to a direct effect of the viral load on the muscle tissue, with an impaired O2 extraction and use, as well as to a prolonged hospital stay and post-hospitalization syndrome. Remarkably, parameters of ventilatory efficiency or gas exchange were still in the limit of normal and there was not a significant difference between patients with preserved and those with a reduced exercise capacity; neither pulmonary function tests nor CT imaging did help discriminate patients with a lower peak VO2. Thirty-nine (52%) patients reported dyspnea during their daily activity. Residual dyspnea origin can depend on multiple factors, and a mildly impaired exercise capacity associated with deconditioning might play a role. In conclusion, this study showed no relevant functional sequelae on ventilatory and gas exchange response to exercise |
296 | March-April | Sakai et al. | 10.2490/prm.20210013. | 2021 | Japan | Between April 21 and August 20, 2020 | To describe the characteristics and efficiency of rehabilitation for patients diagnosed with moderate-to-severe COVID-19. | Descriptive: Historical cohort | Rehabilitation in acute care | Meso Level | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 161 | N/A | Rehabilitation delivery model, integrating in-person sessions with remote treatment by the use of technology, either in ICU, or in general COVID-19 ward. | No treatment | Clinical data, total number of sessions completed by patients. | N/A | N/A | N/A | N/A | N/A | N/A | Out of 191 COVID-19 patients studied , 95 underwent rehabilitation, 78 in the general COVID-19 wards and 17 in the ICU. They completed 1035 rehabilitation sessions in total, 882 in the general ward and 153 in the ICU. Using technology such as tablet, 86 sessions of rehabilitation were remotely performed in order to reduce exposition to COVID-19 ward to clinical operators. According to the authors, rehabilitation in acute settings is feasible in COVID-19, and potentially remote rehabilitation can be used to decrease the use of protective equipment and exposure of operators. |
297 | March-April | Shendy W et al. | N/A | 2021 | Egypt | From September 15 to December 15, 2020 | To determine the prevalence of fatigue in adult people post mild and moderate COVID-19 cases and the relation between fatigue post COVID-19 and several factors. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Chronic | COVID-19 | 81 | N/A | N/A | N/A | MFIS and Fatigue NRS. | N/A | N/A | N/A | N/A | N/A | N/A | Adult patients with mild and moderate COVID-19 were studied after three to five months from their recovery. They showed fatigue in 64.2% cases . There was no significant association between fatigue and age, sex, BMI, smoking, hospitalization and received treatment. The association between NRS and MFIS was moderately positive and significant. |
298 | March-April | Shi S et al. | 10.1016/j.jamda.2021.04.003 | 2020 | USA | From March 15 to May 30, 2020 | To compare functional recovery between older adults presenting with and without COVID-19 and post-acute recovery in SNF by baseline frailty in older adults presenting with COVID-19. | Descriptive: Historical cohort | Rehabilitation in social assistance | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 42 | N/A | N/A | 31 COVID-19 negative elderly people admitted to a SNF | The primary outcome was discharge to community. Secondary outcomes included change in functional status from SNF admission to discharge, based on BI. | N/A | N/A | N/A | N/A | N/A | N/A | The study, including 42 COVID-19 positive elderly and 31 COVID-19 negative admitted to a SNF for post hospitalization care, shows that COVID-19 positive patients has community discharge rates and functional improvement comparable to a COVID-19 negative group. At baseline, patients had comparable length of hospitalization (COVID-19 negative and positive respectively 10.4 and 11.6). The results of the present study suggest that those with moderate or worse frailty at baseline improved significantly less on their occupational therapy functional score, compared with those nonfrail and mild frail at baseline. Older adults admitted to a SNF for post-acute care with COVID-19 generally had good functional recovery and were discharged back to the community; however, those who are frailer tended to have a lower function at discharge. |
299 | March-April | Spielmanns M | 10.3390/ijerph18052695 | 2021 | Switzerland | From March to December 2020 | To compare the effect of pulmonary rehabilitation (PR) in post-COVID-19 patients and in patients with other lung diseases referred to PR in 2019. | Analytical: Case-control study | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 99 | N/A | Three weeks standard inpatient PR , for a total 25–30 therapy sessions on 5–6 weekdays | PR delivered to patients with pulmonary diseases in 2019 (n = 419) | FIM, 6-MWT, FT | N/A | N/A | N/A | N/A | N/A | N/A | This study compared the results of post-acute comprehensive PR delivered to severe post-COVID-19 patients with results observed in individuals with pulmonary diseases referred for PR in the preCOVID era. Improvements in physical performance, endurance, actual wellbeing during PR were significantly higher for the Post-COVID-19 patients. Consequently, healthcare facilities should develop and implement plans for providing multidisciplinary rehabilitation treatments in various settings to recover functioning and prevent the development of long-term consequences of the COVID-19 disease. |
300 | March-April | Sryma P | 10.4103/lungindia.lungindia_794_20 | 2021 | India | N/A | To determine whether the early use of PP combined with noninvasive modalities of oxygen therapy can improve oxygenation and avoid the need for intubation in patients with hypoxemic respiratory failure due to COVID-19 | Analytical: Cohort study | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 45 | N/A | PP (maintained for a minimum of 2 h per session and with a target duration of 8 h/day) combined with noninvasive modalities of oxygen therapy (30 cases) | Standard treatment (15 cases) | Rate of intubation; ROX index at 30 min from the start of the intervention, ROX index at 12 h, days to hypoxia resolution (defined as room air SpO2 >93%), and mortality. | N/A | N/A | N/A | N/A | N/A | N/A | 45 COVID-19 patients with hypoxic respiratory failure were included ; mean age 53.1 years. Age, comorbidities, and baseline ROX index were similar across subgroups (undergone PP or standard treatment) . The median duration of PP was 7.5 h on the 1st day. The need for MV was higher in the control group (33.3%) versus the PP group (6.7%). At 30 min, there was a statistically significant improvement in the mean ROX index of cases compared with that of the controls. No significant adverse effects related to intervention were noted. Early awake PP is associated with significant improvement in oxygenation and may reduce the need for MV in subjects with COVID‐19. |
301 | March-April | Sun J et al. | 10.21037/apm-20-2014 | 2021 | China | From January 30 to March 3, 2020 | To investigate the effects of a 3-week physical rehabilitation program delivered to inpatients with severe COVID-19 in a stable phase . | Analytical: Cohort study | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 31 | N/A | breathing exercise; respiratory muscle training; stretching training; psychotherapy; physical rehabilitaiton (2 sessions per day for 3 weeks). | N/A | Respiratory symptoms, exercise endurance, activities of daily living (ADL) score, SaO2%, and oxygen intake. | N/A | N/A | N/A | N/A | N/A | N/A | The baseline prevalence for dry cough, productive cough, and dyspnea was 67.74%, 54.84%, and 51.61%, respectively, which all decreased pronouncedly over time. Already after 2-week physical rehabilitation, the prevalence rate was 6.9% in dry cough, 20.69% in productive cough,and only 31.03% of patients reported dyspnea as a remained symptom. After the completion of the 3-week physical rehabilitation, overall the patients had significant improvement of their clinical condition: none had sputum, and fewer felt fatigue or shortness breathe or palpitation, and all patients were able to wear clothes or shoes or go to the toilet by themselves. |
302 | March-April | Sun LL et al. | 10.1111/1751-2980.12983 | 2021 | China | February - March 2020 | To perform an updated analysis of detailed clinical characteristics and a 3-month follow-up in hospitalized COVID-19 patients in order to disclose the symptomatic features | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 932 | N/A | N/A | N/A | Fever, cough, mMRC dyspnoea, fatigue, myalgia, and other COVID-19 symptomatic features | N/A | N/A | N/A | N/A | N/A | N/A | Fever (60%), cough (50.8%), and fatigue (36.4%) were the most common symptoms in the 932 COVID-19 patients. Most dyspneoa occurred on the fourth day after illness onset, with a median duration of 16 days. multivariate regression analysis showed that fever lasting for more than 5 days (OR=1.9; P=0.0498), anorexia (OR=2.6; P=0.0096) and mMRC dyspnoea >2 (OR=14.2; P<0.0001) were symptomatic risk factors for severe COVID-19. At the 3-month follow-up evaluation, dyspnoea (7.2%) and cough (6.2%) were the significant remaining symptoms. |
303 | March-April | Taboada M et al. | 10.1016/j.jinf.2020.12.022 | 2020 | Spain | From March 1 to April 30, 2020 | To describe functional status and the presence of persistent dyspnea six months after hospitalization. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Chronic | COVID-19 | 242 | N/A | N/A | N/A | Clinical history, pulmonary function tests, 6-MWT, chest CT, HADS, SF-12, PCFS. | N/A | N/A | N/A | N/A | N/A | N/A | In the present study, a decreased functional status measured with PCFS scale was reported in 87 (47.5%) patients at 6 months of COVID-19 infection. Female sex, age, length of hospital stay, mechanical ventilation, and ICU admission were associated with limitations in the functional status (grade II-IV of the PCSF). Six months after COVID-19, patients are susceptible to present reduced functional status that impact their ability to care for themselves and to perform usual activities of daily living. |
304 | March-April | Taboada M et al. | 10.1016/j.bja.2020.12.007. | 2021 | Spain | March - April 2020 | To evaluate through a structured interview HRQoL, functional status, and persistent symptoms in post-COVID-19 patients at 6 months after requiring ICU treatment | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Chronic | COVID-19 | 91 | N/A | N/A | N/A | EQ-5D-3L, PCFS | N/A | N/A | N/A | N/A | N/A | N/A | At 6 months after COVID-19, persistent symptoms correlated with COVID-19 were present in the 91 patients. A high proportion of patients reported dyspnoea on exertion (57%), asthaenia (37%), myalgia (37%), and arthralgia (29%). Only 15 (16%) patients were completely free of persistent symptoms. Moreover, they had a significantly lower HRQoL (p<0.001) compared with their pre-COVID-19 status. |
305 | March-April | Tomar BS et al. | 10.2147/IJGM.S295499. | 2021 | India | October - November 2020 | To investigate the prevalence of different symptoms in the post- acute care phase in COVID-19. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-acute | COVID-19 | 50 | N/A | N/A | N/A | Clinical characteristics | N/A | N/A | N/A | N/A | N/A | N/A | The most common symptoms at the baseline were fever (94%), cough (78%) and breathlessness (68%), showed by the 50 COVID-19 patients in the acute care facility. At the follow-up evaluation after discharge (range 15 to 50 days), 82% showed at least one persistent symptom, where fatigue was the most common one (74%), followed by breathlessness (44%), and muscle weakness (36%). Thus, authors concluded that patients discharged from the acute COVID care facility had a high prevalence of post-COVID symptoms even after 14 days. |
306 | March-April | Townsend L | 10.1371/journal. pone.0247280 | 2021 | Republic of Ireland | From August to October 2020 | To investigate the presence of autonomic dysfunction following SARS-CoV-2 infection and its relationship with post-COVID fatigue. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Cardiovascular functions (Blood pressure b420) | Chronic | COVID-19 | 40 | N/A | N/A | N/A | Chalder Fatigue Scale, Ewing’s autonomic function test battery | N/A | N/A | N/A | N/A | N/A | N/A | This study presents a comprehensive autonomic assessment of patients with post-COVID fatigue and contextualise the results with matched non-fatigued COVID survivors at a median of 166 days following infection. The authors found no objective findings of autonomic dysfunction, with no significant pathological differences noted between groups in any of the Ewing’s battery parameters. They also demonstrate a significant symptom burden, with 70% of fatigued patients reporting symptoms at the time of the active stand, but these were independent of neurocardiovascular changes. Fatigue was strongly associated with increased anxiety, with no patients having a pre-existing diagnosis of anxiety. . Finally, they demonstrate the impact of post-COVID fatigue on daily function, with 35% of the fatigued cohort not yet returned to full-time employment. |
307 | March-April | Walle-Hansen MM et al. | 10.1186/s12877-021-02140-x | 2021 | Norway | From March 1 to July 1, 2020 | To study age related change in HR-QoL, functional status and mortality among patients aged 60 years and older after hospitalisation due to COVID-19. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Chronic | COVID-19 | 216 | N/A | N/A | N/A | EQ-5D-5L, MoCA, SPPB, mortality | N/A | N/A | N/A | N/A | N/A | N/A | The study investigated hospitalized COVID-19 at a 6 months follow up. Out of 216 patients contacted, 171 were still alive (21% 6-months mortality) and 106 attended the follow-up. More than half patients (57 patients) reported a decrease in EQ-5D-5L scores after 6 months, with no difference between older (75 years old more) and younger patients (60-75 years old). Forty-six participants (43%) reported a negative change in cognitive function compared to before the COVID-19 hospitalisation. |
