Rehabilitation Needs of Children Admitted with Covid-19 Pneumonia

ABSTRACT

INTRODUCTION: Adults with COVID-19 pneumonia have well-documented decline in physical function and mobility, yet little is known regarding pediatric patients' rehabilitation needs during and after inpatient treatment for COVID-19 pneumonia. We sought to characterize the rehabilitation needs noted in children who were admitted with COVID-19 pneumonia. METHOD(S) This small cohort study took place at a standalone academic children's hospital. Subjects were identified by reviewing the physical and occupational therapy consult list and the infectious disease surveillance list for patients with a primary diagnosis of COVID-19 pneumonia, acute respiratory failure due to COVID-19, or acute respiratory distress syndrome secondary to COVID-19 during a 6-week period from September 1, 2021- October 13, 2021. Data were extracted from the electronic medical record. RESULT(S) The entire cohort included 29 patients, 20 of which had rehabilitation (rehab) consults and nine who did not. When comparing groups, the rehab cohort was older (median age 16 years, IQR 13-17, vs. median age 0 years, IQR 0-1.5) and more likely to be obese (12 [60%] vs. none). Fifteen (75%) of the rehab cohort and four (44%) of the norehab cohort required the intensive care unit (ICU), with five (25%) requiring invasive mechanical ventilation compared to none in the no-rehab group. The rehab cohort had a longer ICU length of stay (median 5 days [IQR 3-17] vs. 2.5 days [IQR 2-3]) and hospital length of stay (median 7 days [IQR 4-8.75] vs. 4 days [IQR 3.5-4.5]. In the rehabilitation cohort, on initial evaluation 19/20 (95%) were recommended physical and occupational therapy while inpatient, and on discharge 17/20 (85%) were recommended outpatient rehabilitation. CONCLUSION(S) In this small cohort of children requiring hospitalization for COVID-19 pneumonia, rehabilitation needs during admission and post discharge were prevalent. It is unknown if the cohort of children not evaluated by the rehabilitation team may have had unrecognized needs and benefited from therapy. Further larger scale prospective studies are needed to ascertain the true burden of rehabilitation needs in this patient population and help guide screening and treatment recommendations.