| 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. |
| 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. |
| 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. |
| 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. |
| 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 |
| 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. |
| 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. |
| 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. |
| 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. |
| 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 |
| 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. |
| 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. |
| Lima MS |
10.1590/2317-1782/20192020222
|
2020 |
Brasil |
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 |
| 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. |
| 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. |
| 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. |
| 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) |
| 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 |
| 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 |
| 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. |
| 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. |
| 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. |