308 | March-April | Wu et al. | 10.1016/j.ijid.2021.04.020 | 2021 | China | January 2020 - January 2021 | To evaluate the respiratory and physical functions of patients who retested positive for SARS-CoV-2 RNA during post-COVID-19 rehabilitation. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-acute | COVID-19 | 302 | N/A | N/A | N/A | mMRC dyspnea scale, Borg rating of perceived exertion, MMT | N/A | N/A | N/A | N/A | N/A | N/A | The study compares mMRC, Borg, and MMT scores in re-detectable positive (23) and non re-detectable positive (279) COVID-19 patients at 2 weeks after discharge. There were no differences in the quoted scores between groups at the follow-up evaluations (at 14 days and at 6 months after discharge). The proportion of patients using antiviral drugs in the re-detectable positive group was significantly lower than those non re-detectable positive (78.3% vs 95.4%; p=0.003). The authors concluded that the prognoses of re-detectable positive and not-re-detectable positive patients are not different in terms of respiratory and physical function. at in the follow-up evaluations. |
309 | March-April | Zampogna E et al. | 10.1159/000514387. | 2021 | Italy | April - August 2020 | To evaluate the effectiveness of pulmonary rehabilitation in hospitalized patients consecutively admitted to an in-patient pulmonary rehabilitation program after COVID-19 | Descriptive: Historical cohort | Specialized postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-acute | COVID-19 | 140 | N/A | Pulmonary rehabilitation tailored to the individual patient according to age, clinical severity, length of immobilization, comorbidities, starting from a minimum of one, 20-min daily session up to two-three, 30-min daily sessions | N/A | BI, SPPB, 6MWT | N/A | N/A | N/A | N/A | N/A | N/A | 140 COVID-19 patients were admitted to inpatient rehabilitation after 47 days of acute care , on average. A high proportion of patients had undergone mechanical ventilation either invasive or NIV. At admission, 6.2% of patients still had a tracheostomy, 7.1% were still under NIV, and 23.8% still used oxygen supplementation. After a mean LOS in rehabilitation of 24 days, they showed a significant improvement in SPPB (from 0.5 to 7; p<0.001) and BI (from 55 to 95; p<0.001). The proportion of patients unable at admission to stand, rise from a chair and walk was significantly reduced (p < 0.00). Pulmonary rehabilitation is feasible and effective in patients recovering from COVID-19. |
310 | March-April | Zazzara MB | 10.1093/ageing/afaa223 | 2021 | UK | March-May 2020 | To assess how frailty affects presenting COVID-19 symptoms in older adults. | Descriptive: Historical cohort | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Acute | COVID-19 | 857 | N/A | N/A | N/A | Frailty was classified as a binary variable: CFS ≥ 5 = frail; CFS < 5=not frail for the hospital cohort; PRISMA7 ≥ 3=frail; PRISMA7 < 3=not frail in the community-based cohort | N/A | N/A | N/A | N/A | N/A | N/A | This study analyzed data of presenting COVID-19 symptoms from 2 cohorts of patients: hospitalized older patients (n = 322, 51% were frail) and community-dwelling older people who submitted data via the COVID Symptom Study mobile application (n = 535, 36% were frail). In the Hospital cohort, there was a significantly higher prevalence of probable delirium in the frail sample (38% of frail and 12% of non-frail patients), with no difference in fever or cough. In the Community-based cohort, there was a significantly higher prevalence of possible delirium in frailer (49%), older adults, and fatigue and shortness of breath. This study demonstrates that the prevalence of probable delirium is significantly higher in frail compared to non-frail older adults with COVID-19, highlighting both that a frailty assessment is fundamental and a systematic evaluation of change in mental status needs to be included when assessing this population. |
311 | March-April | Zhu S et al. | 10.1371/journal.pone.0243883 | 2020 | China | From February 21 to April 7, 2020. | To estimate the prevalence of disability and anxiety in Covid-19 survivors at discharge from hospital and analyze relative risk by exposures. | Descriptive: Historical cohort | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Post-acute | COVID-19 | 432 | N/A | N/A | N/A | Clinical data, IADL, BI, Zung’s self-reported anxiety scale | N/A | N/A | N/A | N/A | N/A | N/A | At hospital discharge, COVID-19 subjects presented at least one IADL problem in 36.81%. ADL dependence was present in 16.44% and 28.70% were screened positive for clinical anxiety. A significant proportion of COVID-19 survivors had disability and anxiety at discharge from hospital. Disease severity was the only independent risk factor with consistent adverse effects on all outcomes. |
312 | March-April | Zifko et al. | 10.1016/j.jns.2021.117438 | 2021 | Austria | March - April 2020 | To describe neurological symptoms occurring during a COVID-19 infection and determine the pattern of symptoms by comparing outpatients with inpatients | Analytical: Cross-sectional study | Specialized postacute rehabilitation | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Post-acute | COVID-19 | 82 | N/A | N/A | N/A | Neurological symptoms | N/A | N/A | N/A | N/A | N/A | N/A | Neurological symptoms were found in 32/40 inpatients (80%) and in 36/42 outpatients (86%), without differences between groups. The most common symptoms were fatigue (53% for inpatients and 55% for outpatients) and headache (33% for inpatients and 29% for outpatients), followed by loss of taste (31%), and loss of smell (27%). The onset could be clearly defined only in 41 patients with neurological symptoms (36 outpatients and 5 inpatients) and was on the first or second day of COVID-19 illness, in 63.4% of cases. A more severe course of disease was correlated with age and male sex, but age was not identified as a predictor for the occurrence of neurological symptoms. Women suffered from central and neuromuscular symptoms more often than men (p = 0,004). Pre-existing dementia was associated with increased lethality; similarly, pre-existing stroke was associated with a more severe course of Covid-19 infection. Hallucinations and confusion were related to an increased likelihood of death. |
313 | May-June | Albu S | 10.3233/NRE-210025 | 2021 | Spain | N/A | To characterize persistent symptoms, physical, neurological and respiratory sequelae and their impact on daily life activities and quality of life in post COVID-19 patients included in an outpatient rehabilitation program | Analytical: Cross-sectional study | General postacute rehabilitation | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 30 | N/A | N/A | N/A | Fatigue, sleep quality, respiratory functional parameters, muscle strength, physical function, physical performance, independence in ADL, neuropsychological function, anxiety and depression, and quality of life | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 30 COVID-19 patients (mean age: 54 years; 19 male; 16 admitted to the ICU) referred for rehabilitation more than 3 months after acute COVID-19. Cognitive impairment was found in 63.3% of patients, irrespective of the previous admission to the ICU. Increased physical fatigue, anxiety and depression and low quality of life were prevalent irrespective of acute COVID-19 severity. Post-ICU patients did not start rehabilitation earlier than non-ICU patients and their functional independence measures, cognitive affective state and quality of life were similar to the non-ICU sub-group. |
314 | May-June | Bardakci MI | 10.1002/jmv.27101 | 2021 | Turkey | From March 11 to July 30, 2020 | To evaluate long-term radiological changes in severe COVID-19 patients, to investigate pulmonary function, exercise capacities, and health-related quality of life results. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 65 | N/A | N/A | N/A | Spirometry, 6MWT, SF-36 were applied in the sixth month. Chest CT | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 65 COVID-19 patients who had severe pneumonia (75.4% male; mean hospitalization time was 11.7 days). They were assessed in the sixth month after discharge from the hospital. The main finding is represented by Functional and radiological abnormalities that were detected in a significant number of patients: FEV1% values in 30.5% of patients, FVC% values in 45.8%, and 6MWT in 23.2% were found lower than expected in the sixth month. On the SF-36 scale, physical function, energy-vitality, social functionality, pain, and general health parameters were found lower than normal. Minimal interstitial changes in chest CT were seen in 26 patients. Nine patients had lung area involvement between 10% and 50% of the surface, there was a correlation between FEV1% and FVC% values in this group. There was severe pulmonary fibrosis in four patients. There was a correlation between pulmonary function and physical function and general perception of health from SF-36 scale subparameters. A systematic monitoring plan must be established to assess and properly manage the long-term problems that may arise after COVID-19 infection. |
315 | May-June | Chun HJ et al. | 10.1172/jci.insight.148476 | 2021 | USA | N/A | To better understand the relationship between subjective and objective respiratory abnormalities in patients recovered from COVID-19 infections. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 61 | N/A | N/A | admitted to the post–COVID-19 rehabilitation unit | PFT, symptoms, biomarkers | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 61 COVID-19 patients (median age 63, 56% male; 21% were treated at home, 48% in hospital, 31% in ICU) assessed at a median 9 weeks after onset of symptoms. The main findings is represented by the rate of symptoms persistence (85% of patients). There was no relationship between PFT and symptoms persistence. |
316 | May-June | de Souza | 10.1016/j.jsams.2021.05.011 | 2021 | Brazil | June 2020 - August 2020 | To assess the association of physical activity before the pandemic and quarantine measures with the prevalence of hospitalizations in surviving patients infected with SARSCoV-2 virus and investigated symptoms of the disease, length of hospital stay, and the use of mechanical ventilation in patients infected with SARS-CoV-2 and the association with sufficient and insufficient physical activity | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 938 | N/A | N/A | N/A | Symptoms, medications, hospitalization, and length of hospital stay, and physical activity level assessed with the IPAQ short version. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 938 COVID-19 patients (35% male). They were assessed after full recovery from COVID-19 infection. The main finding is that performing at least 150 min a week of moderate-intensity, or 75 min a week of vigorous-intensity physical activity, before the infection, was associated with 34.3% reduction in hospitalization rate . Moreover, an increased risk of hospitalization was observed in presence of the following risk factors: male sex ( p = 0.013), age over 65 years (p<0.001), obesity I (p=0.001), preexisting disease (p=0.002), 3 or more symptoms (p<0.001), and using 2 or more medications (p<0.001). |
317 | May-June | Delbressine | 10.3390/ijerph18116017 | 2021 | Netherlands | June 2020 - September 2020 | To assess the impact of COVID-19 on the level of self-reported PA (time spent walking per week and leisure-time sports activities) in patients with post-COVID-19 syndrome | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 239 | N/A | N/A | N/A | existing comorbidities received care, symptoms, and hospital admission. The average time spent walking performed before COVID-19 (retrospectively) and at the time spent walking after COVID | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 239 post-COVID-19 patients (mean age: 50 years; 82.8% female) with persistent symptoms, who were all members of online long COVID support groups, were requested to complete a questionnaire in two timepoints, at around 10.4 ±2.4 weeks (T1) and 22.6 ± 2.4 weeks (T2), of symptom onset. The main finding is represented by the rate of change in time spent walking per week. After three months of follow-up, walking time was significantly reduced compared to pre-COVID-19 (p<0.05). Although there was an improvement at six months (p<0.05), subjects still demonstrated a significantly decreased self-reported walking time six months after the onset of symptoms. In contrast, the proportion of participants that reported walking or cycling indoors increased over the course of six months after the onset of symptoms. |
318 | May-June | Divanoglou A et al. | 10.1016/j.eclinm.2021.100920 | 2021 | Sweden | From March 1 to May 31, 2020 | To determine Covid-19-associated mortality, as well as Covid-19 associated rehabilitation needs, four months after discharge from hospital. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any Activity limitation and participation restriction (d) | Post-Covid | COVID-19 | 734 | N/A | N/A | N/A | Symptoms at follow-up. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 734 hospitalized COVID-19 patients (median age 61 years, 56.8% were males, median LOS 6 days, 15.7% needed ICU) at 4 months follow-up after hospital discharge. One hundred twenty-five patients were dead at follow-up. Almost half of patients (40%) reported activity limitations/participation restrictions (25% patient reported problems walking > 1 km), and 20-40% of cases reported cognitive and affective impairments. These impairments should be considered when designing rehabilitation services for COVID-19 patients. |
319 | May-June | Finn A | N/A | 2021 | USA | From April 1 to November 30, 2020 | To aid the clinician in early identification, diagnosis and management of cardiac complications in COVID-19. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Cardiovascular functions (Heart b410) | Ongoing | COVID-19 | 41 | N/A | N/A | N/A | echocardiography | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 41 COVID-19 patients (mean age 66, 73.2% were male, mean length of hospital stay 9 days) with severe cardiac complications (70.7% of patients had a previous history of cardiac or related conditions).The main finding is represented by the fact that among survivors with COVID-19-related cardiomyopathy, only 20% demonstrated recovery of left ventricular function on follow-up echocardiography done within 12 weeks after initial diagnosis. |
