THE REHABILITATION NEEDS OF PATIENTS TWO MONTHS POST COVID-19 HOSPITAL DISCHARGE

M. Pote¹, S.-l. Quinn¹, R. Hayward¹, T. Aptowitzer¹, V. Manson¹

Background: The COVID-19 pandemic has resulted in a significant loss of life worldwide and little is known about the medium and long-term effects of COVID-19 infection. Although evidence is sparse, there is increasing concern that patients post COVID-19 infection may have long lasting effects. A study conducted in Rome by Carfi et al (2020) found that patients, approximately two months post COVID-19 infection, still reported fatigue (53%), dyspnoea (43%), joint pain (27%), and chest pain (21%). As a result of the concerns regarding long-term recovery, we established a COVID-19 rehabilitation service within the London North West University Trust (LNWH) physiotherapy department. This paper presents the findings of this rehabilitation service in order to inform colleagues and policy makers about the rehabilitation needs of patients who have been discharged from hospital after having been treated for COVID-19 infection.

Purpose: This service evaluation monitored participants’ return to baseline function, breathlessness and fatigue at least two months after being discharged from hospital after having been treated for COVID-19 infection.

Methods: 123 participants who were discharged from LNWH post COVID infection between February 2020 and April 2020 were included in this service evaluation. Participants were called by a physiotherapist at least two months post COVID-19 discharge from a LNWH hospital. Participants were asked if they felt that they were back to their pre COVID-19 functional baseline, if they were experiencing breathlessness at rest, or fatigue. Breathlessness was assessed using the Borg Dyspnoea Scale. Fatigue was assessed by asking the participants to rate two statements from the Fatigue Severity Scale, namely, ‘Fatigue is among my three most disabling symptoms’ and ‘Fatigue interferes with my work, family or social life’.  Participants were also provided with an information booklet on post COVID-19 recovery and signposted to their GP if necessary.

Results: Out of 123 participants contacted 73 (59%) reported that they were back at their baseline function and 50 (41%) reported that they were not. In terms of fatigue, 47 (38%) said they experienced no fatigue; 22 (18%) reported mild fatigue; 50 (41%) moderate fatigue; and 4 (3%) significant fatigue. In terms of breathlessness, 66 (54%) reported no breathlessness; 2 (2%) very, very slight breathlessness; 8 (7%) very slight breathlessness; 15 (12%) slight breathlessness; 14 (11%) moderate breathlessness; 9 (7%) somewhat severe breathlessness; 5 (4%) severe breathlessness; 2 (2%) very severe breathlessness; 2 (2%) very, very severe breathlessness. Of the 123 participants called, 18 had been ventilated (17 invasive, one non-invasive). The average (SD) length of hospital stay at LNWH was 5 (6) days. It should be noted that not all participants were discharged home. 

Conclusion(s): Two out of every five participants were not back at their baseline function at least two months post COVID-19 hospital discharge from a LNWH hospital. A significant percentage of participants were still struggling with breathlessness at rest and fatigue two months post COVID hospital discharge from a LNWH hospital.

Implications: This service evaluation highlights the urgent need to provide community rehabilitation support to assist recovery post COVID-19 hospital discharge.

Funding, acknowledgements: Thank you to London North West University Healthcare NHS Trust for sponsoring this service evaluation.

Keywords: COVID-19, rehabilitation, function

Topic: COVID-19

Did this work require ethics approval? No

Institution: London North West University Healthcare NHS Trust

Committee: London North West University Healthcare NHS Trust (LNWH)

Reason: The protocol was, however, assessed by LNWH Research and Development and we were given a service evaluation code (SE20/023).