Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms
Background: This report describes and objectivizes reported problems among a cohort of previously hospitalized COVID-19 patients by clinical examination and determination of the required level of rehabilitation sevices. Methods: This report forms part of the Linköping COVID-19 Study (LinCoS) that in...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-01-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021005009 |
| _version_ | 1819042995611107328 |
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| author | Carl Wahlgren Anestis Divanoglou Melanie Larsson Emma Nilsson Åse Östholm Balkhed Katarina Niward Ulrika Birberg Thornberg Eva Lilliecreutz Gudmundsson Richard Levi |
| author_facet | Carl Wahlgren Anestis Divanoglou Melanie Larsson Emma Nilsson Åse Östholm Balkhed Katarina Niward Ulrika Birberg Thornberg Eva Lilliecreutz Gudmundsson Richard Levi |
| author_sort | Carl Wahlgren |
| collection | DOAJ |
| description | Background: This report describes and objectivizes reported problems among a cohort of previously hospitalized COVID-19 patients by clinical examination and determination of the required level of rehabilitation sevices. Methods: This report forms part of the Linköping COVID-19 Study (LinCoS) that included 745 individuals from one of 21 Swedish healthcare regions, Region Östergötland (RÖ), admitted to hospital for COVID-19 during March 1st–May 31st, 2020. In this descriptive ambidirectional cohort study, all 185 individuals who had reported concerning persisting symptoms were invited to a multi-professional clinical assessment of somatic, functional, affective, neuropsychological status and rehabilitation needs. Rehabilitation needs were assessed using three sub-scales of the Rehabilitation Complexity Scale-Extended. Findings: Among the 158 (85·4%) cases consenting and included in the analysis, we found a broad array of symptoms and signs attributable to COVID-19 involving respiratory, visual, auditory, motor, sensory and cognitive functions that could be confirmed clinically at five months post-discharge. This translated into 16% [95% CI 13–20] of survivors (70/433) of the total regional cohort of hospitalised patients requiring further rehabilitative interventions at follow-up. Weakness in extremities was reported in 28·5% [21·6, 36·2] (45/158). On examination, clinically overt muscle weakness could be corroborated in 15 individuals (10·5%) [6·1, 16·4]. 48% [40, 56] (76/158) reported cognitive symptoms, while the physician noted overt cognitive impairments in only 3% [1·1, 7·5]. In neuropsychological testing, 37% [28–46] (45/122) performed 1.5 SD below the norm, indicating neurocognitive deficits. Fifty-five individuals (34·8%) [27·4, 42·8] reported new or aggravated pain. In three fourths of them, it exerted a ‘moderate’ or worse detrimental effect on their ability to work. Interpretation: Our study underscores the importance of providing extensive examination of cases with persisting problems after COVID-19, especially since symptoms such as fatigue and breathlessness are highly nonspecific, but may represent significant underlying functional impairments. Robust neurocognitive testing should be performed, as cognitive problems may easily be overlooked during routine medical consultation. In the Swedish context, most rehabilitative interventions could be provided in a primary care setting. A substantial minority of patients should be triaged to specialized rehabilitation services. |
| first_indexed | 2024-12-21T09:49:45Z |
| format | Article |
| id | doaj.art-25d8be123c1c4552a97c61629117a4af |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-21T09:49:45Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-25d8be123c1c4552a97c61629117a4af2022-12-21T19:08:13ZengElsevierEClinicalMedicine2589-53702022-01-0143101219Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptomsCarl Wahlgren0Anestis Divanoglou1Melanie Larsson2Emma Nilsson3Åse Östholm Balkhed4Katarina Niward5Ulrika Birberg Thornberg6Eva Lilliecreutz Gudmundsson7Richard Levi8Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Infectious Diseases and Department of Biomedical and Clinical Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Infectious Diseases and Department of Biomedical and Clinical Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, SwedenDepartment of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, SwedenBackground: This report describes and objectivizes reported problems among a cohort of previously hospitalized COVID-19 patients by clinical examination and determination of the required level of rehabilitation sevices. Methods: This report forms part of the Linköping COVID-19 Study (LinCoS) that included 745 individuals from one of 21 Swedish healthcare regions, Region Östergötland (RÖ), admitted to hospital for COVID-19 during March 1st–May 31st, 2020. In this descriptive ambidirectional cohort study, all 185 individuals who had reported concerning persisting symptoms were invited to a multi-professional clinical assessment of somatic, functional, affective, neuropsychological status and rehabilitation needs. Rehabilitation needs were assessed using three sub-scales of the Rehabilitation Complexity Scale-Extended. Findings: Among the 158 (85·4%) cases consenting and included in the analysis, we found a broad array of symptoms and signs attributable to COVID-19 involving respiratory, visual, auditory, motor, sensory and cognitive functions that could be confirmed clinically at five months post-discharge. This translated into 16% [95% CI 13–20] of survivors (70/433) of the total regional cohort of hospitalised patients requiring further rehabilitative interventions at follow-up. Weakness in extremities was reported in 28·5% [21·6, 36·2] (45/158). On examination, clinically overt muscle weakness could be corroborated in 15 individuals (10·5%) [6·1, 16·4]. 48% [40, 56] (76/158) reported cognitive symptoms, while the physician noted overt cognitive impairments in only 3% [1·1, 7·5]. In neuropsychological testing, 37% [28–46] (45/122) performed 1.5 SD below the norm, indicating neurocognitive deficits. Fifty-five individuals (34·8%) [27·4, 42·8] reported new or aggravated pain. In three fourths of them, it exerted a ‘moderate’ or worse detrimental effect on their ability to work. Interpretation: Our study underscores the importance of providing extensive examination of cases with persisting problems after COVID-19, especially since symptoms such as fatigue and breathlessness are highly nonspecific, but may represent significant underlying functional impairments. Robust neurocognitive testing should be performed, as cognitive problems may easily be overlooked during routine medical consultation. In the Swedish context, most rehabilitative interventions could be provided in a primary care setting. A substantial minority of patients should be triaged to specialized rehabilitation services.http://www.sciencedirect.com/science/article/pii/S2589537021005009SARS-CoV-2Post-COVID-19PACSRehabilitationConsequencesResidual symptoms |
| spellingShingle | Carl Wahlgren Anestis Divanoglou Melanie Larsson Emma Nilsson Åse Östholm Balkhed Katarina Niward Ulrika Birberg Thornberg Eva Lilliecreutz Gudmundsson Richard Levi Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms EClinicalMedicine SARS-CoV-2 Post-COVID-19 PACS Rehabilitation Consequences Residual symptoms |
| title | Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms |
| title_full | Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms |
| title_fullStr | Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms |
| title_full_unstemmed | Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms |
| title_short | Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms |
| title_sort | rehabilitation needs following covid 19 five month post discharge clinical follow up of individuals with concerning self reported symptoms |
| topic | SARS-CoV-2 Post-COVID-19 PACS Rehabilitation Consequences Residual symptoms |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021005009 |
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