320 | May-June | Frontera | 10.1016/j.jns.2021.117486 | 2021 | USA | March 2020 - May 2020 | To compare global functional outcomes between COVID-19 hospital survivors with and without neurological complications using an ordinal analysis of the modified Rankins Scale (mRS) | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any Activity limitation and participation restriction (d) | Post-Covid | COVID-19 | 790 | N/A | N/A | 395 COVID-19 patients with neurological complicationwere compared to 395 COVID-19 patients without neurological complications | modified Rankin Scale, Barthel Index, Telephone Montreal Cognitive Assessment, and Quality of Life in Neurological Disorders short form self-reported health measures of anxiety, depression, fatigue and sleep. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 395 COVID-19 patients surviving neurological complications, and as many control patients surviving COVID-19 without suffering from neurological complications. Of the total 790 subjects, 196 with neurological complications and 186 controls completed the follow-up at 6.7 months of COVID-19 onset (median time). The six-month mRS scores were significantly worse in patients with neurological complications compared to controls (P =0.014). Patients with neurological complications were more likely to have impaired activities of daily living as measured by the Barthel Index (53% versus 35% of controls, P =0.002) and were less likely to return to work (41% versus 64% of controls, P =0.004). |
321 | May-June | Gramaglia C et al. | 10.3389/fpsyt.2021.667385 | 2021 | Italy | From March 1 to June 29, 2020 | To assess the possible differences between anxiety and depressive symptoms as identified by the clinical interview performed by an experienced psychiatrist and as assessed with self-administered screening questionnaires | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Post-Covid | COVID-19 | 238 | N/A | N/A | N/A | Clinical and socio-demographic data, PFT, MINI, BAI, BDI-II, RSA, IES. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 238 COVID-19 patients (no available data on the mean age of the whole population, 59,8% males), assessed at a median of 131 days after hospital discharge. At the psychiatric assessment, participants complained of anxiety and depression in 32.9% and 29.5% cases respectively. Changes in appetite and sleep patterns emerged for 15.6% and 31.2% of patients, respectively. According to the self-administered questionnaires, 7.1% of participants had moderate-severe anxiety levels (BAI), while 10.5% had mild to severe depression (BDI-II). Psychiatric symptoms showed no correlation with acute COVID-19 severity, but rather with ongoing and persistent physical symptoms. |
322 | May-June | Groah SL et al. | 10.1002/pmrj.12645 | 2021 | USA | From March 1 to September 30, 2020 | To describe COVID-19 patients undergoing inpatient rehabilitation and their rehabilitation outcomes | Analytical: Cohort study | General postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 82 | N/A | N/A | 814 COVID-19 negative patients in need of respiratory rehabilitation | Clinical data, LOS; discharge location; FA-SC; FA-Mob | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 896 patients who underwent rehabilitation. 82 of them were COVID-19 positive (mean age 59.4 years, 46.3% were female), while 814 were COVID-19 negative (mean age 62.95 years, 45.5% were female). Overall, patients COVID-19 positive and negative who had access to rehabilitation for neurological or orthopedic condition, showed similar improvement in functional abilities. |
323 | May-June | Kashif A | 10.1038/s41598-021-92717-8 | 2021 | Pakistan | From April to June, 2020 | To identify the presence of post‐viral symptomatology in patients recovered from mild COVID‐19 disease. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 242 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 242 COVID‐19 recovered patients with mild disease (mean age, 69.4% male), assessed 3 months after hospital discharge or 3 months after their hospital visit, for patients who were advised home quarantine initially. Mild disease was defined as mild clinical symptoms, i.e. fever < 38 °C (quelled without treatment), with or without cough (no dyspnea, no gasping, no underlying chronic lung disease) and, no imaging findings of pneumonia. The main finding is represented by the high rate of persistent post-viral sequelae, the most common being fatigue (41.7%). The sample was also stratified into two groups, those without any comorbidity (88%) and those with co-morbidities (12%) . People with comorbid conditions were older, and had more frequently decreased appetite and sleep disturbances than people without. The females had a significantly greater occurrence of myalgias, decreased appetite, headache, low mood, nausea/vomiting, chest pain, sleep disturbances, and fatigability.amongst females as compared to males. These results validate the presence of prolonged symptoms months after recovery from mild COVID‐19 disease, particularly in association with the female gender. |
324 | May-June | Liyanage-Don NA et al. | 10.1007/s11606-021-06855-w | 2021 | USA | From March 26 to May 27, 2020 | To examine the association of depression and PTSD with perceived recovery following COVID-19 illness. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Nervous system structures (s1) and related functions (Mental functions b1) | Ongoing | COVID-19 | 153 | N/A | N/A | N/A | PTSD Checklist for DSM-5, PHQ-8, length of stay, level of inpatient care during the COVID-19 hospitalization. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 153 COVID-19 patients (mean age 54.5 years, 39.9% were female) 3 months post-discharge. The most common persistent COVID-related physical symptoms were body aches (23.5%), fatigue (20.3%), shortness of breath (19.0%), and headaches (13.1%). Depression and PTSD were each associated with a greater mean number of persistent physical symptoms and a higher likelihood of feeling unrecovered. |
325 | May-June | Maniscalco M et al. | 10.1016/j.rmed.2021.106470 | 2021 | Italy | N/A | To verify the impact of a preexisting cardiorespiratory comorbidity on multidisciplinary rehabilitation in post-COVID-19 patients. | Analytical: Cohort study | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 95 | N/A | 5-week pulmonary rehabilitation program with daily sessions (6 sessions/week). | Patients without comorbidities. | PFT, DLCO, 6MWT | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 95 consecutive COVID-19 patients after acute phase, at admission in a pulmonary rehabilitation ward. Patients were divided into two groups, patients with comorbidities (N=46, mean age 65.3, 84% females) and without comorbidities (N=49, mean age 61.5, 84% females). The main finding is represented by the improvement observed in PFT, DLCO and 6MWT in both groups. Response to the rehabilitation cycle tended to be greater in those without preexisting comorbidities, but DLCO was the only parameter that showed a significant greater improvement in patients without comorbidities. |
326 | May-June | Mei Q et al. | 10.3389/fmed.2021.617689 | 2021 | China | From January 18 to March 29, 2020 | To investigate both the physical and psychological symptoms, including severe acute respiratory syndrome-related coronavirus 2 immune recognition, among a large cohort of COVID-19 survivors. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 3677 | N/A | N/A | N/A | Incidence of post-COVID-19 sequelae. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 3677 COVID-19 patients (median age 59 years, 55.5 % were female) observed from hospital discharge to a median follow-up of 144 days.During follow-up, 976 (26.5%) patients had at least one post-COVID-19 sequela (such as dysfunction in pulmonary, cardiac or neurologic function). The incidence of post-COVID-19 sequelae among elderly COVID-19 survivors (age ≥60 years) was slightly increased compared to that of young COVID-19 survivors (age <60 years; relative risk=1.05). |
327 | May-June | Parizad N | 10.1016/j.ctcp.2021.101335 | 2021 | Iran | From June 15, 2020 to July 07, 2020 | To determine the effect of guided imagery on anxiety, muscle pain, and vital signs in patients with COVID-19. | Randomised controlled trial | N/A | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 110 | N/A | ten sessions of guided imagery for five consecutive days, twice a day | Routine care | Spielberger State-Trait Anxiety In- ventory (STAI), the Short-Form McGill Pain Questionnaire (SF-MPQ), the Visual Analogue Scale (VAS), and the Vital Signs Flow Sheet. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports the effect of guided imagery in addition to routine care on anxiety, muscle pain, and vital signs in patients with COVID-19, compared to only routine care. No details on the demographic and clinical characteristics of the enrolled patients are provided. The results showed that the implementation of guided imagery by nurses reduces the anxiety and the intensity and quality of pain. Moreover, this approach can affect heart rate, systolic blood pressure, and oxygen saturation in patients with COVID-19. These results suggestes the effectiveness of this complementary method. |
328 | May-June | Pistarini | 10.3389/fneur.2021.643646 | 2021 | Italy | May 2020 | to explore and compare cognitive and psychological status of patients in the subacute phase of the disease (COVID-19 group) and patients in the postillness period (post–COVID-19 group). | Analytical: Cohort study | General postacute rehabilitation | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Mental functions b1) | Ongoing | COVID-19 | 40 | N/A | N/A | post COVID-19 patients | MMSE MoCA), Hamilton Rating Scale for Depression, and Impact of Event Scale–Revised (IES-R). | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 40 COVID-19 patients admitted to an inpatient rehabilitation facility. 20 of them (age: 62.85 ± 12.35) had a positive swab and were assessed at around 10 days of symptom onset, the remaining 20 (age: 65.40 ± 11.51) were post-COVID19 subjects and were assessed at 25.14 ± 10.39 days after the second consecutively negative swab. Post-COVID subjects had higher score in MMSE subtests of language (p = 0.02) and in MoCA subtests of executive functions (p = 0.05), language (p = 0.01), and abstraction (p = 0.02) and also reported significantly higher levels of distress at the IES-R (p = 0.02). compared to the subgroup in the acute phase |
329 | May-June | Polese J et al. | 10.6061/clinics/2021/e2848 | 2021 | Brazil | From September to October, 2020 | To evaluate pulmonary function after hospital discharge of individuals who presented with the severe COVID-19. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 41 | N/A | N/A | N/A | Clinical and demographic parameters, symptoms, PFT, radiographic findings. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 41 COVID-19 patients hospitalized due to severe disease (mean age 51 years, 73% were males). PFT was executed a mean of 36 days after the onset of symptoms. Approximately 93% of patients still had symptoms at examination. PFT showed a restrictive pattern in 54% of patients. A reduction of DLCO was observed in 79% of patients. |
330 | May-June | Scarpino M | 10.1111/ane.13433 | 2021 | Italy | From January 2016 to June 2020 | To determine if there were any differences between ARDS from COVID-19 and other aetiologies in the frequency of CINPM and outcome at discharge from the intensive care unit | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Ongoing | COVID-19 | 23 | N/A | N/A | 21 with ARDS due to other aetiologies | electroneurography/electromyography | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 23 patients with ARDS due to COVID-19 (mean age 66, 87% male) and 21 with ARDS due to other etiologies (mean age 57, 76% male). The length of ICU stay was similar in all patients with ARDS, with a median stay of 38 days for non-COVID-19 ARDS patients and 36 days for COVID-19 ARDS patients). They were assessed by ENG/EMG at 14-38 days, with a median of 18 days, from ICU admission. The incidence of CIPNM was similar in the two groups, 65% in COVID-19 patients and 71% in patients affected by ARDS of other aetiologies. At ICU discharge, subjects with CIPNM more frequently required ventilatory support, regardless of the aetiology of ARDS. ENG/EMG represents a useful tool in the identification of the neuromuscular causes underlying ventilator wean failure and patient stratification. A high incidence of CIPNM, with a similar percentage, has been observed in ARDS patients of all aetiologies |
331 | May-June | Srinivasan V | N/A | 2021 | India | N/A | To explore the efficacy of combining various breathing exercise to improve the pulmonary ventilation. | Randomised controlled trial | General postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 48 | N/A | pursed lip breathing and the Bhastrika pranayama: at home, daily for 5 min thrice a day over a period of 6 weeks. | breathing exercise with incentive spirometry: at home, 5-10 times thrice a day over a period 6 weeks | Pulmonary Function Testing with the FVC & FEV1 | N/A | N/A | N/A | N/A | N/A | N/A | The present study analyzed the efficacy of interventions for patients with dyspnea in post covid follow-up clinic. No details on the demographic and clinical characteristics of the enrolled patients are provided. Both groups showed improvement after treatment, there was a significant difference between groups in the FEV1 post-test |
332 | May-June | Sultana S | 10.7759/cureus.15351 | 2021 | Bangladesh | From April 1, 2020, to July 30, 2020. | To estimate the prevalence of acute post-COVID symptoms and long post-COVID symptoms among the recovered medical doctors, and find out the risk factors of long post-COVID symptoms. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 186 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 186 COVID-19 recovered medical doctors (mean age 34.8 years., 66.1% male). The interval between the participants' COVID-19 detection and the date of data collection was 124.4 (21.6) days on average. The authors classified the post-COVID symptoms based on their duration: symptoms persisting ≤60 days following recovery were considered as acute post-COVID symptoms and >60 days following recovery were considered as long post- COVID symptoms. The main findings are represented by: 1) about 70% of participants had at least one acute post-COVID symptom, including fatigue (43.0%), sleep disturbance (13.4%), lack of concentration (11.8%), breathing difficulty (10.2%), headache (6.5%), and muscle pain (6.5%). 2) About 24% of participants reported having long post-COVID symptoms like fatigue (8.1%), difficulty in breathing (6.5%), lack of concentration (4.8%), hair fall (4.3%), memory lapses (4.3%), sleep disturbance (3.8%), and joint pain (1.6%). 3) Female sex and comorbid conditions are risk factors for the long post-COVID symptoms. |
