The impact of early rehabilitation in intensive care unit for COVID-19 patients

Abstract

Purpose

To evaluate the impact of early rehabilitation in intensive care unit (ICU) on the survival and functional outcomes of COVID-19 patients admitted to ICU at acute phase.

Materials and methods

We conducted a prospective quasi-experimental study including 346 eligible COVID-19 patients from all admitted cases in an ICU in Vietnam, divided into three groups: no rehabilitation (n = 32), late rehabilitation (n = 109), and early rehabilitation (n = 205). Baseline characteristics and survival information of patient were collected with BORG-CR10 scale and PFIT; the data were collected at different time points: before intervention, when switching to oxygen-therapy, and at discharge.

Results

The control group (patients not using rehabilitation therapy) has worse survival than both early rehabilitation group (hazard ratio [HR] 0.553; 95% confidence interval [CI] 0.380–0.806; p value < 0.001) and late rehabilitation group (HR 0.374; CI 0.235–0.594; p value < 0.001). Regarding functional improvement, during the first five days, rehabilitation did not make a significant impact on the patients (p value > 0.05), however if continued from day 5 to day 20, the early-rehabilitation patients obtained a statistically significant improvement for BORG-CR10 (p value < 0.01). No clear association was found for PFIT (p value > 0.05).

Conclusion

The research emphasises the benefits of the early rehabilitation in ICU for COVID-19 patients.

IMPLICATION FOR REHABILITATION

• Rehabilitation for severe COVID-19 patients in the intensive care unit (ICU) can improve patient survival during the ICU stay.

• This study suggests the benefit of early rehabilitation in ICU for COVID-19 patients.

• Early rehabilitation shows statistically significant improvement for exertion in patients who underwent rehabilitation at least 5 d.

Keywords:

• COVID-19
• rehabilitation
• ICU
• BORG-CR10
• PFIT

Acknowledgments

The authors acknowledge all participating patients and Bach Mai Hospital 16th Facility for supporting this study. We also acknowledge all staff in the COVID-19 unit for help with data collection.

Authors’ contributions

D.V.D designed, oversaw the study and wrote the manuscript. T.H.V.P and D.V.D performed data analysis. T.L.N produced and collected the data. V.G.V and X.C.D involved in scientific discussion and manuscript correction. All authors have read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

The datasets used and/or analysed during this study are available from the corresponding author on reasonable request.

Additional information

Funding

This study is supported by the Bach Mai Hospital Foundation (Grant number 2726/QD-BVBM).