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The COVID-19 pandemic has altered people's lifestyles around the world. Prevention of recurrent episodes of the disease and mitigation of its consequences are especially associated with effective post-COVID-19 rehabilitation in patients. The aim of the study was to evaluate the effects of the drug Likopid (glucosaminylmuramyl dipeptide, GMDP) for post-COVID-19 rehabilitation in patients. Material and methods. Patients who recovered from mild to moderate COVID-19 (n=60, mean age 54+/- 11.7 years) were randomized into the observation group (n=30, 15 men and 15 women) who received 2 courses of Licopid (1 mg twice a day) and the comparison group (n=30, 15 men and 15 women). Analysis of the phenotypic and functional characteristics of the innate immune cellular factors was carried out before the start of immunomodulatory therapy, immediately after the end of the course, and also after 6 months observations. In order to assess the quality of life of all patients, we used the SF-36 Health Status Survey and the Hospital Anxiety and Depression Scale questionnaires. Results. During assessing the effect of immunomodulatory therapy on the parameters of innate immunity of patients at the stage of rehabilitation after COVID-19, an increase in the protective cytolytic activity of CD16+ and CD8+Gr+ cells, as well as a persistent increase in TLR2, TLR4 and TLR9 expression was found, which indicates the antigen recognition recovery and presentation at the level of the monocytic link of the immune system. The use of GMDP as an immunomodulatory agent resulted in an 8-fold reduction in the frequency and severity of respiratory infections due to an increase in the total monocyte count. As a result of assessing patients' quality of life against the background of the therapy, a positive dynamic in role functioning was revealed in patients. In the general assessment of their health status, an increase in physical and mental well-being was noted during 6 months of observation. The comparison group showed no improvement in the psychoemotional state. Discussion. The study demonstrated the effectiveness of GMDP immunomodulatory therapy in correcting immunological parameters for post-COVID-19 rehabilitation in patients. The data obtained are consistent with the previously discovered ability of GMDP to restore impaired functions of phagocytic cells and induce the expression of their surface activation markers, which in turn contributes to an adequate response to pathogens. Conclusion. The study revealed that the correction of immunological parameters with the use of GMDP in COVID-19 convalescents contributed not only to a decrease in the frequency and severity of respiratory infections, but also to an improvement in the psycho-emotional state of patients, and a decrease in anxiety and depression.Copyright © Eco-Vector, 2023. All rights reserved.
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Background. The rapidly developing resistance of viruses to synthetic antiviral drugs indicates the need to use substances with multitarget action (to avoid polypharmacy and to improve the safety of treatment). Objective(s): systematic analysis of the scientific literature on the pharmacology of bioflavonoids with an emphasis on their antiviral action. Material and methods. More than 150,000 references of primary sources were found in the PubMed/MEDLINE database of biomedical publications, including 3282 references on the antiviral effects of bioflavonoids. A systematic computerized analysis of this array of publications was carried out in order to identify the main directions in the pharmacology of bioflavonoids with an emphasis on their antiviral, antibacterial and immunomodulatory effects. The literature analysis was carried out using modern methods of topological and metric analysis of big data. Results. The molecular mechanisms of action of baicalin, hesperidin, rutin, quercetin, leukodelphinidin bioflavonoids and epigallocatechin-3gallate, curcumin polyphenols, their anti-inflammatory, antioxidant, antiviral, bactericidal, angioprotective, regenerative effects, and their prospects in therapy, prevention and rehabilitation of patients with COVID-19 and other respiratory viral infections were described in detail. Conclusion. Bioflavonoids and synergistic polyphenols exhibit not only multitarget antiviral effects by inhibiting the main protease, spike proteins, and other target proteins, but also pronounced anti-inflammatory, hepatoprotective, and immunomodulatory effects.Copyright © 2023 Modern Medical Technology. All rights reserved.