333 | May-June | Tian F | 10.23736/S1973-9087.21.06892-1 | 2021 | China | From March 1, 2020 to April, 5 2020 | To evaluate the efficacy and safety of short-wave diathermy for moderate COVID-19 patients. | Randomised controlled trial | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 40 | N/A | A session of 10-min pulsed short-wave diathermy treatment once a day for 14 days or less (in the case of discharge or death within 14 days). The pulse repetition rate was 350 Hz. The electrodes were placed on the chest and upper back. | 13 COVID-19 patients underwent placebo short-wave diathermy | clinical improvement according to a seven- category ordinal scale: (1) not hospitalized with resumption of normal activities; (2) not hospitalized, but unable to resume normal ac- tivities; (3) non-ICU hospitalization, not requiring supplemental oxygen; (4) non-ICU hospitalization, requiring supplemental oxygen; (5) ICU hospitalization, not requiring ECMO and/or invasive mechanical ventilation; (6) ICU hospitalization, requiring ECMO and/or invasive mechanical ventilation; (7) death. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 40 hospitalized COVID-19 patients with moderate symptom category as for fever, fatigue, and respiratory symptom (mean age 65, 37.5% female, 15.8 days between onset and enrollment, 6.8 days between diagnosis and enrollment). The main finding is represented by the clinical improvement that occurred in 92.6% of COVID19 patients exposed to SWD, as compared to 69.2% of patients in the control group. Similarly, CT improvement occurred in 85.2 % of patients in the SWD group and 46.2 % of patients in the control group respectively by day 14 . There was no significant difference in adverse events between the SWD group and the control group (2 of 27 with headache and dizziness vs. 1 of 13 with headache, respectively). This study provides the first evidence that SWD is a promising adjuvant therapy for COVID-19. |
334 | May-June | Vaes A W et al. | 10.1183/23120541.00141-2021 | 2021 | Netherlands | From June 4 to June 11, 2020 | To evaluate symptoms in COVID-19 patients up to 6 months after the onset of COVID-19 related symptoms. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 1939 | N/A | N/A | N/A | Number of symptoms, work productivity, self reported health, functional status and QoL (EQ5D) | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 1939 COVID-19 patients (mean age 50 years, 82.8 % were female, 26% were hospitalized, not in ICU, while 74% were treated at home) 3 to 6 months after symptom oneset. The main finding is represented by the rate of persistent symptoms even after 6 months from the onset of symptoms: only 5,4% of patients were without symptoms. Those symptoms affected productivity, functional status and quality of life. These findings support the existence of a post-COVID-19 syndrome |
335 | May-June | Wang X | 10.1093/qjmed/hcaa178 | 2021 | China | February 2020-March 2020 | To investigate clinical outcomes, distribution of quarantine locations and the infection status of the contacts of COVID-19 patients after discharge. | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 131 | N/A | N/A | N/A | Complete blood count and COVID-19 symptoms including fever, cough, expectoration, dyspnea, chest distress, chest pain, pharyngeal pain, rhinobyon, rhinorrhea, diarrhea, nausea, vomiting, inappetence, myalgia, fatigue, headaches, dizziness and palpitation. | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 131 COVID-19 patients (mean age 49 [36–62], 45.0% male). They were assessed every week up the 4 weeks from hospital discharge. The main finding is represented by the rate of change at the 4 week in cough (40.1% vs 9.1%), fatigue (7.6% vs 0%), dyspnea (3.82% vs 1.53), chest tightness (6.11% vs 0.8%), and chest pain (3.05% vs 0%). |
336 | May-June | Wu Xiaoyan | 10.3389/fcvm.2021.654405 | 2021 | China | March 2020 - October 2020 | To observe the persistent impact of COVID-19 in patients with and without cardiac injury | Analytical: Cohort study | N/A | Epidemiology - Natural history/Determining and modifying factors | Cardiovascular functions (Heart b410) | Post-Covid | COVID-19 | 27 | N/A | N/A | COVID-19 patients without cardiac injury | Self-reported symptoms, medications, laboratory findings, Short Form 36-item scores, 6-min walk test, clinical events, electrocardiogram assessment, echocardiography measurement, and cardiac magnetic resonance imaging | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 27 COVID-19 patients (13 with cardiac injury, mean age 63 [59, 70], 30.8% male, and 14 without cardiac injury, mean age 63 [57, 70], 28.6 % male). They were assessed at 6 months of hospital discharge. The main finding is represented by no statistically significant differences in terms of the quality of life and exercise capacity between the patients with and without cardiac injury |
337 | May-June | Yan X | 10.1016/j.jinf.2021.05.034 | 2021 | China | 1 year follow-up: From March 16 to March 28, 2021, acute infection: From January 24–March 18, 2020 | To assess pulmonary function in survivors who had recovered from COVID-19 one year before. | Analytical: Cross-sectional study | N/A | Epidemiology - Prevalence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 119 | N/A | N/A | N/A | Spirometry, DLCO | N/A | N/A | N/A | N/A | N/A | N/A | This study reports about 119 COVID-19 survivors (mean age 52.97, 41% male) assessed one year after recovering from COVID-19 infection. The subjects were subdivided in asymptomatic (n = 9), non-severe (n = 82), and severe (n = 28), based on clinical picture at COVID-19 onset. The main finding of this study was that lung functional impairment is highly prevalent in survivors with COVID- 19 at 1 year after discharge, and persistent lung function impairment still affects about 40% of survivors. Lung damage might be related to pulmonary fibrosis. |
338 | July-August | Acar RD et al. | 10.1088/1752-7163/ac22bb | 2021 | Turkey | N/A | To evaluate the cardiopulmonary function and impairment of exercise endurance in patients with COVID-19 after 3 months of the second wave of the pandemic | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 51 | N/A | N/A | N/A | Cardiopulmonary exercise stress test | This study reports about 51 COVID-19 patients, mostly healthcare providers,(median age was 42 [25–71] years, and 45% were female, 33% had severe COVID-19 while the remaining 67% had moderate COVID-19, percentage of hospitalisation was 57%). They underwent cardiopulmonary exercise stress test 3 months after the second wave of the pandemic in Turkey (the latency time between evaluation and diagnosis is not better specified). Main findings : 1)Dyspnoea on exertion was the common clinical complaint of the patients. 2) The peak VO2 values of COVID-19 survivors decreased, and simultaneously, their exercise performance decreased due to peripheral muscle involvement. 3) the percentage of the maximum predicted VO2 max value was lower in male than in female COVID-19 survivors; 4)there was a positive correlation between the percentage of the predicted VO2 max value and the age. So, these results suggested that COVID-19 significantly affects young men among COVID-19 survivors. | ||||||
339 | July-August | Amini A et al. | 10.1007/s10072-021-05502-w | 2021 | Iran | N/A | To investigate the effect of cognitive-motor training on the components of cognitive health of the elderly who recovered from COVID-19. | Non randomised controlled trial | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Mental functions b1) | Post-Covid | COVID-19 | 42 | N/A | Interactive CMT | This is a time series where subjects serve as their own controls | MMSE, GH-2 | This study reports about 42 patients recovered from mild COVID-19 (mean age 70 years, mean BMI 22, severe cases were excluded, no information was provided about distance from recovery). They underwent 4-week CMT program twice a week. They were assessed at three time-points the beginning of the intervention, two weeks and 3 months after the end of the program. The main finding is represented by the decrease of the scores of depression, anxiety, physical symptoms, and social performance components and the overall GHQ-2 score both in short-term follow-up and in long-term follow-up compared to baseline assessment. | ||||||
340 | July-August | Aranda J et al. | 10.1016/j.jinf.2021.08.018 | 2021 | Spain | From February 28 to April 15, 2020 | To determine the clinical outcomes, exercise capacity, psychiatric disorders, and long-term HRQoL of patients with COVID-19 who developed ARDS and survived to hospital discharge. | Inception Cohort study | N/A | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 166 | N/A | N/A | N/A | Physical examination, chest X-ray, and 6MWT, scales to evaluate post-traumatic stress disorder, depression, anxiety, and health-related QoL. | This study reports about the 8 -month outcome of a cohort of 166 COVID-19 survivors (out of a total 365 patients with ARDS in the acute phase). The median age was 64 years, 79 % were males, median BMI was 29. At 240 days after COVID-19 onset, only 113 were available for the assessment. In these 113, 81% complained of persistent symptoms, most of them showed reduced tolerance to physical effort, 93% presented psychological disorders (depression/anxiety). Female sex, non-Caucasian race, and comorbidities were independent risk factors for a worse quality of life due to mental health component. | ||||||
341 | July-August | Bernocchi P et al. | 10.1089/tmj.2021.0181 | 2021 | Italy | From March to June 2020 | To describe the implementation and preliminary observational data of a service of telecare and telemonitoring of patients with chronic heart failure and chronic obstructive pulmonary disease. | Cohort study | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Cardiovascular functions (Heart b410) | Post-Covid | COVID-19 | 130 | N/A | Telecare nursing and specialist teleconsultation program for 3 months, including monitoring of vital signs and symptoms. | N/A | SF-12, symptoms, patient satisfaction. | This study reports about 130 COVID-19 patients (mean age 68 years, 56% males, all the patients needed hospitalization). Patients were recruited in a COVID-19 ward at discharge. They underwent a 3 month program based consisting in telecare nursing and specialist teleconsultation, including monitoring of vital signs and symptoms. They were assessed at the beginning and at the end of the program. The main finding is represented by the statistically significant improvement between start to finish of the program in physical SF-12 scores, while mental SF-12 worsened in older patients ( <70 years old). Patient satisfaction with the program was very high in all 130 patients. | ||||||
342 | July-August | Blomberg B et al. | 10.1038/s41591-021-01433-3 | 2021 | Norway | From February 28 to April 4, 2020 | To assess persistent symptoms 6 months after initial COVID-19 in a prospective cohort of hospitalized and home-isolated patients from the first pandemic wave in Bergen, Norway. | Cohort study | N/A | Epidemiology - Natural history | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 312 | N/A | N/A | 60 seronegative patients | Symptoms | This study reports about 312 COVID-19 patients (median age 46 years, mean BMI 22, 22% needed hospitalization) available at the 6-month follow-up after COVID-19 diagnosis. Compared to 61% rate of persisting symtoms in the whole sample, up to 52% home-isolated young adults, aged 16–30 years (32/61) also complained of loss of taste and/or smell (28%, 17/61), fatigue (21%, 13/61), dyspnea (13%, 8/61), impaired concentration (13%, 8/61) and memory problems (11%, 7/61). | ||||||
343 | July-August | de Graaf MA et al. | 10.1016/j.eclinm.2021.100731 | 2021 | Netherlands | March-June 2020 | To assess pulmonary, cardiac, infectious and psychological outcomes in patients with COVID-19 at 6 weeks of hospital discharge | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 81 | N/A | N/A | N/A | Cardiopulmonary function and pulmonary function testing | This study reports about 81 COVID-19 patients (51 (63%) male, mean age 61±13 years, Mean Body Mass Index 27.8±4.5kg/m^2). They were assessed at 6 weeks after hospital discharge. The main finding is represented by the rate of change in cardiopulmonary function and psychological impairment after hospitalization. The majority of COVID-19 patients had residual symptoms at the outpatient clinic 6 weeks after discharge, mainly dyspnea on exertion as assessed by NYHA class. Patients showed relatively good psychological adjustment and limited prevalence of depression, anxiety, or PTSD symptoms (ranging from 5-17%). A lower pulmonary diffusion capacity correlated with functional status, dyspnea was found. DLCOc value was significantly lower in the ICU group versus the non-ICU group (mean difference 12.5%P=0.01). Also, FEV1 and FVC were significantly lower in de ICU group than in the non-ICU group (mean difference FEV1 14.9%;P<0.001; mean difference FVC 15.4%;P<0.001; respectively). CT Severity index was significantly higher in the ICU group (15.6±5.2) compared to non-ICU patients (10.8±3.6) (P<0.001). Patients with a higher NYHA class (2-3) had significantly lower DLCOc values (75±17% vs 83±13%, P=0.040). | This study reports the clinical condition of 81 COVID-19 patients, of whom 34 (41%) had been admitted to the ICU, at 6 weeks of hospital discharge . They were 51 (63%) male, with mean age 61±13 years, mean Body Mass Index 27.8±4.5. The main finding is represented by the rate of change in cardiopulmonary function and psychological impairment after hospitalization. The majority of COVID-19 patients had residual symptoms at the outpatient clinic 6 weeks after discharge, mainly dyspnea on exertion as assessed by NYHA class. Patients showed relatively good psychological adjustment and limited prevalence of depression, anxiety, or PTSD symptoms (ranging from 5-17%). A lower pulmonary diffusion capacity correlated with functional status, dyspnea was found. DLCOc value was significantly lower in the ICU group versus the non-ICU group (mean difference 12.5%P=0.01). Also, FEV1 and FVC were significantly lower in de ICU group than in the non-ICU group (mean difference FEV1 14.9%;P<0.001; mean difference FVC 15.4%;P<0.001; respectively). CT Severity index was significantly higher in the ICU group (15.6±5.2) compared to non-ICU patients (10.8±3.6) (P<0.001). Patients with a higher NYHA class (2-3) had significantly lower DLCOc values (75±17% vs 83±13%, P=0.040). | |||||
