COVID-19 and hospital restrictions: physical disconnection and digital re-connection in disorders of consciousness

ABSTRACT

Purpose: The coronavirus disease 2019 (COVID-19) pandemic forced hospitals to adopt tighter restrictions, the most impacting is no access to visitors. Disorder of consciousness (DOC) due to severe acquired brain injury is a condition needing neurorehabilitation and the role of relatives is essential, hence besides physical “disconnection” digital “re-connection” is crucial. We aimed to assess whether digital communication benefits in patients with DOC, considering the sensorial and emotional deprivation due to the COVID-19 emergency lock-down.

Methods: For eleven consecutive patients with DOC admitted to our Intensive Neurorehabilitation Care (mean age: 45; females: 9), two observers registered neurobehavioral changes during a video-calls with their relatives. Heart-rate variability was measured before and during the calls. The video-call was performed by using two displays of different sizes: tablet (T-video-call) and large screen (LS-Video-call).

Results: The video-calls impacted on the patients’ vigilance and in the relationship with relatives. Moreover, positively impacted on their relatives. The current results showed significant greater impact on patients during the LS-video-call than when they are exposed to T-video-call.

Conclusions: During the COVID-19 pandemic, besides the physical disconnection to stop the contagion spread, a “digital re-connection” is needed for all and especially for fragile population groups as patients with DOC.

KEYWORDS:

• COVID-19
• disorder of consciousness
• emotional deprivation
• rehabilitation
• personalized medicine

Acknowledgements

We would like to thank Dr. Serena Vincenza Capobianco, Dr. Chiara Piccininni, Dr. Angela De Luna and Dr. Letizia Castelli for their technical support. We would like to thank Alfonso Benevento (Etutorweb.it) and Federico Campilli (Romana Diesel SpA) for their support.

Disclosure Statement

There are no conflicts of interest.

Financial Support

This research did not receive any specific grant from funding agencies in the public, commercial or not for-profit sectors.

Author Contributions

LP, GF, DC and GR analyzed and interpreted the data; LP, GF, DC, and CL drafted the manuscript; LP, GF and DC conceived and designed the research; DG and CP acquired the data and visualized final draft; GR and CL reviewed and edited the manuscript; RB made a critical revision of the manuscript.

Disclosures

All authors report no disclosures