Recovery from Coronavirus Disease 2019 among Older Adults in Post-Acute Skilled Nursing Facilities.
Sandra Shi, On-Yee Lo, Natalie Newmeyer and 2 others
PMID 33894176WHAT IT FOUND
Older adults recovering from COVID-19 in skilled nursing facilities generally regained function and returned home, with no significant difference in discharge rates compared to non-COVID patients.
However, those with moderate-to-severe frailty started lower and ended with significantly less independence than non-frail peers.
Key findings
01There was no significant difference in the proportion of patients discharged to the community between those who were COVID-19 positive and those who were negative.
02Among patients discharged to the community, those with moderate-to-severe frailty had significantly lower functional scores at discharge than non-frail patients, despite similar lengths of stay.
03Patients who tested negative for COVID-19 showed significantly less improvement in modified Barthel Index scores than those who tested positive.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study was conducted in only two facilities in Boston, limiting generalizability. The sample size was small (73 patients), and the authors note it was likely underpowered to detect differences in some outcomes. The study could not adjust for specific complications of COVID-19 versus other illnesses because the non-COVID group had a wide range of diagnoses. Discharge functional status was not captured for patients transferred back to the hospital, potentially biasing results toward those who improved. The study design was observational, so it cannot establish causality or attribute effects solely to rehabilitation.
Declared interests
The study was supported by the National Institutes of Health (Extramural). No other conflicts of interest are explicitly declared in the provided text.
The easy way to misread this
Do not conclude that COVID-19 infection itself enhances rehabilitation potential. The finding that COVID-19 positive patients had greater mBI improvement may reflect a greater severity of illness in the non-COVID comparison group or other unmeasured factors, rather than a benefit of the virus.