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Background: The SARS-CoV-2 pandemic is a global crisis with massive effects on all areas of society, such as the labor market, social security systems, and healthcare. It represents a complex stress situation that hardly leaves anyone unscathed. As a result, a significant increase in mental stress and ill- ness has been observed since the beginning of the pandemic. The coronavirus pandemic almost paralyzed rehabilitation in the spring of 2020. When comparing the 1st quarter of 2019 with that of 2021 (cumulative), a decrease of –32.8% is recorded for 2021 in the applications for services for medical rehabilitation (total 2020 to 2019: –14.2%). For the rehabilitation centers, the central and vital question is under which conditions rehabilitation measures can be carried out safely and successfully even in times of a pandemic. This also includes the confi-dence of potential rehabilitation patients, referring physicians, and employees in the structural and procedural measures taken by the centers. Materials and methods: The study aims to shed light on the effects and coping attempts of the pandemic in medical rehabilitation from different perspectives and to provide indications for routine care in “COVID normal operation”. The focus is on a comparative analysis of the results of the routine survey in the period October 2019 to June 2020, interviews with the management level of the center as well as a cat-amnestic follow-up survey of rehabilitation patients who completed a psychosomatic rehabilitation measure in the center in the period January to September 2020. Results: The interviews at the management level and the analysis of the safety concept show that a crisis team was installed at a very early stage in the center and a safety concept was established, which met with a high level of acceptance among all participants and contributed to a feeling of safety. The comparison of the routine survey shows that, with the exception of individual cases, the rehabilitation measures were carried out and completed according to plan. In most areas, the ratings have even improved in the 1st half of 2020 compared to the 4th quarter of 2019. The results of the catamnestic survey confirm the results of the routine survey. The rehabilitation patients who were treat-ed at the Rehazentrum Bad Bocklet during the COVID pandemic showed pronounced psychosomatic and participation-related limitations in the period before or at admis-sion. Regarding concerns and fears about the COVID situation, almost half of all respondents stated strong or very strong fears about the effects of the COVID pandemic on personal or close persons. In the foreground are fears that a close person could become infected or die. The hospital’s safety measures in terms of hygiene and adapted struc-tures and processes were rated positively by around three quarters of respondents. This is also confirmed by the results of the outcome parameters examined. The personal therapy goals were achieved for about three quarters of the respondents. Positive chang-es were seen in terms of health, health com-plaints, anxiety and depression symptoms, global health and the development of the ability to work, among other things. The RTW rates are 71% (time point method) and 81% (cumulative time course). The benefit of the rehabilitation measure is rated as high by 73% of the respondents is the treatment satisfaction. Substantial influences of rehab motivation, admission periods, and percep-tion and evaluation of COVID measures at the center on key outcome parameters are shown. These results emphasize the role of appropriate safety and hygiene measures adapted to the current hazard situation in the context of rehabilitation measures. The results indicate that the hospital succeeded in implementing suitable measures right at the beginning of the pandemic, and in com-municating and living these measures ac-cordingly. In addition, they allow the conclu-sion that under suitable safety and hygiene conditions, rehabilitation measures can also be carried out safely in times of pandem c and still show stable effects in essential tar-get criteria of medical rehabilitation after one year.
