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PM R . Outcomes of a COVID-19 Recovery Program for Patients Hospitalized with SARS-CoV-2 Infection in New York City: A Prospective Cohort Study

tetano

Editor, Senior Moderator
PM R


. 2021 Feb 18.
doi: 10.1002/pmrj.12578. Online ahead of print.
Outcomes of a COVID-19 Recovery Program for Patients Hospitalized with SARS-CoV-2 Infection in New York City: A Prospective Cohort Study


Farah Hameed[SUP] 1 [/SUP], Eugene Palatulan[SUP] 1 2 [/SUP], Abhishek Jaywant[SUP] 3 [/SUP], Rami Said[SUP] 4 [/SUP], Corinna Lau[SUP] 5 [/SUP], Vandana Sood[SUP] 2 [/SUP], Aimee Layton[SUP] 6 [/SUP], Alfred Gellhorn[SUP] 2 [/SUP]



Affiliations

Abstract

Introduction: In the Spring of 2020, New York City was an epicenter of COVID-19. The post-hospitalization needs of COVID-19 patients were not understood and no outpatient rehabilitation programs had been described.
Objective: We implemented a program across two hospital campuses to treat patients discharged home with persistent COVID-19 symptoms. We evaluated if a virtual rehabilitation program would lead to improvements in strength and cardiopulmonary endurance when compared with no intervention.
Design: Prospective cohort study SETTING: Academic medical center PATIENTS: We treated 106 patients discharged home with persistent COVID-19 symptoms between April-July 2020. 44 patients performed virtual physical therapy (VPT); 25 patients performed home physical therapy (HPT); 17 patients performed independent exercise program (IE); and 20 patients did not perform therapy.
Interventions: All patients were assessed by physiatry. VPT sessions were delivered via secure HIPAA-compliant telehealth platform 1-2 times/week. Patients were asked to follow up 2 weeks after initial evaluation.
Main outcome measures: Primary study outcome measures were the change in lower body strength, measured by the 30-second sit-to-stand test; and the change in cardiopulmonary endurance, measured by the 2-minute step test.
Results: At the time of follow up, 65% of patients in the VPT group and 88% of patients in the HPT group met the clinically meaningful difference (CMD) for improvement in sit-to-stand scores, compared with 50% and 17% of those in the IE group and no-exercise group (p=0.056). 74% of patients in the VPT group and 50% of patients in the HPT, IE and no-exercise groups met the CMD for improvement in the step test (p=0.12).
Conclusions: Virtual outpatient rehabilitation for patients recovering from COVID-19 improved lower limb strength and cardiopulmonary endurance, while a home physical therapy program improved lower limb strength. Virtual rehabilitation seems to be an efficacious method of treatment delivery for recovering COVID-19 patients. This article is protected by copyright. All rights reserved.

Keywords: COVID 19; Coronavirus; SARS-CoV-2; Telerehabilitation; neuropsychology; pandemic; physical therapy; pulmonary rehabilitation; rehabilitation; speech therapy; telehealth; telemedicine; virtual therapy.
 
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