Many patients self-identify need for pulmonary rehab following COVID-19 hospitalization
In a new study, 30% of patients discharged following COVID-19 hospitalization self-identified the need for pulmonary rehabilitation within 6 months.
“Early in the pandemic it was identified by the European Respiratory Society/American Thoracic Society consensus statement that patients requiring hospitalization with COVID-19 may have ongoing rehabilitation needs, and that current pulmonary rehabilitation services were best placed to deliver that intervention,” Enya Daynes, PhD, clinical academic physiotherapist at the University Hospitals of Leicester and the University of Leicester, England, said during a presentation at the ATS International Conference. “Shortly after that, we had guidance from the British Thoracic Society and NHS England on how we could adapt current pulmonary rehabilitation programs to cater for the needs of COVID-19 survivors.”
However, she said, the volume of patients requiring pulmonary rehabilitation following COVID-19 hospitalization is unknown. Daynes and colleagues thus conducted a study to explore the number of patients who self-identify a need for pulmonary rehabilitation following discharge for COVID-19 hospitalization.
Researchers contacted 938 patients hospitalized at the University Hospitals of Leicester from March to November 2020 who had a positive COVID-19 test result or a clinical diagnosis of COVID-19 infection. Patients were asked about ongoing symptoms following discharge and if they experienced any symptoms requiring pulmonary rehabilitation. Thirty-seven percent of patients were deemed not appropriate for pulmonary rehabilitation due to reasons such as discharge to nursing home, transfer out of area or incidental positive COVID-19 test without symptoms. Thirteen percent of patients were unable to be contacted or were unresponsive, according to Daynes.
The mean time to telephone call was 32 days, according to the results.
In total, 466 patients (50%) were assessed for ongoing COVID-19 symptoms and rehabilitation needs and 39% of those assessed did not identify a need for rehabilitation. Sixty-one percent (n = 282) of patients assessed did identify need for rehabilitation and were referred to a COVID-19 rehabilitation program, Daynes said.
The primary self-reported symptoms were fatigue, breathlessness and limitations with activities of daily living, according to the results.
“We are expecting there to be quite a huge volume of patients requiring intervention, and this might place burden on the current pulmonary rehabilitation programs, especially as lockdown eases and we’re expected to see our current caseload as well as COVID-19 survivors,” Daynes said.