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Introduction: Clinical pharmacists specialising in critical care have become integrated into the critical care workforce providing valuable contributions to patient care.1 These findings are supported through the inclusion of clinical pharmacy services within national professional and commissioned standards for critical care.2,3 On admission to critical care, clinical focus changes from management of any chronic conditions to that of immediate preservation of life. This is inherently associated with acute changes in prescribed medicines.Medicines reconciliation on admission to and discharge from critical care is included specifically within the commissioning standards3 and aims to address any discrepancies generated by this change in focus. Unprecedented pressures experienced during the COVID-19 pandemic have resulted in stretched staff to patient ratios and mobilisation of less experienced staff. This has negatively impacted the end-to-end reconciliation process causing patients to be discharged home with unresolved medicines discrepancies. In line with recent NICE4 and Intensive Care Society guidance,5 rehabilitation of patients, post-critical care is important in completing unresolved actions and optimising care. Consequently, in September 2020 a carousel rehab clinic was introduced. All professional groups were invited to contribute. Objectives: To embed a pharmacist within the rehabilitation clinic to focus on any unresolved medicines reconciliation issues. Methods: Five senior critical care pharmacists (band 8a or above) participated in service provision to the clinic, which ran on two days a week. For consistency and structure, a local SOP and electronic note template was produced. All interventions recommended were discussed with the patient at the time and for GPs to review and action as appropriate in the context of their responsibility for ongoing care. Data collection for this service evaluation was retrospective and performed by one of the critical care pharmacists who had participated in the clinic. Historic clinic dates for September - November 2020 (inclusive) were reviewed on the electronic scheduling system to identify patients who attended clinic;these were then filtered for pharmacist entries to ascertain: • Number of patients reviewed • Number of medication-related interventions made • Intervention type and medication(s) involved Results: Over the 3-month period 51 patients were reviewed with a total of 59 medicine interventions made. The average number of interventions per patient was 1.2, with a range of 0 - 7. Eight intervention categories were identified (see Figure 1);the top three of which recommended stopping a medication (27%), reviewing a medication's need (19%) or restarting a medication (17%). The drugs most frequently intervened on were lansoprazole (12%) and bisoprolol (7%). Examples of significant clinical interventions made include: • Stopping acutely initiated bisoprolol (resolution of acute AF secondary to acute sepsis/dehydration on ICU) • Stopping of acutely started olanzapine for ICU-related agitation/delirium • Dose optimisation of bisporolol (post recent NSTEMI) • Re-initiation of atorvastatin (for secondary prevention of IHD) Conclusion: Medication interventions made by pharmacists in the post ICU rehabilitation clinic setting are clinically significant and add value to patient care both in terms of morbidity and mortality. Our results demonstrate a reduction in polypharmacy burden in line with wider healthcare initiatives.
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Background: Intermittent hypoxia conditioning reduces the levels of infam-matory parameters and cytokines (C-reactive protein, TNF-α, IL-4, IL-6, IL-8), increases the tolerance to acute hypoxia, the functional capacity and improves parameters of respiratory and cardiovascular systems [1-4]. Objectives: To evaluate the efficiency of the interval hypoxic-hyperoxic training (Reoxy therapy) in the rehabilitation of patients with osteoarthritis (OA) and post-COVID syndrome. Methods: 36 patients with OA (78% females, age of 43 to 68 years, generalized OA, OA of the knee or hip joints) where included in the randomized placebo-controlled study. Coronavirus infection COVID-19 were diagnosed from 12 to 26 weeks before the study. The main symptoms of post-COVID syndrome were dry cough, smell loss, breathlessness, weakness, fatigue, sleep disorders, cognitive symptoms, memory problems, anxiety, depression, headache, dizziness, joint and muscle pain. All patients were randomized into 3 groups. 13 study group patients received 10 Reoxy therapy procedures, 9 placebo group patients-10 placebo procedures of Reoxy therapy, 14 control group patients-only standard rehabilitation. The patients of all groups underwent 2-week standard rehabilitation program: 10 procedures of electrostatic massage for muscles and periar-ticular tissues, 10 sessions of general magnetic therapy, 10 group sessions of physical exercises with elements of breathing exercises. All patients received NSAIDs and SYSADOA at standard dosages. Intra-articular corticosteroids was not used. The study group patients were breathing hypoxic (FiO2 13-15%) and hyperoxic (FiO2 up to 40%) gas mixture through the mask in the interval mode with biofeedback using device «ReOxy» (Ai Mediq S.A., Luxembourg). 10-min hypoxic test (FiO2 12-13%) was performed before the frst and fourth procedures. The duration of 1-4 procedures was 30 min, 5-10 procedures-40 min. The placebo procedures were performed using the mask with the atmospheric air hole. Joint pain and general health on 100-mm VAS, Lequesne and WOMAC indexes, Spielberger-Khanin anxiety test, Beck depression inventory and breath-lessness on Modifed Borg scale were evaluated at baseline and at 2 weeks. Results: After 2 weeks in the study group pain on VAS decreased by 49,6% (p<0,05), Lequesne index-by 39,3% (p<0,05), WOMAC-by 1,4 times (p<0,01), anxiety level on Spielberger-Khanin test-by 40,9% (p<0,05), depression level on Beck depression inventory-by 64,1% (p<0,01), general health on VAS improved by 69,3% (p<0,01). The level of breathlessness on Modifed Borg scale in the study group initially was 2,5±0,9 score (moderate-slight breathlessness). After rehabilitation in the study group the level of breathlessness decreased to 0,3±0,4 score (extremely slight-no breathlessness). In the study group there were statistically signifcant differences from the placebo group (p<0,05) and the control group (p<0,05) in all parameters. Conclusion: 2-week complex rehabilitation program, including interval hypox-ic-hyperoxic training (Reoxy therapy), reduces pain, breathlessness, depression and anxiety, improves functional status and general health in patients with OA and post-COVID syndrome.
