Outcomes of Acute Inpatient Rehabilitation for Debility and COVID-19 Infection

ABSTRACT

Objective: The COVID-19 pandemic has presented a unique challenge for inpatient rehabilitation facilities to deliver safe and effective rehabilitation for patients recovering from COVID-19 and other rehabilitation diagnoses. There is a paucity of research assessing the effectiveness of inpatient rehabilitation on patients with COVID-19. The objective of this study was to compare post-acute rehabilitation outcomes of patients with debility and COVID-19 to outcomes of patients with debility only. Design(s) Retrospective Cohort Study Setting: Single inpatient rehabilitation facility Participants: Patients admitted for debility from April 1, 2020 to July 30, 2020. COVID-19 status was determined by a positive PCR test during the acute care or inpatient rehabilitation hospitalization period. Intervention(s) None Main Outcome Measure(s) Differences in admission and discharge functional performance scores (GG scores) and length of stay were compared. Rehabilitation efficiency, the average increase per day in functional performance score, was calculated. Result(s) 560 patients admitted for debility were reviewed. There were 83 (14.8%) patients admitted with COVID-19, who were on average 61 years old, male (55.4%), and African American (72.3%). Patients admitted with COVID-19 had a mean GG score gain of 26 points and median length of stay of 15 days. Patients admitted without COVID-19 had a mean GG score gain of 18 and median length of stay of 15 days. Compared to patients without COVID-19, patients with COVID-19 had a comparable length of stay but a significantly increased change in GG score at discharge (p < 0.001) and higher rehabilitation efficiency (p=0.001). Conclusion(s) There was a significantly greater improvement in GG scores and rehabilitation efficiency for patients with debility and COVID-19 compared to patients with debility without COVID-19. Our findings suggest that patients with debility and COVID- 19 benefit from acute inpatient rehabilitation and may be even more amenable to intensive therapeutic rehabilitation compared to patients with debility without COVID-19.