Virtual Post-Intensive-Care Rehabilitation for Survivors of COVID-19: A Service Evaluation

Abstract

Aim: The objective of this study is to evaluate the safety, utilisation, and effectiveness of a novel, virtual rehabilitation programme for survivors of SARS‑CoV‑2 infection (COVID-19) and intensive care admission.

Methods: A service evaluation was performed. Adults admitted to a United Kingdom intensive care unit with COVID-19-induced respiratory failure and surviving hospital discharge were invited to an eight-week rehabilitation programme. The programme consisted of virtually delivered exercise classes and support groups led by critical care physiotherapists and follow-up nurses.

Results: Thirty-eight of 76 eligible patients (50%) agreed to participate, of which 28 (74%) completed the rehabilitation programme. On completion of the rehabilitation programme, there were significant improvements in exercise capacity (one-minute sit-to-stand test; 20 stands vs. 25 stands, p < 0.001), perceived breathlessness (Medical Research Council dyspnoea scale; 3 vs. 2 p < 0.001), shoulder disability (Quick Dash; 43 vs. 19 p = 0.001), anxiety (Hospital Anxiety Depression Scale; 4 vs. 3 p = 0.021), depression (Hospital Anxiety Depression Scale; 4 vs. 2.5 p = 0.010), and psychological distress (Intensive Care Psychological Assessment Tool; 3 vs. 2 p = 0.002). No adverse events or injuries were recorded during the programme.

Conclusion: It is feasible to recruit and retain survivors of COVID-19-induced respiratory failure for virtual post-intensive-care rehabilitation. It appears that the virtual rehabilitation programme is safe and improves physical and psychological morbidity.

Keywords: coronavirus; critical care; follow-up; rehabilitation; remote.

Figure 1. Diagram to demonstrate recruitment and retention to virtual rehabilitation.

ICU: intensive care unit; COVID-19: coronavirus disease 2019 infection.