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This study is a systematic review of rehabilitation techniques, medical and nursing care, and heart monitoring in patients with lung involvement and fractures and multiple traumata. The lung is one of the main organs affected by the corona virus. According to the guidelines published in March 2020 for physiotherapists in the treatment of patients with COVID-19, cardiopulmonary physiotherapy focuses on the treatment and rehabilitation of acute and chronic respiratory conditions of patients, and the goal is to improve the physical strength of people following the disease. Based on this, physiotherapy can play an effective role in respiratory treatment and physical rehabilitation of patients with COVID-19. Dr. Kia added: People who have underlying risk factors and heart problems are more exposed to Covid-19, and of course, this virus itself can cause heart disease in people who do not have heart disease. A significant number of hospitalized corona patients suffer from myocardial damage, which is associated with an increased risk of death in these people. Myocardial damage can be caused in two ways: myocarditis or heart failure, which can be measured by echocardiography or blood markers. Another damage that the corona virus causes to the heart is the blockage of the coronary arteries in the form of MI or acute heart attacks. Another damage is cardiac arrhythmias or disturbances in the normal rhythm of the heart with the mechanism of the virus attack on the conduction system of the heart, which causes the person to experience an increase or decrease in the heart rate. Another complication of this virus is thrombosis or blood clots in the body or lung embolism or strokes. One of the symptoms that patients report these days when visiting doctors or medical centers is the feeling of pain while lying down, and in fact, it is most likely inflammation of the pericardium or pericarditis, which is caused by the attack and attack of the corona virus on the heart. The person becomes inflamed and it is one of the common symptoms of this disease.
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Background: Long term respiratory complications seems to be a major concern in patients treated for COVID 19 infection. Objectives: To study the association between CT severity and lung age in patients treated for COVID 19 infection and to thereby study the impact of COVID 19 infection on pulmonary functions of patients. Methodology: This cross sectional hospital based study was conducted on 147 patients in the Department of Pulmonary Medicine, Goa Medical College for 6 months. Patients confirmed to be COVID 19 positive by either molecular test or antigen test were subjected to 128 slice CT machine for assessing CT severity score at admission. Based on clinical and radiological parameters patients were called for follow up at 6 weeks for assessment of lung Age , FEV1 and FEV6 using a Vitalograph lung age monitor device Results: Patients with severe CT severity score (CTSS) had a higher mean lung age (102.4) at follow up than patients with mild and moderate CTSS ,who had lung age of 48.3 and 87 respectively. Thus as CT severity progresses there will be an accelerated decline in lung function. Conclusion: The Vitalograph lung Age monitor is a hand held device which is easily available OPD level/ bed side to assess the limitations of pulmonary functions/ extent of damage in suspected cases of post covid fibrosis .This method of assessment will avoid the unnecessary radiation exposure in our patients (in the form of follow up CT thorax) and ultimately help in better rehabilitation of patients.
