Persistent Symptoms and Disability After COVID-19 Hospitalization: Data From a Comprehensive Telerehabilitation Program.

OBJECTIVE: To report symptoms, disability, and rehabilitation referral rates after coronavirus disease 2019 (COVID-19) hospitalization in a large, predominantly older population. DESIGN: Cross-sectional study, with postdischarge telemonitoring of individuals hospitalized with confirmed COVID-19 at the first month after hospital discharge, as part of a comprehensive telerehabilitation program. SETTING: Private verticalized health care network specialized in the older population. PARTICIPANTS: Individuals hospitalized because of COVID-19. We included 1696 consecutive patients, aged 71.8±13.0 years old and 56.1% female. Comorbidities were present in 82.3% of the cases (N=1696). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Dependence for basic activities of daily living (ADL) and instrumental activities of daily living (IADL) using the Barthel Index and Lawton's Scale. We compared the outcomes between participants admitted to the intensive care unit (ICU) vs those admitted to the ward. RESULTS: Participant were followed up for 21.8±11.7 days after discharge. During postdischarge assessment, independence for ADL was found to be lower in the group admitted to the ICU than the ward group (61.1% [95% confidence interval (CI), 55.8%-66.2%] vs 72.7% [95% CI, 70.3%-75.1%], P<.001). Dependence for IADL was also more frequent in the ICU group (84.6% [95% CI, 80.4%-88.2%] vs 74.5%, [95% CI, 72.0%-76.8%], P<.001). Individuals admitted to ICU required more oxygen therapy (25.5% vs 12.6%, P<.001), presented more shortness of breath during routine (45.2% vs 34.5%, P<.001) and nonroutine activities (66.3% vs 48.2%, P<.001), and had more difficulty standing up for 10 minutes (49.3% vs 37.9% P<.001). The rehabilitation treatment plan consisted mostly of exercise booklets, which were offered to 65.5% of participants. The most referred rehabilitation professionals were psychologists (11.8%), physical therapists (8.0%), dietitians (6.8%), and speech-language pathologists (4.6%). CONCLUSIONS: Individuals hospitalized because of COVID-19 present high levels of disability, dyspnea, dysphagia, and dependence for both ADL and IADL. Those admitted to the ICU presented more advanced disability parameters.

Injury Profile in a Brazilian First-Division Youth Soccer Team: A Prospective Study.

CONTEXT: Despite the popularity of soccer at the male first-division youth level, data on the incidence of injuries in Brazil are limited. OBJECTIVE: To prospectively study the injury profile of male first-division youth soccer players during 1 season (January to December 2017). DESIGN: Descriptive epidemiology study. SETTING: Data compiled at a youth soccer academy. PATIENTS OR OTHER PARTICIPANTS: The study involved 228 players between 10 and 20 years old from a first-division Brazilian soccer academy. MAIN OUTCOME MEASURE(S): Injury incidence rate was reported as the number of injuries divided by overall exposure (training and match hours) multiplied by 1000. The rate ratio (injury incidence rate during matches in relation to training) was also calculated. Time-loss injuries (ie, physical complaints sustained during soccer matches or training that resulted in a player being unable to take part in soccer training or match play) during the season were recorded. RESULTS: A total of 187 injuries were documented in 122 players (65.2%). During the season, 100 389 hours of exposure (5995 hours of match play and 94 394 of training) were registered. The overall injury incidence rate was 1.86 per 1000 hours. In total, 4792 days were lost from soccer activities. The majority of injuries were noncontact thigh muscle disorders and ankle sprains. Injury incidence was greater in matches than in training, and the oldest age group (under 20 years old) had the highest injury incidence rate in matches, while the under 17-year-old group had the highest injury incidence rate in training sessions (22.48 and 3.05 per 1000 hours, respectively). CONCLUSIONS: Muscle injury incidence rates observed among Brazilian soccer athletes under 20 years old were similar to those reported in professional players. Preventive measures are recommended to reduce injury rates. Additionally, the number of injuries incurred during training was high compared with match play, and training programs need to be assessed so that injury prevention can be improved.