Rehabilitation in Acute COVID-19 Patients: A Japanese Retrospective, Observational, Multi-Institutional Survey.
Yuka Yamada, Michiyuki Kawakami, Syoichi Tashiro and 10 others
PMID 34896082WHAT IT FOUND
Most mild and severe patients recovered walking and swallowing independently without rehabilitation.
Critical patients had higher rates of persistent disability. Rehabilitation was provided to only 13% of patients, often delayed or suspended due to PPE shortages and staff concerns, though no therapists were infected.
Key findings
01Rehabilitation was provided to only 13.4% of the total 456 patients, with rates varying by severity: 58.3% for critical, 16.9% for severe, and 3.8% for mild cases.
02Among surviving patients, 94% of those with severe symptoms and 97% of those with mild symptoms were able to walk independently at discharge, regardless of whether they received rehabilitation.
03Three of five hospitals temporarily postponed or suspended rehabilitation due to lack of personal protective equipment or human resources, yet no therapists contracted the virus from known positive patients during direct intervention.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was retrospective, so the criteria for providing rehabilitation were not uniform across hospitals. Patients who received rehabilitation were older and sicker at baseline than those who did not, confounding any comparison of outcomes between the two groups. The study was conducted in urban Japanese hospitals, which may have different patient severity profiles and resource availability compared to other countries. Respiratory function, neurological status, and other ADLs beyond eating and walking were not evaluated. The number of patients receiving rehabilitation was small, particularly in the severe and mild groups.
Declared interests
None declared.
The easy way to misread this
Do not interpret the higher discharge independence rates in non-rehabilitated patients as evidence that rehabilitation is ineffective. The patients who received rehabilitation were older, had longer hospital stays, and were more likely to have pre-existing walking disabilities, making them a fundamentally different and more impaired group than those who did not receive therapy.