344 | July-August | De Marchi T | 10.2147/JIR.S318758 | 2021 | Brazil | From May 2020 to July 2020. | To investigate the effects of photobiomodulation therapy combined with static magnetic field (PBMT-sMF) on the length of ICU stay and mortality rate of severe COVID-19 patients requiring invasive mechanical ventilation and assess its role in preserving respiratory muscles and modulating inflammatory processes | Randomised controlled trial | Rehabilitation in acute care | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 30 | N/A | photobiomodulation therapy combined with static magnetic field (15 cases) | placebo photobiomodulation received daily throughout the ICU stay (15 controls) | The primary outcome was length of ICU stay, defined by either discharge or death. The secondary outcomes were survival rate, diaphragm muscle function, and the changes in blood parameters, ventilatory parameters, and arterial blood gases. | This study reports about 30 severe COVID-19 patients requiring invasive mechanical ventilation in ICU (mean age 66.06 years, 53.33% were male. ) equally randomized into the two groups: patients who underwent photobiomodulation therapy combined with static magnetic field and placebo control group. The length of ICU stay was not significantly different between the PBMT-sMF and placebo groups (16.26 and 23.06 days, respectively). In contrast, PBMT-sMF was significantly associated with reduced diaphragm atrophy, improved ventilatory parameters and lymphocyte count, and decreased C-reactive protein levels and hemoglobin count. | ||||||
345 | July-August | Ganesh R | 10.1177/21501327211030413 | 2021 | USA | From March to September 2020. | To determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®) | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 817 | N/A | N/A | N/A | The questionnaires concern fatigue, sleep disturbance , sleep-related impairment , ability to participate in social roles and activities, physical function, and pain interference | This study reports about 817 COVID-19 patients (mean age 44±17; 61.1%females).The mean interval between initial positive PCR for SARS-CoV-2 and survey response was 68.4 days. Main findings : persistent symptoms (>28 days) are common in patients after resolution of acute COVID-19 disease and lead to impairment in the ability to participate in social roles (43.2%) and physical function (pain 17.8%, and fatigue 16.2%); PROMIS® scales reliably assess these symptoms and are comparable to findings in other survey studies; post COVID impairments prevalence and characteristics were influenced by being young (44 years), white (87%), and female (61%). | ||||||
346 | July-August | Gonzalez-Gerez JJ et al | 10.3390/ijerph18147511 | 2021 | Spain | October 2020 | to evaluate the feasibility and effectiveness of a novel program based on breathing exercises through telerehabilitation tools in COVID-19 patients with mild to moderate symptomatology in the acute stage. | Randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute | COVID-19 | 42 | N/A | Breathing Exercise Program via telerehabilitation | two assessments | Feasibility of the intervention. Six-MinuteWalk Test (6MWT). Multidimensional Dyspnoea-12 (MD12). Thirty-Second Sit-To-Stand Test (30STST). Borg Scale (BS). | Significant differences were found for all of the outcome measures in favour of the experimental group. BS: Int: --2.63 DS 1.05, Control: -0.32 DS0.04, P: <0.001. MD12. Int:-6.37, DS 2.44, Control: 0.05 DS 0.21; P: <0.001. 30STST: Int: 1.32, DS 0.14, Control:-0.31, DS: 0.72, P:0.001. 6MWT: Int: 112.86, DS -18.23, Control: 6.00, DS 1.14, P: 0.007 | This study reports about 42 COVID-19 patients with mild to moderate symptomatology in the acute stage (patients with positive PCR test and/or antigen test results in the last forty days were in home confinement). Subjects were random assigned to receiving either breathing exercises through telerehabilitation tools (mean age 40.79 ± 9.84) or sedentary activities (mean age 40.32 ± 12.53). The patients were assessed through video calls on the first and the seventh days. Thirty-eight subjects, with nineteen in each group, completed the one-week telerehabilitation program.The main finding is represented by the significant differences for all of the outcome measures in favor of the experimental group. Breathing exercises through telerehabilitation appeared as a promising strategy for improving outcomes related to physical condition, dyspnoea, and perceived effort among people exhibiting mild to moderate COVID-19 symptoms in the acute stage. | |||||
347 | July-August | Grover S et al. | 10.1016/j.ajp.2021.102815 | 2021 | India | From May to June 2, 2020 | To evaluate psychological morbidity, PTSD, fatigue, cognitive deficits and perceived stigma among patients with COVID-19 after recovery from the acute phase of COVID-19 infection. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Nervous system structures (s1) and related functions (Mental functions b1) | Ongoing | COVID-19 | 206 | N/A | N/A | N/A | Patient Health Questionnaire-4 (PHQ-4), Impact of Events Scale-Revised (IES-R), Fatigue Severity Scale, questionnaire to assess perceived stigma, 4-item Likert scale (ranging from 0 to 3), specifically designed to tap cognitive deficits | This study reports about 206 COVID-19 patients (median age 36 years, 54 % males, 66% of patients needed hospitalization, 8% needed ICU stay). They were assessed a mean of 33.72 (SD=49.52) days after recovery or hospital discharge, at around 2 months of COVID_19 infection. The main findings are represented by the prevalence of anxiety, depressive symptoms, and PTSD in the study sample that was 24.8 %, 23.8 %, and 30 % respectively. Moreover, 23.7% subjects reported feeling of being "confused, mentally foggy”, 31.5 % reported having a “lack of attention and concentration”, 22.3 % reported “forgetting recent things” and 18.4 % reported “forgetting past events”. | ||||||
348 | July-August | Hampshire A et al | 10.1016/j.eclinm.2021.101044 | 2021 | UK | between January and December 2020 | to assess wheter those who had recovered from COVID-19 would show objective cognitive deficits when performing tests of attention, working memory, problem solving and emotional processing | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Nervous system structures (s1) and related functions (Mental functions b1) | Post-Covid | COVID-19 | 12689 | N/A | N/A | 68648 people not affected by COVID-19 | global cognitive scores | This study reports about 81,337 subjects undergoing a clinically validated web-optimized assessment as part of the Great British Intelligence Test ( mean age 46.75 years, male 44.5%). Of them, 12689 reported a suspected or confirmed COVID-19 infection, requiring hospitalization in 192 cases (ventilation in 44 of them). Time of assessment after symptoms onset not reported. The main finding is represented by the rate of persistent significant cognitive deficits versus controls when controlling for age, gender, education level, income, racial-ethnic group, pre-existing medical disorders, tiredness, depression and anxiety. The deficits were of substantial effect size for people who had been hospitalised (N = 192), but also for non-hospitalised cases who had biological confirmation of COVID-19 infection (N = 326). These differences were likely not present prior to infection | ||||||
349 | July-August | Hayden MC, | 10.3390/ijerph18179001 | 2021 | Germany | From 28 April 2020 to 8 January 2021 | To evaluate the efficacy of PR in patients after COVID-19 | Non randomised controlled trial | General postacute rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 108 | N/A | Three-week inpatient PR | Fiftyfive subjects with severe COVID-19 symptoms treated in the acute phase (55) were compared to 32 subjects with severe symptoms receiving treatment after more than 1 month of hospital discharge and 21 subjects with mild symptoms | Primary outcome: dyspena (NRS, mMRC dyspnea scale). Secondary outcome: 6MWT, lung function, Brief Fatigue Inventory, EQ-5D-5L, PHQ-9,GAD-7 | This study reports about 108 COVID-19 patients (mean age 55.6 ± 10.1 years, 45.4% female) undergone PR as outpatients because of persistent symptoms after COVID-19 . The mean interval between hospital discharge (or end of the acute phase in non-hospitalized patients) and beginning of PR was 69±75.3 days. Post-hoc analysis of outcome was performed in the three subgroups identified according to the initial disease severity and the latency of rehab referral and (acute severe: 10.8±11.2 days; severe after interval:120.6±70.2 days; mild after interval:142.9±55.1days). The main finding is represented by the improvement with large effect sizes in exertional dyspnea, physical capacity, QoL, fatigue, and depression observed in the overall group exposed to PR program. There was a trend toward greater efficacy after ‘severe courses’ of COVID-19 and an earlier start of rehabilitation after the acute phase of the disease. Results were not compared to a control group. | ||||||
350 | July-August | Huang L et al. | 10.1016/S0140-6736(21)01755-4 | 2021 | China | January 2020 - May 2021 | To compare consequences between 6 months and 12 months after symptom onset among hospital survivors with COVID-19. | Cohort study | N/A | Epidemiology - Natural history | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 1276 | N/A | N/A | N/A | symptoms, mMRC score, health-related quality of life, distance walked in 6 min (6MWD), lung function, chest CT pattern, outpatient visit and hospital admission after discharge, and work status at follow-up | This study reports about 1276 COVID-19 patients (681 (53%) male, mean age 59 years). They were assessed at 6 and 12 months after symptom onset. The main finding is represented by the rate of change in functional outcomes 12 months after symptom onset in COVID-19 patients (hospitalized). The proportion of patients with at least one sequelae symptom decreased from 68% (831/1227) at 6 months to 49% (620/1272) at 12 months (p<0·0001). The proportion of patients with dyspnoea, characterized by mMRC score of 1 or more, slightly increased from 26% (313/1185) at 6-month visit to 30% (380/1271) at 12-month visit (p=0·014). No significant difference in 6MWD was observed between 6 months and 12 months. 88% (422/479) of patients who were employed before COVID-19 had returned to their original work at 12 months. | This study reports about 1276 COVID-19 patients (681 (53%) male, mean age 59 years). They were assessed at 6 and 12 months after symptom onset. The main finding is represented by the rate of change in functional outcomes 12 months after symptom onset in COVID-19 patients (hospitalized). The proportion of patients with at least one sequelae symptom decreased from 68% at 6 months to 49% at 12 months (p<0·0001). The proportion of patients with dyspnoea, characterized by mMRC score of 1 or more, slightly increased from 26% at 6-month visit to 30% at 12-month visit (p=0·014). No significant difference in 6MWD was observed between 6 months and 12 months. 88% (422/479) of patients who were employed before COVID-19 had returned to their original work at 12 months. | |||||
351 | July-August | Johnsen S | 10.1183/23120541.00205-2021 | 2021 | Denmark | From March 15 to August 31, 2020. | To systematically describe and measure pulmonary and extra-pulmonary post-COVID-19 complications in relation to acute COVID-19 severity. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 57 | N/A | N/A | N/A | COPD Assessment Test, MRC dyspnoea score,EQ-5D-5L ,WPAI, Lung function testing, CFQ, 1-MSTST, CPET, HRCT, SCIP-D, TMTB | This study reports about 57 COVID-19 patients (mean age 51±13, 49% male) who were evaluated in the respiratory outpatient clinic 3 months after discharge (hospitalised group) or resolution of the acute disease for patients referred by their general practitioner because of persistent post-COVID-19 symptoms. The main finding is that all 34 initially hospitalised patients and 22 out of 23 non-hospitalised patients had at least one complaint or abnormal finding 3 months post COVID-19. Most noteworthy, in the cohort of hospitalised patients, DLCO decreased below normal and HRCT abnormalities were found in about half of patients with the most common abnormality being ground-glass opacities. | ||||||
352 | July-August | Kaspersen KA et al. | 10.1016/j.ijid.2021.06.017 | 2021 | Denmark | From May to August, 2020 | To investigate the prevalence of COVID-19-associated symptoms obtained from self-reported questionnaires in a large cohort of patients with mild and asymptomatic infections. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 447 | N/A | N/A | Seronegative subjects (10691) | Self-reported symptom type and duration | This study reports about 11 138 healthcare and administrative personnel that were tested for SARS-CoV-2 antibodies. Out of the total population, 447 (4%) reported to be seropositive (mean age 44 years, 9 % males, BMI 24, with mild and asymptomatic infections). The main findings is represented by a higher risk of reporting symptoms (fever, dyspnoea, muscle or joint ache, fatigue, cough, headache and sore throat, even persisting for more than 30 days), with the strongest association observed for loss of sense of taste and smell (OR = 35.6; 95% CI: 28.6–44.3), in seropositive subjects with respect to seronegative subjects. | ||||||
