Patient Outcomes and Lessons Learned From Treating Patients With Severe COVID-19 at a Long-term Acute Care Hospital: Single-Center Retrospective Study.

This was a retrospective single-center record review, so it describes outcomes and usual care rather than proving that any specific treatment caused improvement. The comparison group was historical, not concurrent, and the authors used a shorter time frame, which can introduce differences in patient mix, staffing, and treatment practices. Sample size was not planned before the study, and some comparisons were underpowered, especially ventilator weaning, where the reference cohort had only 7 mechanically ventilated patients. Functional outcome comparisons were incomplete: complete admission and discharge gait and FIM data were available for 99 of 127 COVID-19 admissions and 90 of 170 reference admissions. Cognitive-communication outcomes could not be compared with the reference cohort because the needed values were not readily available. Treatment practices changed during the pandemic, and some patients may have received less therapy intensity because of isolation and droplet precautions. The cohort included patients selected or prioritized for LTACH care, including health care workers and first responders when beds were scarce, so it may not represent all severe COVID-19 patients.

Do not conclude that this LTACH rehabilitation program caused the improvements. The study was retrospective, used a historical comparison group, did not randomize patients, and did not test a specific intervention, so it cannot separate the effect of any single component of care.