ABSTRACT
PURPOSE: The aim of our study is to evaluate effects of early rehabilitation treatment in hospitalized patients with severe COVID-19, in order to improve patients' autonomy and quality of life. METHODS: This observational study has been performed in hospitalized patients with severe COVID-19. All patients were evaluated at T0 using specific scales: Modified Barthel Index (MBI) for autonomy in ADL, Mini Mental State Examination (MMSE) for cognitive status, Borg scale for dyspnoea, EQ5D scale for quality of life. In absence of contraindications for the rehabilitation treatment, patients start early a rehabilitation protocol consisting of one session (30 minutes) per day, for 2 to 3 weeks;these scales have been repeated at patient's demission (T1). RESULTS: 70 patients (37 women and 33 men, with average age of 71 years) with severe COVID-19 were included in the study. After rehabilitation treatment, MBI increases statistically significantly from T0 to T1 (39.8±35.0 with 95% CI 31.6-48, vs 69.8±38.1 with 95% CI 60.8-78.7, p < 0.001);besides MBI at T0 correlates inversely and statistically significantly with all EQ-5D variables at T0, similarly at T1 (p < 0.001), indicating the improvement of autonomy and therefore of the quality of life. The MMSE correlates statistically significantly with MBI at T0 and T1 (r = 0.569, r = 0.747 respectively, p < 0.001), indicating that an adequate cognitive status is connected with a greater increase in autonomy in ADL after rehabilitation treatment. MBI correlates directly and significantly with the PaO2/FiO2 value both at T0 and T1 (r = 0.263 with p = 0.039, r = 0.389 with p = 0.023 respectively), indicating that improving the oxygen exchanges also improves the patient's autonomy. CONCLUSIONS: An early rehabilitation treatment should promote autonomy and a better quality of life in patients with COVID-19. © 2022-IOS Press. All rights reserved.
ABSTRACT
In April, a 58-year-old woman was admitted to our hospital for dyspnea. She was a healthy nonsmoker. She lived in a place with ahigh burden of Covid disease. The symptoms started in early March,when her husband was found positive for Sars-CoV2 infection andwas transferred to the Covid Hospital. Her asymptomatic daughterwas also found to have a positive nasal swab, whilst the patientturned out to be negative. For the persistence of dyspnea, she arrived to our hospital and isolated in the restricted Covid area, basedon the epidemiological criterion. A second swab performed, whichwas negative. ABG and walking test were within normal limits. Laboratory tests showed normal blood cell counts, PCR, PCT and Ddimer were normal. H1N1 was not detected. ChestX-ray showed alimited area of thickening in the right middle lobe. Dyspnea was stillthe main complaint. Thus, a test for IgM/IgG against Sars-CoV-2was ordered, which revealed the presence of serum specific IgG;CTscan showed widespread reticular thickening of the peripheral interstitium. The patient was transferred to the internal medicine wardand was maintained in isolation. Therapy with azithromycin and hydroxychloroquine was begun;a third nasal swab eventually yieldeda positive result for Sars-CoV2 infection. The patient was finally transferred to the Covid Hospital and discharged home after one month.This case shows that: 1) the epidemiological criterion remains paramount for diagnosis of Covid19 infection;2) the latency period ofthe virus may vary;3) CT scan is a relevant tool in the diagnosticwork-up, particularly in doubtful cases.