353 | July-August | Kayaaslan B et al | 10.1002/jmv.27198 | 2021 | Turkey | December 2020 and February 2021 | to investigate the prevalence and characteristics of the post‐COVID syndrome among COVID‐19 survivors and to determine the factors associated with persistent symptoms. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 1007 | participants who have had COVID‐19 at least 3 months before | N/A | N/A | General systemic symptoms, Respiratory symptoms,Neuropsychiatric system symptoms, | General systemic symptoms including fatigue or easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms, and at least one of them was present in 29.3% of patients.Respiratory symptoms (25.4%) were the second common persistent symptoms and one‐fifth of the patients complained of dyspnea.Neuropsychiatric system symptoms were the third most common system symptoms (24.2%). Concentration or memory deficit (16.2%) and insomnia (9.6%) were the most frequent neurologic symptoms and followed by headache (5.7%).Hair losswas reported as a frequent dermatological symptom by COVID‐19 survivors (16.5%). | This study reports about 1007 COVID-19 patients (mean age, 54.4% male, at least one comorbid disease :54.4%, needed oxygen support during hospitalization: 59.6%). They were assessed at a median time of 20 weeks of symptom onset. The main finding is represented by the rate of persistent fatigue or easy fatigability, myalgia, and loss of weight in post- COVID19 patients at 5 months. At least one of those was present in 29.3% of patients. Respiratory symptoms (25.4%) were the second common persistent symptoms and one‐fifth of the patients complained of dyspnea. Neuropsychiatric system symptoms were the third most common system symptoms (24.2%). Concentration or memory deficit (16.2%) and insomnia (9.6%) were the most frequent neurologic symptoms and followed by headache (5.7%). Hair loss was reported as a frequent dermatological symptom by COVID‐19 survivors (16.5%) | |||||
354 | July-August | Lal P et al. | 10.1007/s12070-021-02752-0 | 2021 | India | From March 1 to August 15, 2020 | To study the presence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19. | Inception Cohort study | N/A | Epidemiology - Prevalence/Incidence | Nervous system structures (s1) and related functions (Sensory functions and pain b2) | Ongoing | COVID-19 | 47 | N/A | N/A | N/A | Subjective improvement in olfactory or gustatory symptoms and an approximate duration of recovery. | This study reports about 47 COVID-19 hospitalized patients who were interviewed about the persistence of olfactory/gustatory disorders complained of in the acute phase (mean age 34.53(10.82) years with the most common age group affected as 20–29 years old; mostly females). They were identified based on a clinical registry review of 435 COVID-19 cases. Patients with previous history of changes in smell or taste sensation, severely ill at the time of admission, with history of taking drugs at the time of COVID-19 infection that affect the smell or taste sensation were excluded. The mean recovery for olfactory dysfunction was 12.1 days. At 6 weeks follow-up only 3 patients were still experiencing incomplete recovery of olfactory dysfunction, and 1 of gustatory disfunction. | ||||||
355 | July-August | LaVergne SMet al | 10.1186/s12879-021-06359-2 | 2021 | USA | since July 2020 | to study differential multi-organ system responses to SARS-CoV-2 infection, post-acute sequelae of COVID-19 (PASC), and vaccination | Inception Cohort study | N/A | Epidemiology - Natural history | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 119 | N/A | N/A | N/A | any Post acute sequelae (PASC) | This study reports about 119 COVID-19 patients (mean age 50.3 years, 44.5% male).They were assessed up to 8 months of symptom onset. The main finding is represented by the rate of persistent fatigue, loss of smell, loss of taste, exercise intolerance, and cognitive dysfunction in COVID19 patients up to 8 months: Forty-nine percent of them had Post-acute sequelae (PASC) at any time during follow-up (up to 8 months post infection). Ninety-three percent of hospitalized participants developed PASC, while 23% of those not requiring hospitalization developed PASC. At 90–174 days post SARS-CoV-2 diagnosis, 67% of all participants had persistent symptoms (N = 37 of 55), and 85% percent of participants who required hospitalization during initial infection (N = 20) still had symptoms. | ||||||
356 | July-August | Li J et al | 10. 1136/ thoraxjnl- 2021- 217382 | 2021 | China | between 22 April and May 28 2020 | to investigate possible superiority of a telerehabilitation programme for COVID-19 (TERECO) over no rehabilitation with regard to functional exercise capacity, lower limb muscle strength (LMS), pulmonary function, perceived dyspnoea and health-related quality of life in formerly hospitalised COVID-19 survivors | Randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 120 | patients discharded from hospitals | unsupervised 6-week home exercise programme delivered through a smartphone application called RehabApp and monitored with a chest-worn heart rate (HR) telemetry device.. 3–4 sessions per week. It included (i) breathing control and thoracic expansion, (ii) aerobic exercise and (iii) LMS exercises specified in a three-tiered exercise plan with difficulty and intensity scheduled to increase over time | short educational instructions at baseline | functional exercise capacity at post-treatment measured with the 6 min walking test (6MWT). Pulmonary function was evaluated by spirometry. Health-related quality of life (HRQOL) was evaluated with the Short Form Health Survey-12 (SF-12) | any reported | This study reports about 120 COVID-19 survivors complaining for persistent dyspnoea at 70 days (+/-16.8) of hospital discharge (53 male; mean age: 50.61 +/-10.98 years) who were randomised to receive an unsupervised 6-week home exercise programme delivered through a smartphone application called RehabApp and monitored with a chest-worn heart rate (HR) (59 cases-TERECO group), or short educational instructions (61 controls) . Outcomes were assessed at 6 and 28 weeks (follow-up).The TERECO group showed a significant improvement in 6MWD, increasing by 65.45 m (95% CI 43.8 to 87.1; p <0.001) at post treatment and 68.62 m (95% CI 46.39 to 90.85; p<0.001) at follow-up. Quality of life (SF-12 physical component) also improved, whereas no group differences were found for lung function except post-treatment maximum voluntary ventilation. | |||||
357 | July-August | Lindhal A et al. | 10.1080/23744235.2021.1965210 | 2021 | Finland | From March to June, 2020 | To evaluate subjective long-term symptoms and their effect on the quality of life in Finnish COVID-19 survivors and the association of these with the individual patient-based and in-hospital factors. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 101 | N/A | N/A | N/A | A survey on demographics and comorbidities, ten specific symptoms, and a RAND-36 quality of life questionnaire. | This study reports about 101 COVID-19 patients (mean age 60 years, mean BMI 28.6, 53 % males, all of them needed hospitalization for a mean length of stay of 15 days). They were assessed 3 months after recovery. Main findings: 90% of patients still experienced symptoms, the most common of which were tiredness (88%), fatigue (79%), sleeping problems (76%), and dyspnoea (70%). Women showed a lower QoL in seven of eight dimensions. Five explanatory variables for the reduced quality of life were identified in multivariate analysis: age, female sex, BMI, sleep apnoea, and duration of mechanical ventilation. | ||||||
358 | July-August | Lombardi F et al | 10.1186/s12890-021-01594-4 | 2021 | Italy | between April 22nd and May 27th, 2020 | to investigate the prevalence of respiratory impairment in a cohort of COVID-19 patients after hospital discharge and to determine the relationship between the severity of pulmonary involvement during hospitalization and the extent of residual clinical and functional abnormalities | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 86 | previous hospitalization for COVID-19; radiological evidence of interstitial pneumonia at the time of hospital admission; nasopharyngeal swab negative for SARS-Cov-2 in the 48–72 h before study enrolment. | N/A | N/A | physical examination, resting ABG, pulmonary function tests (PFT) with DLCO, and 6MWT | On PFTs, lung volumes were overall preserved yet, mean percent predicted residual volume was slightly reduced (74.8 ± 18.1%). Percent predicted diffusing capacity for carbon monoxide (DLCO) was also mildly reduced (77.2 ± 16.5%). Patients reported residual breathlessness at the time of the visit (VAS 19.8, p < 0.001). Patients with p/F below 200 during hospitalization had lower percent predicted forced vital capacity (p=0.005), lower percent predicted total lung capacity (p=0.012), lower DLCO (p < 0.001) and shorter 6MWT distance (p=0.004) than patients with higher p/F. Approximately one month after hospital discharge, patients with COVID-19 can have residual respiratory impairment, including lower exercise tolerance. The extent of this impairment seems to correlate with the severity of respiratory failure during hospitalization. | This study reports about 86 COVID-19 patients (mean age 58 years, 67% male). They were assessed at 35 days post hospital discharge The main finding is represented by the rate of persistent respiratory impairment , including breathlessness and lower exercise tolerance . On PFTs, lung volumes were overall preserved yet, mean percent predicted residual volume was slightly reduced (74.8 ± 18.1%). Percent predicted diffusing capacity for carbon monoxide (DLCO) was also mildly reduced (77.2 ± 16.5%). Patients reported residual breathlessness at the time of the visit (VAS 19.8, p < 0.001). Patients with p/F below 200 during hospitalization had lower percent predicted forced vital capacity (p=0.005), lower percent predicted total lung capacity (p=0.012), lower DLCO (p < 0.001) and shorter 6MWT distance (p=0.004) than patients with higher p/F. | |||||
359 | July-August | Maestre-Muñiz MM et al | 10.3390/jcm10132945 | 2021 | Spain | From March 1 to June 1, 2020 | To evaluate the long-term consequences of the disease among survivors at 1 year follow-up | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 543 | N/A | N/A | N/A | Clinical data, mortality, symptoms. | This study reports about 543 COVID-19 survivors assessed at one year of COVID-19 diagnosis, out of a total 766 people with COVID-19 diagnosis in the acute phase. One-year mortality rate was 29%. Mean age of the total sample was 65.7 years, 50.7 % males; no demographic data is available about those who survived at one-year and were interviewed. Main findings: 90.1% of patients who needed hospitalization in the acute phase and 80.4% of those discharged from the emergency room (with mild symptoms) complained of persistent symtoms, most commonly breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%). | ||||||
360 | July-August | Martin-Martinez A | 10.1016/j.clnu.2021.06.010 | 2021 | Spain | From 14th April to 30th July 2020 | To assess the prevalence, risk factors and clinical outcomes of oropharyngeal dysphagia and malnutrition in a general hospital during the first wave of the COVID-19 pandemic. | Inception Cohort study | N/A | Epidemiology - Natural history | Digestive functions (b510) | Post-Covid | COVID-19 | 205 | N/A | N/A | N/A | Clinical assessment of dysphagia (Volume- Viscosity Swallowing Test), nutritional screening (NRS2002) and assessment (GLIM criteria), Barthel Index. The outcomes were assessed at pre-admission in general wards, admission and discharge, and after 3 and 6-months follow-up. | This study reports about 205 COVID-19 patients hospitalized in general wards (69.28 ± 17.52 years, Charlson 3.74 ± 2.62, mean hospital stay 16.8 ± 13.0 days). The main finding is represented by a high prevalence and burden of oropharyngeal dysphagia and malnutrition in patients hospitalized in COVID-19 wards with a high rate of symptom persistence at 6 months . At admission, Barthel Index was 81.3 ± 30.3, dysphagia prevalence 51.7% (44.1% impaired safety of swallow); and 45.5% developed malnutrition with a mean weight loss of 10.1 ± 5.0 kg during hospitalization. Dysphagia was an independent risk factor for malnutrition during hospitalization, and hospitalization was prolonged in patients with malnutrition compared with those without (21.9 ± 14.8 vs 11.9 ± 8.9 days, respectively). Dysphagia was independently associated with comorbidities, neurological symptoms, and low functionality. At 6-month follow-up, the prevalence of dysphagia was still 23.3% and that of malnutrition only 7.1%. Patients with dysphagia at discharge showed reduced 6-month survival than those without at discharge (71.6% vs 92.9%). In contrast, those with malnutrition at discharge did not show 6-month survival differences compared to those without. The results suggest that optimizing the management of malnutrition might shorten the hospitalization period but optimizing the management of dysphagia will likely impact the nutritional status of COVID-19 patients and improve their clinical outcomes and survival after hospital discharge. | ||||||
361 | July-August | Mittal C | 10.47203/IJCH.2021.v33i02.018 | 2021 | India | N/A | To assess the prevalence of Post COVID symptoms, to assess requirement of treatment and to make recommendation for Post COVID care. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 100 | N/A | N/A | N/A | N/A | This study reports about 100 COVID-19 who were interviewed regarding post covid symptoms in between 6 weeks to 12 weeks after recovery from COVID -19 (60 %were males.Among various age group 57% patient belong to 20-40 age group,35% belong to 40-60 age group while only 8% were 60 years and above. No respondent was below 20 years of age). The main finding is represented by the high prevalence of post covid symptoms: 87% patients developed one or more. Weakness was reported to be most common problem (55%), followed by body ache (26%) and neuropsychiatric symptoms such as difficulty in concentration and insomnia (22%). Every fifth patient reported that symptoms persisted for more than 1 month. Though most of the respondents classified their symptoms as mild and moderate (52.5% and 37.9% respectively), 47% of the symptomatic patients have to take some treatment for these symptoms. | ||||||
362 | July-August | Munker, D. | 10.1007/s15010-021-01669-8 | 2021 | Germany | Acute illness during the first wave (March to August 2020), follow-up up to december 2020. | To Evaluate pulmonary function impairment after COVID-19 in persistently symptomatic and asymptomatic patients of all disease severities and characterisation of risk factors. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 76 | N/A | N/A | N/A | Pulmonary function testing and cycle exercise blood gas analysis | This study reports about 76 COVID-19 patients assessed 4 months after acute illness (mean age was 49.6 ± 17.4, and 43.3% were male), 35 of which were outpatients with mild disease and 41 were hospitalized due to COVID-19 (16 with critical disease requiring mechanical ventilation, 25 with moderate-severe disease). The main finding is represented by the rate of persistent respiratory symptoms (44 patients,58%) at 4-month follow-up. Significant pulmonary function impairment was prevalent in 40 patients (52.6%) occurring among all disease severities. The most common cause was reduced DLCOcSB (51.3%), followed by reduced TLC and FVC. The severity of the pulmonary function impairment was significantly associated with mechanical ventilation. Further risk factors for DLCO impairment were COPD, SARS-CoV-2 antibody-Titer, and in hospitalized patients CT score. Gas exchange abnormalities were revealed upon cycle exercise in 1/5 of patients with mild disease courses and no preexisting pulmonary condition. | ||||||