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Introduction: The geriatric patient cohort is at high risk of falling and sustaining a fragility fracture, leading to an admission to the orthopaedic rehabilitation ward. Outbreaks of COVID-19 on wards were a common occurrence, with 13% of cases classified as 'healthcare acquired'. This study examines a group in whom these two scenarios coincided, those who sustained a fragility fracture, and later contracted COVID-19 during their rehabilitation stay. The study aims to identify whether access to orthopaedic rehabilitation services during the acute phase of COVID-19 was associated with better patient outcomes. Methods: A retrospective, cohort observational study was carried out. Data from 26 rehabilitation patients aged over 65 years with confirmed COVID-19 at two Irish orthopaedic rehabilitation wards were collected from health records. Symptom profile, COVID-19 severity level based on Irish Thoracic Society guidelines, Clinical Frailty Scale (CFS), Cumulative Illness Rating Scale-Geriatric (CIRS-G) scores and radiological data were reviewed and compared with outcomes from a similar study carried out in the hospital setting. Results: Patient mortality rate was 7.7% (n = 2) in the orthopaedic rehabilitation population compared to 23.2% (n = 16) in the acute hospital orthopaedic population. Median survivor age was 79.5 years (IQR 70-85.5) and 81.5 years (IQR 76.5-86.5), respectively. Mean CFS was 4.15 (SD 1.6) and 5 (SD 1.6), respectively. Mean CIRS-G scores were 10.6 (SD 4.3) and 8.19 (SD 4.4). Most patients were categorised as mild COVID-19 cases (n = 25, 96%), (n = 56, 81.1%). Eight patients (n = 8, 30.8%) in rehabilitation group were asymptomatic compared to five (n = 5, 7%) in the acute hospital group. Atypical symptom presentation was 15.4% (n = 4) and 7% (n = 5) respectively. Delirium was noted in 11.6% (n = 3) of rehabilitation patients compared to 30.4% (n = 21) of acute patients. Non-invasive ventilation was required in 3.8% (n = 1) of rehab patients and 2.9% (n = 2) of acute hospital patients. Conclusion: Orthopaedic rehabilitation patients were younger, less frail, had a milder COVID-19 disease profile and lower mortality rate when compared with orthopaedic patients in the acute hospital setting. Rehabilitation patients had lower rates of reported delirium. Rehabilitation patients' better outcomes may have been associated with an increased accessibility to allied healthcare, increased time between sustaining a fragility fracture and being diagnosed with COVID-19 and a hospital environment more conducive to recuperation.
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Introduction: In January 2021, Ireland was undergoing the 'Third Wave' of COVID-19, with almost 2,000 persons hospitalised with COVID-19. Over 50% of all COVID-19-related deaths in the EU have occurred in those aged 80 years and older. The same patient cohort is also at high risk sustaining a fragility fracture, leading to an admission to the orthopaedic rehabilitation ward. This study examines a patient group in whom these two scenarios coincided, describing a patient cohort who having sustained a fragility fracture, later contracted COVID-19. This study aims to describe the characteristics and outcomes of orthopaedic rehabilitation patients with COVID-19 and to examine the response of an orthopaedic rehabilitation ward to an outbreak of COVID-19. Methods: This is a retrospective observational study. Data from 26 hospitalised patients aged over 65 years with COVID-19 at an Irish orthopaedic rehabilitation ward was collected. Symptom profile, degree of COVID-19 severity, Clinical Frailty Scale (CFS), Charleston co-morbidity scores, laboratory and radiological data were reviewed. Individual treatment pathways were recorded for each patient. Infection control records were reviewed to examine the response of the ward to an outbreak of COVID-19. Results: Patient mortality rate was 7.7% (n = 2). Median survivor age was 79.5 years (IQR 70-85.5). Mean CFS and Charleston Co-morbidity scores were 4.15;(SD1.6) and 5.08, respectively. The majority of patients (n = 25, 96%) were categorised as mild COVID-19 cases. Delirium was noted in more than 10% of patients (n = 3, 11.6%). One patient (n = 1, 3.8%) required non-invasive ventilation. In those whose disease was classifies as severe (n = 2, 7.7%), intubation/resuscitation were not deemed appropriate and when they deteriorated, comfort measures were taken. The majority of patients (n = 21, 81%) were able to return home upon discharge. Three patients (11.5%) had increased care needs and required long term care to be arranged. Conclusion: An outbreak of COVID-19 requires a multidisciplinary approach with a focus on not only medical management but also clinical workforce management, patient flow, management of access to the wards and information and communications management. The overall outcomes in this group, including mortality and proportion discharged to long term care, were positive when compared to similar cohorts of elderly hospitalised patients with COVID-19. These outcomes support a multidisciplinary model of care.
