PROLONGED SYMPTOMS FOLLOWING COVID: IMPLICATIONS FOR PHYSIOTHERAPY

D. Ehrmann Feldman¹, B. Mazer²

¹Université de Montréal, School of Rehabilitation, Montreal, Canada, ²McGill University, School of Physical and Occupational Therapy, Montreal, Canada

Background: The long term impact of COVID-19 infection among persons hospitalized and discharged home is unknown. It would be important to understand prolonged symptoms and effects on functional limitations so that physiotherapy needs can be determined.

Purpose: We aimed to
1) report the prevalence of long COVID in persons hospitalized for COVID-19 and discharged home;
2) estimate the prevalence of physical, sensory, and psychological/mental health impairments;
3) explore associated factors;
4) determine disability and limitations at least 2 months after COVID infection and
5) explore services received and unmet needs in persons with long COVID.

Methods: We conducted a telephone survey of adult residents of Laval, Quebec, who were discharged home >2 months post COVID-19 infection. Participants responded to standard questionnaires regarding persistent symptoms (Newcastle Post COVID Syndrome Questionnaire). Those who reported that they had not completely recovered and were still troubled by persistent symptoms (considered as long COVID) responded to the COVID-19 Yorkshire Rehab Screen that documented change in functional activities, and the COVID-19 Rehabilitation Needs Questionnaire that assessed services received and unmet needs. We calculated the prevalence of long COVID and also reported types of symptoms and evaluated associated factors using bivariate analysis and multivariable logistic regression. Next, we calculated the prevalence of change in function among those with long COVID and assessed factors associated with various types of functional decline. Finally, we described services that were received and unmet needs regarding rehabilitation.

Results: In our sample (n=398), 70% reported physical symptoms, 58% psychological problems, and 16% sensory impairments; 31.5% reported being troubled by persistent symptoms (long COVID). Factors associated with long COVID were a greater number of symptoms (Odds Ratio (OR) =1.97; 95% Confidence Interval (CI)=1.69-2.28), and increased length of hospital stay (OR=1.03; 95% CI=1.01-1.06). Other factors associated with physical and psychological symptoms were female sex (OR=2.17, 95% CI=1.27-3.71 and OR=2.06, 95% CI=1.25-3.39; respectively), higher education level (OR=2.10; 95% CI=1.20-3.68 and OR=2.43; 95% CI=1.44-4.14; respectively) and obesity (OR=1.95; 95% CI=1.15-3.34 and OR=1.70; 95% CI=1.05-2.77; respectively). Among those with long COVID, 90% noted change in health status, 60% reported a deterioration in their level of mobility, and 72.3% a deterioration in participation in daily activities. Of the 120 who had long COVID, 42 had received some physiotherapy, 23 occupational therapy, 8 speech therapy and 13 psychology. Thirty percent (36/120) reported unmet service needs, and the main reasons were not being referred and not knowing where to go.

Conclusions: In this population-based study of persons hospitalized for COVID-19 and discharged home, nearly one-third were troubled by symptoms for 2 months or more post-infection. There was a high proportion with persistent physical and psychological/mental health symptoms. Among those with long COVID, most reported deterioration in health status and between 60 and 72% deteriorated with respect to function (mobility or participation in daily activities). While 35% had received some physiotherapy, another 30% reported unmet rehabilitation service needs.

Implications: Assessing the specific needs of these patients will serve to inform health policy makers on physiotherapy requirements for these persons.

Funding acknowledgements: Fondation Cité de la Santé & the Jewish Rehabilitation Hospital Foundation, Laval, Québec, Canada

Keywords:
Long COVID
Functional change
Physiotherapy needs

Topics:
COVID-19

Did this work require ethics approval? Yes

Institution: CISSS Laval

Committee: CISSS Laval

Ethics number: 2022-734