363 | July-August | Nambi G et al. | 10.1177/02692155211036956 | 2021 | Saudi Arabia | March 2020 - April 2021 | To investigate the effects of different aerobic training protocols combined with resistance training in community-dwelling older adults with post-COVID-19 sarcopenia symptoms | Randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 76 | N/A | Low-intensity aerobic training (n = 38) for eight weeks. Resistance training was prescribed to both groups | High-intensity aerobic training (n = 38) for eight weeks. | Physical (muscle strength and muscle mass) and psychological (kinesiophobia and quality of life) scales) measures | This study reports about 76 COVID-19 patients divided into two groups (low-intensity aerobic training group, mean age 63.2 ± 3.1; high-intensity aerobic training group, mean age 64.1 ± 3.2). The patients were assessed at the baseline, fourth week, the eighth week, and at six months follow-up. The main finding is presented by the significant differences (P < 0.001) in terms of handgrip strength, −3.9 (95% CI −4.26 to −3.53), kinesiophobia level 4.7 (95% CI 4.24 to 5.15), and quality of life −10.4 (95% CI −10.81 to −9.9) between low-intensity aerobic training group rather than high-intensity aerobic training group, with better results in the low-intensity aerobic training group. Muscle mass did not show any significant difference (P> 0.05) between groups. | This study reports about 76 COVID-19 patients with post-Covid sarcopenia who were random assigned to two intervention groups (low-intensity aerobic training group, mean age 63.2 ± 3.1; high-intensity aerobic training group, mean age 64.1 ± 3.2). Interval from COVID_19 onset and treatment start is not reported. The patients were assessed at the baseline (before starting training), fourth week, the eighth week, and at six months follow-up. The main finding is presented by the significant differences (P < 0.001) in terms of handgrip strength, −3.9 (95% CI −4.26 to −3.53), kinesiophobia level 4.7 (95% CI 4.24 to 5.15), and quality of life −10.4 (95% CI −10.81 to −9.9) between low-intensity aerobic training group rather than high-intensity aerobic training group, with better results in the low-intensity aerobic training group. Muscle mass did not show any significant difference (P> 0.05) between groups. | |||||
364 | July-August | Rodriguez-Blanco | 10.3390/medicina57070684 | 2021 | Spain | 6–13 April 2021 | To evaluate the feasibility and effectiveness of a novel therapeutic exercise program through telerehabilitation tools in COVID-19 patients with mild to moderate symptomatology in the acute stage. | Randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Acute | COVID-19 | 40 | N/A | One week telerehabilitation: Non-Specific Conditioning Exercise Program, consisting of 10 exercises based on non-specific toning exercises of resistance and strength | 18 patients who did not perform physical activity. | 6MWT, Thirty seconds sit-to-stand test, Borg scale | This pilot RCT study reports about 40 COVID-19 (19 women) with mild to moderate symptomatology, confined at home by less than 40 days. They were random assigned to an experimental group receiving muscle conditioning exercises, and a control group, who did not perform physical activity. 36 subjects, 18 in each group (mean age 39.39±11.74 in exercise group and 41.33 ±12.13 in control group), completed the one-week intervention with 90%adherence.The main finding is represented by the greater improvement in all outcome measures in the experimental group. No gender-related differences in outcome were found. | ||||||
365 | July-August | Rousseau, A. F | 10.1186/s13613-021-00910-9 | 2021 | Belgium | From March 1st to July 17th, 2020 | To describe the physical, cognitive, psychological, and biological outcomes of COVID-19 survivors at 3 months following ICU discharge. | Cross-sectional study | General postacute rehabilitation | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 32 | N/A | N/A | N/A | EQ-5D-3L, PSQI, Barthel index, HADS and IES-R, MoCA | This study reports about 32 COVID-19 patients assessed 3 months after ICU stay (median age was 62 [49–68] years; 72% were male; ICU LOS days 23 [15–39]; and nearly half received inpatient rehabilitation following ICU discharge.)The main finding is represented by a high prevalence of patients (87.5%) who have not regained their baseline level of daily activities. The main observed disorders were sleep disorders (75%), cognitive impairment (44%), dependency in ADL (31%), and mental health disorders (28%). Combined disorders were observed in 40.6% of the patients. The quality of life was reduced as for EQ-5D-3L score at 71 [61–80]. A quarter of patients (8/32) demonstrated a persistent inflammation based on C-reactive protein blood level. | ||||||
366 | July-August | Salem AM et al. | 10.2147/IJGM.S319436 | 2021 | Saudi Arabia | From March to October, 2020 | To investigate the impact of COVID-19 pneumonia on pulmonary function measurements after three months from recovery. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 20 | N/A | N/A | 30 subjects that tested negative to COVID-19 testing | Pulmonary function testing. | This study reports about 20 COVID-19 patients (mean age 47 years, 65 % males, all of them were hospitalized during acute phase and 2 of them needed ICU stay). They were assessed at 3 months after recovery. They were compared to a control group of 30 subjects that resulted negative to COVID-19 testing. The main finding is represented by the 50% rate of restricted lung impairment, and the 35% rate of mild diffusion defect in COVID19 patients at 3 months, compared to the rate respectively of 20% and 23.3% in the control group. | This study reports about 20 COVID-19 patients (mean age 47 years, 65 % males, all of them were hospitalized during acute phase and 2 of them needed ICU stay). They were assessed at 3 months after recovery and the outcome was compared to that assessed in 30 healthy non-smoker volunteers with no history of asthma, allergy, chronic pulmonary diseases, past COVID-19 infection, and who were negative to COVID-19 testing. The main finding is represented by the 50% rate of restricted lung impairment, and the 35% rate of mild diffusion defect in COVID19 patients at 3 months, compared to the rate respectively of 20% and 23.3% in the control group. | |||||
367 | July-August | Salesi M et al. | 10.34172/ipp.2021.34. | 2021 | Iran | From February to May, 2020 | To understand whether the presence of the disease itself or the use of glucocorticoids and DMARDs in patients with concurrent RD and COVID-19 increases or decreases the severity of symptoms and outcome. | Cohort study | N/A | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | COVID-19 and concurrent RD | 19 | N/A | N/A | 200 subjects with COVID-19 without RD . | Severity of symptoms. | This study reports about 200 COVID-19 patients (mean age 54 years, 69 % males, all of them were hospitalized during acute phase and 17% needed ICU stay). They were assessed at 3 months after recovery. They were assessed from hospital presentation and followed-up for 12 weeks. They were compared to a control group of 19 patients with concurrent RD and COVID-19. The main finding is represented by the higher rate of respiratory symptoms in the RD compared to the NRD group after, but not before, recovery. However, no difference was found between the RD patient who received corticosteroid as a treatment and those who did not. | This study reports about 19 patients with Rheumatic disease (RD) and concurrent COVID-19 (mean age 58.26±12.77 years, 66 % males), hospitalized during acute phase, longitudinally assessed from hospital presentation up to 12 weeks. They were compared to a control group of 200 COVID-19 patients without concurrent RD . The main finding is represented by the higher rate of respiratory symptoms in the RD compared to the NRD group after, but not before, recovery. No difference was found between the RD subjects who received corticosteroid as a treatment and those who did not. An increased risk for severe forms of COVID-19 is estimated in RD patients. This risk is possibly attributable to a high prevalence of comorbidities . | |||||
368 | July-August | Salmon-Ceron D et al | 10.1016/j.jinf.2020.12.002 | 2021 | France | May 2020 | to describe the clinical, biological and imaging profile of patients with persistent or resurgent symptomsin order to suggest a classification of the symptoms and raise hypotheses about their pathophysiology. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 70 | N/A | N/A | N/A | Major fatigue or exhaustion - Neurological symptoms,. - Cardiothoracic symptoms - Muscular or/and articular pains - ENT symptoms: persistent or recurrent anosmia, hyposmia and/or dysgeusia . - Gastro-intestinal symptoms n. - Skin and vascular symptoms ). | Major fatigue or exhaustion for 51 patients (72.9%) - Neurological symptoms, in 54 (77.1%). Those were divided into neuro-cognitive disorders (such as memory, mood or attention disorders), headaches, sensory disturbances (such as balance disorders, tingling, burning sensations and neurogenic pains), or others (swallowing or speech disorders, thermoregulation disorders). - Cardiothoracic symptoms in 50 patients (71.4%): chest pain and tightness, palpitations, cough, dyspnea. - Muscular or/and articular pains for 20 (25.7%). - ENT symptoms: persistent or recurrent anosmia, hyposmia and/or dysgeusia for 21 (30%). - Gastro-intestinal symptoms for 17 (24.3%): diarrhea, nausea/ vomiting, epigastric or abdominal pain. - Skin and vascular symptoms in 10 (14.4%). | This study reports about 70 COVID-19 patients (median age 45 years, 21.4% male). They were assessed at1-2 months after symptoms onset The main finding is represented by the rate of persistent major fatigue or exhaustion (72.9%), neurological symptoms (77.1%) such as neuro-cognitive disorders, headache, sensory disturbances or others (swallowing or speech disorders, thermoregulation disorders). Patients also reported cardiothoracic symptoms (71.4%) such as chest pain and tightness, palpitations, cough, dyspnea, muscular or/and articular pains (25.7%), persistent or recurrent anosmia, hyposmia and/or dysgeusia (30%), gastro-intestinal symptoms (24.3%) such as diarrhea, nausea/vomiting, epigastric or abdominal pain, skin and vascular symptoms (14.4%). | |||||
369 | July-August | Sathyamurthy P et al. | 10.7759/cureus.17189 | 2021 | India | August-November 2020 | To analyze a cohort of older adults hospitalized with COVID-19 for the presence, prevalence, and patterns of post-COVID-19 syndrome alongside their functional outcomes 90 days after their recovery and discharge from the hospital. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any Activity limitation and participation restriction (d) | Post-Covid | COVID-19 elderly patients | 279 | Hospitalized older adults | N/A | M/M (mild to moderate illness) vs. S/C (severe to critical illness) | functional outcomes | This study reports about 279 COVID-19 patients (178 (63.8%) male, mean age 71 years). They were assessed 90 days after discharge. The main finding is represented by the prevalence of fatigue (8.9%) followed by cough (4.3%), breathlessness (1.8%), dizziness (1.4%), myalgia (1.1%), loss of smell and taste (0.8%), and chest discomfort (0.7%). There was no difference in the prevalence of persisting symptoms between men and women. The prevalence of post-COVID-19 syndrome (two or more clinical features) was significantly high among severe to critical illness patients (14% vs. 6%) when compared with mild to moderate ilness patients (p = 0.50). followed by cough (4.3%), breathlessness (1.8%), dizziness (1.4%), myalgia (1.1%), loss of smell and taste (0.8%), and chest discomfort (0.7%). There was no difference in the prevalence of persisting symptoms between men and women. | This study reports about 279 COVID-19 patients older than 65 (178 (63.8%) male, mean age 71 years), who were interviewed 90 days after hospital discharge. Clinically, 58.4%) patients suffered from mild/moderate disease, whereas 41.6% from severe/critical COVID-19. The main finding is represented by the prevalence of fatigue (8.9%) followed by cough (4.3%), breathlessness (1.8%), dizziness (1.4%), myalgia (1.1%), loss of smell and taste (0.8%), and chest discomfort (0.7%). There was no difference in the prevalence of persisting symptoms between men and women. 23.6% patients reported the presence of at least one clinical feature while 9.3% had two or more clinical features, with this risk being greater among severe to critical illness patients compared with mild to moderate ilness patients (14% vs. 6%) (p = 0.50). Most older adults retained their baseline functional status after 90 days of recovery from acute COVID-19. | |||||
370 | July-August | Seeßle, J | 10.1093/cid/ciab611 | 2021 | Germany | From 22nd of February 2020 to 18th of April 2020 | To better understand the long-term course and etiology of COVID-19 symptoms | Inception Cohort study | N/A | Epidemiology - Natural history | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 96 | N/A | N/A | N/A | symptoms assessment, antinuclear antibodies (ANA) titers , and SARS-CoV-2 antibody levels, SF12 | This study reports about 96 patients (median age 57; 55.2% females; 32.3% hospitalised) systematically assessed at 5, 9, and 12 months after COVID-19 symptom onset. The main findings are represented by: 1) At month 12, only 22.9% of patients were completely free of symptoms and the most frequent symptoms were reduced exercise capacity (56.3%), fatigue (53.1%), dyspnoea (37.5%), concentration problems (39.6%), problems finding words (32.3%), and sleeping problems (26.0%). 2) Compared to patients without symptoms, patients with at least one long COVID symptom at 12 months did not differ significantly with respect to their SARS-CoV-2-antibody levels, but had a significantly reduced physical and mental life quality compared to patients without symptoms. 3) Females showed significantly more neurocognitive symptoms than males. 4) Several neurocognitive symptoms were associated with ANA titre elevations rendering autoimmunity a potential cofactor in aetiology of long COVID. | ||||||