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The proceedings contain 35 papers. The topics discussed include: ambulatory phlebectomy in the treatment of superficial venous disease;artificial intelligence in the research of vein valve damage;associated factors, natural history and management of venous leg ulceration from the UK Biobank cohort;biomatrix sclerofoam in large recurrent varices with three year follow-up;comparison of the effects of detergent and osmotic sclerosants in an ex-vivo human vein study using histology and immunohistochemistry;COVID-19 and VTE: institution of an aggressive anticoagulation policy decreased venous thromboembolism (VTE) in surgical patients;cyanoacrylate adhesive closure of incompetent perforator veins;and efficiency of non-drug complex rehabilitation of patients with chronic venous diseases of the lower limbs and obesity.
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BACKGROUND AND PURPOSE: Covid-19 is a novel respiratory disease leading to high rates of acute respiratory distress syndrome (ARDS) and causes adverse effects on both the peripheral and respiratory muscles. Despite optimal medical management some patients with severe Covid-19 develop irreversible lung injury. Patients who cannot be weaned from mechanical ventilation (MV) or extracorporeal life support, lung transplantation (LTX) may be the only life-saving option. Inspiratory muscle training (IMT) has been extensively studied in a variety of non-LTX population with results indicating improvements in exercise capacity, diaphragmatic thickness, reduced dyspnea with ADL's and improved quality of life. Several previous studies found that IMT is a feasible and safe modality in ICU patients. A recent study showed significant improvements in the dyspnea index and quality of life following 2 weeks of IMT in Covid-19 patients after weaning from MV. To the best of our knowledge, no studies have investigated the use of IMT immediately after lung transplantation due to Covid-19 in addition to physical therapy intervention. This report describes the effects of IMT on inspiratory muscle strength, perceived dyspnea and physical performance over the course of 22 weeks in two patients post lung transplantation. CASE DESCRIPTION: Two males (45 ± 9 yr, BMI 33.6 ± 0.1 kg/m2) admitted to the hospital with ARDS secondary to Covid-19 underwent double lung transplantation and performed IMT (2 sessions/day;30 breathes, 50% maximal inspiratory pressure, (MIP);5 days/week) in addition to physical therapy immediately following surgery. Inspiratory muscle strength (MIP), perceived dyspnea (Modified Borg Dyspnea Scale, MBS) and physical performance (4- meter walking speed and 5 times sit to stand) were assessed at baseline and weekly for a total of 22 weeks. Length of hospital stay (LOS) was 58 ± 22 days and both patients participated in a 12 week Pulmonary Rehab Program upon hospital discharge. OUTCOMES: There were no adverse events associated with the intervention. IMT resulted in an increase MIP from -25.7 ± 13 cmH2O to -79.8 ± 7 cmH2O (22% to 66% of predicted normal). MBS improved 4 and 2, to 3 and 0 respectively. Baseline physical performance: 4-meter walking speed and 5-time sit to stand test were 0.40 ± 0.3 m/sec and 60 seconds, and improved to 1.28 ± 0.1 m/s and 7 ± 3 seconds, respectively, after IMT. Activity Measure for Post-Acute Care mobility score (AM-PAC) 7 improved from 7.5 ± 0.7 at evaluation to 18 ± 6.4 upon discharge. DISCUSSION: The present case report describes the integration of IMT to physical therapy intervention in two patients immediately following double lung transplantation due to Covid-19. Improvements in inspiratory muscle strength, perceived dyspnea and functional performance following IMT were present in both cases after a 22 week intervention. These results indicate that IMT program should be encouraged in the rehabilitation of patients post Covid-19. Further research is needed to investigate the benefits of IMT for patients requiring lung transplantation and/or post-Covid-19.
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Introduction: The SARS-CoV2 pandemic fundamentally changed our daily work. All rehabilitation clinics developed a comprehensive safety and hygiene concept at the beginning of 2020 to perform rehabilitation safely. In addition, we early started routine PCR screening of all patients. This comprehensive testing and safety strategy was accompanied by significant logistical and financial challenges. Methods: From April - September 2020 (first study period), PCR testing of all rehabilitation patients was performed on the day of arrival following pre-hospital screening for symptoms, contact history, information about testing, and the necessary 1-2 days of quarantine after arrival. From October 2020 - February 2021 (second study period) a rapid antigen test was performed in all patients on arrival and repeated 3-7 days later. In addition, routine screening of the clinic staff for SARS-CoV2 was performed. The testing strategy was accompanied by extensive hygiene measures covering all rehabilitation processes. Number and test results, age, indication, and period of stay were prospectively recorded and are reported here. Results: A total of 5051 patients underwent PCR testing during the first study period. Of these, 3204/5051 (63.4%) had an oncological and 1227/5051 (28.2%) had an orthopedic diagnosis. 367/5051 (7.3%) had a psychosomatic disease, and 252/5051 (4.9%) underwent an ophthalmological rehabilitation. 4/5051 patients (0.08%) were tested positive. 2/4 were tumour patients. In the 2nd study period from October 2020 to February 2021, 65/6885 (0.9%) of patients tested positive on a rapid antigen test kit. Of the tumour patients, 20/2574 (0.78%) were positive in the antigen test. Since the start of the employee testing in October, 25 employees with contact to patients have been tested positive. One clinic had to be closed for 1 week during this period by order of the local health department. Conclusions: As expected, the proportion of positively tested patients increased by a factor of 10 in the second study period from October 2020 - February 2021. Remarkably, the proportion of positively tested oncological patients who might be particularly vulnerable to infection did not differ from other (orthopedic/psychosomatic) patients. Our experience with >10 000 patients after more than 1 year of pandemic shows that with a comprehensive hygiene and testing concept, rehabilitation can be performed without increased risk of infection.
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Patients with novel coronavirus disease-19 (COVID-19) pneumonia continue to have problems with respiratory function, physical and psychological function, the ability to perform activities of daily living, and social participation after discharge from the hospital. As such, strengthening rehabilitation treatments for discharged patients and relapse prevention after recovery are important aspects of the prevention and control of COVID-19. This paper combined the principles and practices of in Chinese and Western medicine and compiled the recommendations of both for home rehabilitation in the post-COVID-19 epidemic stage. The purpose of this paper is to facilitate the self-rehabilitation of patients with COVID-19 and to promote the prevention and control of COVID-19 at this current stage.
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This study aimed to clarify the effects of the interruption of cardiac rehabilitation (CR) and refraining from going outside due to the COVID-19 pandemic on hemodynamic response and rating of perceived exertion (RPE) during exercise including differences by age in phase 2 CR outpatients. Among 76 outpatients participating in consecutive phase 2 CR in both periods from March to April and June to July 2020, which were before and after CR interruption, respectively, at Sanda City Hospital were enrolled. The inclusion criterion was outpatients whose CR was interrupted due to COVID-19. We compared the data of hemodynamic response and RPE during exercise on the last day before interruption and the first day after interruption when aerobic exercise was performed at the same exercise intensity in the < 75 years group and ≥ 75 years group. Fifty-three patients were enrolled in the final analysis. Post-CR interruption, peak heart rate increased significantly (p = 0.009) in the < 75 years group, whereas in the ≥ 75 years group, weight and body mass index decreased significantly (p = 0.009, 0.011, respectively) and Borg scale scores for both dyspnea and lower extremities fatigue worsened significantly (both, p < 0.001). CR interruption and refraining from going outside due to the COVID-19 pandemic affected the hemodynamic response, RPE during exercise and body weight in phase 2 CR outpatients. In particular, patients aged ≥ 75 years appeared to be placed at an increased risk of frailty.