371 | July-August | Skjørten I et al | 10.1183/13993003.00996-2021 | 2021 | Norway | between June 1, 2020 and september 2020 | to describe cardiopulmonary function during exercise 3 months after hospital discharge for COVID-19 and compare groups according to dyspnea and intensive care unit (ICU) stay. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 156 | N/A | N/A | Normal values from a Norwegian reference population with similar comorbidities | Peak oxygen uptake (VO2), Dyspnea, Ventilatory efficiency, Breathing reserve assessed 3 months after dischage | This study reports about 156 COVID-19 patients (median age 56.2 years, 61.6% male). They were assessed at 3 months after hospital. The main finding is represented by a reduction of ventilatory efficiency in 15% of participants and of breathing reserve <15% in 16% . Oxygen pulse <80% of predicted was found in 18%. Dyspnea (mMRC ≥1) was reported by 38%. In participants treated at ICU vs. non-ICU, mean peak (SD) VO2 % of predicted were 82 (15)% and 90 (17)% (p=0.004), respectively. Ventilation, breathing reserve, and ventilatory efficiency were similar between the ICU and non-ICU groups.. | ||||||
372 | July-August | Stavrou VT, | 10.3390/jpm11080806 | 2021 | Greece | From September 2020 to December 2020 | To determine the impact of unsupervised Pulmonary Rehabilitation (uns-PR) on patients recovering from COVID-19, and determine its anthropometric, biological, demographic and fitness correlates. | Non randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 20 | N/A | unsupervised Pulmonary rehabilitation. Adherence to the program was determined via 2 phone calls per week prior to the visit. | This is a before-after study where subjects serve as their own controls | Anthropometric characteristics and body composition,Pulmonary function test, Oxidative stress biomarkers, 6 MWT, Pittsburgh Sleep Quality Index | This study reports about 20 COVID-19 patients (age: 64.1 ± 9.9 years, 75% male) who participated in unsupervised Pulmonary Rehabilitation (uns-PR) program for eight weeks. The main findings were that after uns-PR significant improvement were observed in all outcome measures, during 6MWT (i.e. systolic blood pressure, heart rate , oxygen saturation, dyspnea at the end of 6 MWT, distance , estimated O2 uptake, plasma antioxidant capacity, body composition parameters and muscle mass). The authors support the implementation of unsupervised pulmonary rehabilitation programs in patients following COVID-19 recovery, targeting the improvement of many aspects of long COVID-19 syndrome. | ||||||
373 | July-August | Stute NL rt al. | doi: 10.1113/EP089820 | 2021 | USA | NR | to investigate whether central and peripheral hemodynamics during handgrip exercise were different in young adults 3-4 weeks following infection with of SARS-CoV-2 compared with young healthy adults. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Cardiovascular functions (Heart b410) | Acute | COVID-19 | 13 | N/A | 13 otherwise healthy young adults whose data were collected prior to the COVID-19 pandemic | Symptom Severity. Central hemodynamics, Peripheral hemodynamics during handgrip exercise | This study reports about 13 young adults who tested positive for SARS-CoV-2 in the prior 3-4 weeks and 13 age-matched healthy controls (mean age 21 years in COVID patients, 27 years in control subjects , 61% male in either group).They were assessed up to 25 days after testing positive for SARS-CoV-2. The main finding is represented by higher systolic blood pressure, end systolic arterial pressure, and rate pressure product in the SARS-CoV-2 group during exercise at 45%MVC compared with controls; lower brachial artery BF and brachial artery vascular conductance at both 30%MVC .The shear-induced dilation of the brachial artery increased similarly across exercise intensities in the two groups, suggesting the decrease in exercising blood flow may be due to microvascular impairments. | |||||||
374 | July-August | Taylor, R. R | 10.7861/clinmed.2021-0037 | 2021 | UK | November 2020 | To describe the post-COVID symptoms of patients stratified by severity of acute COVID-19 infection. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 675 | N/A | N/A | N/A | N/A | This study reports about a total 675 COVID-19 patients interviewed after 12 weeks of hospital discharge (of which, 129 were high-risk pneumonia patients , mean age 57.1±12.9; 68%male; and 376 were low-risk pneumonia patients, mean age 59.3±16.2; 59%male), or after 12 weeks of confirmed or suspected COVID (n=130 home treated subjects, mean age 46.8; ±12.9; 42%male). The main findings is represented by the high prevalence of physical health and mental health symptoms in hospital-treated patients following both ‘high-risk’ and ‘low-risk’ acute COVID pneumonia and in community-referred patients. The most common was fatigue (50.3% of high- risk patients, 46.8% of low risk, and 82.3%of community ). Pneumonia severity in the acute phase is not a predictor of long COVID symptoms. | ||||||
375 | July-August | Tempany M et al. | 10.1093/occmed/kqab109 | 2021 | Ireland | From June to November, 2020 | To assess the prevalence and nature of persistent symptoms among HCWs presenting for duty, who had either (i) nominally recovered from clinically apparent and PCR diagnosed infection or (ii) demonstrated evidence of previous sub-clinical COVID-19 infection by having reactive antibody results. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 217 | N/A | N/A | N/A | Degree of recovery and persistent symptoms. | This study reports about 217 COVID-19 patients, 139 PCR positive and 78 antibody positive (the range of the age was 20 to 69 with no information about median and mean, 80 % males, only 59% truly symptomatic in the acute phase). All were assessed at least 3 months after COVID-19 diagnosis. Among the first group, only 19% reported feeling 100% recovered, and 71% reported persistent symptoms. Among the latter group 39% still complained of residual symptoms. | ||||||
376 | July-August | Trevissón-Redondo B et al. | 10.3390/ijerph18147258 | 2021 | Spain | From March to December, 2020 | To evaluate ADLs using the Barthel Index before and after infection with the severe acute respiratory syndrome coronavirus 2 in a population of geriatric inpatients. | Inception Cohort study | N/A | Epidemiology - Natural history | Any Activity limitation and participation restriction (d) | Post-Covid | COVID-19 | 68 | N/A | N/A | N/A | BI | This study reports about 68 geriatric subjects living in nursing homes who were hospitalized due to COVID-19 (mean age 85.9 years, 50% males, BMI 24). The Barthel index assessed within the 3 months preceding COVID-19 onset was compared to the BI assessed in the 3 month-period following COVID-19 onset. The main findings is represented by the reduced independence in ADLs of institutionalized elderly in nursing homes after experiencing COVID-19, regardless of gender. | ||||||
377 | July-August | Van Veenendaal et al. | 10.3390/healthcare9070865 | 2021 | Netherlands | March-September 2020 | To assess the long-term physical, social and psychological functioning of COVID-19 ICU-survivors and their family members | Cohort study | N/A | Epidemiology - Natural history | Any Activity limitation and participation restriction (d) | Post-Covid | COVID-19 and family members | 60 COVID-19 ICU-survivors and 78 family members | COVID-19 ICU survivors | N/A | N/A | Physical functioning, frailty, spirometry, social functioning, return to work, psychological functioning. Results: Sixty COVID-19 ICU-survivors and 78 family members participated in this study | This study reports about 60 COVID-19 ICU-survivors (mean age 62.5 (55.3–68.0) ; 41 male) and 78 family members (mean age 56.0 (41.0–63.0), 20 male). They were assessed at three- and six months following ICU discharge. The main finding is represented by the levels of physical functioning impairment in ICU-survivors (33.3 (IQR 16.7–66.7) and 50 (IQR 16.7–83.3) out of 100 at 3- and 6-month follow-ups). Ninety percent of ICUsurvivors reported persistent symptoms after 6 months. Social functioning was impaired since 90% of COVID-19 ICU-survivors at 6 months. Psychological functioning was unaffected in COVID-19 ICU-survivors. Family members experienced worse work status in 35% and 34% of cases, including a decrease in work rate among 18.3% and 7.4% of cases at 3- and 6-months. Sixty-three percent of family members reported impaired well-being. | This study reports about 60 COVID-19 ICU-survivors (mean age 62.5 (55.3–68.0) ; 41 male) and 78 family members (mean age 56.0 (41.0–63.0), 20 male). They were assessed at three- and six months following ICU discharge. The main finding is represented by the levels of physical functioning impairment in ICU-survivors (33.3 (IQR 16.7–66.7) and 50 (IQR 16.7–83.3) out of 100 at 3- and 6-month follow-ups). Ninety percent of ICUsurvivors reported persistent symptoms after 6 months. Social functioning was impaired since 90% of COVID-19 ICU-survivors at 6 months. Psychological functioning was unaffected in COVID-19 ICU-survivors. Family members experienced worse work status in 35% and 34% of cases, including a decrease in work rate among 18.3% and 7.4% of cases at 3- and 6-months. Sixty-three percent of family members reported impaired well-being. | |||||
378 | July-August | Walsh-Messinger J et al. | 10.1101/2020.11.24.20238261 | 2021 | USA | From October 7 to November 11, 2020 | To investigate the prevalence and features of post- COVID syndrome in a sample of university students with mild to moderate acute illness severity. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 43 | N/A | N/A | Patients that fully recovered from COVID-19 and subjects not diagnosed with COVID-19 | Self-reported symptoms | This study reports about 148 students involved in an online survey . Out of the entire population analyzed, 43 were COVID-19 patients assessed at 86 days (on average) after COVID-19 onset (22 of them complained of symptoms lasting≥28 days; mean age 19 years, 36% males; whereas 21 were fully recovered; mean age 19 years, 33% males), 58 were COVID-19 test negative (mean age 19 years, 36% males), whereas the remaining were not clinically diagnosed with COVID-19. Main finding: 51% of partecipants who contracted COVID-19 were still experiencing symptoms and all but one of them were females. | ||||||
379 | July-August | Zampogna E et al. | 10.36416/1806-3756/e20210076 | 2021 | Italy | From May 27 to September 17, 2020 | To evaluate the exercise capacity of patients four weeks after discharge from an acute care facility and after a three-month follow-up. | Cohort study | Specialized outpatient rehabilitation | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 30 | N/A | N/A | Patients were divided in two groups of 15 patients each, according to the results of the 6MWT (<75% of the predicted value group and ≥75% group) | Pulmonary function testing, SPPB, Euro QoL VAS. | This study reports about 30 COVID-19 patients (mean age 63.6 years, 70 % males, all of them were hospitalized during acute phase and needed ICU stay). They were assessed at two time-points: three to five weeks after discharge and three months later. Patients were divided in two groups of 15 patients each, according to the results of the 6MWT (<75% of the predicted value group and ≥75% group). Exercise capacity and functional status values returned to predicted values in patients of both group at the end of the follow-up; however, only the subjects in the <75% group showed significant improvements in dyspnea and lower extremity function. | This study reports about 30 COVID-19 patients (mean age 63.6 years, 70 % males, all of them were hospitalized during acute phase and needed ICU stay). They were assessed at two time-points: three to five weeks after discharge and three months later. Patients were analysed in subgroups based on the results of the 6MWT (<75% of the predicted value group and ≥75% group). Exercise capacity and functional status values returned to predicted values in patients of both groups at the end of the follow-up; however, only the subjects in the <75% group showed significant improvements in dyspnea and lower extremity function. | |||||
380 | July-August | Zhou M. et al | 10.3389/fmed.2021.682087 | 2021 | China | between March 5th and March 31st, 2020 | To investigate whether coronavirus disease 2019 (COVID-19) survivors who had different disease severities have different levels of pulmonary sequelae at 3 months post-discharge. | Cohort study | N/A | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 146 | N/A | N/A | N/A | Static and dynamic lung volumes;The lung diffusion capacity for carbon monoxide (DLCO) and per-unit alveolar volume (DLCO/VA);pulmonary function parameters were expressed as a percentage of the predicted value (e.g., FEV1% pred, TLC% pred, FVC% pred, RV% pred, DLCO% pred, etc.,), Ground glass opacity (GGO) and solid components (SC) at CT scan; quality-of-life evaluation (St. George Respiratory Questionnaire [SGRQ]) | This study reports about 146 subjects, 95 recovered from severe/critical COVID-19 (SPs), 51 recovered from mild/moderate disease (MPs). Volunteers who recovered from asymptomatic COVID-19 from an isolation hotel (28) and uninfected healthy controls from the community (42) were recruited as controls. COVID -19 subjects were assessed 3 months after hospital discharge. The SGRQ scores were highest in the SPs, while APs had slightly higher SGRQ scores than those of HCs; 85.1% of SPs and 68.0% of MPs still had residual CT abnormalities, mainly ground-glass opacity (GGO) followed by strip-like fibrosis at 3 months after discharge, but the pneumonic lesions were largely absorbed in the recovered SPs or MPs relative to findings in the acute phase. Pulmonary function showed that the frequency of lung diffusion capacity for carbon monoxide abnormalities were comparable in SPs and MPs (47.1 vs. 41.7%), while abnormal total lung capacity (TLC) and residual volume (RV) were more frequent in SPs than in MPs (TLC, 18.8 vs. 8.3%; RV, 11.8 vs. 0%). |