Characteristics of COVID-19 Inpatients in Rehabilitation Units during the First Pandemic Wave: A Cohort Study from a Large Hospital in Champagne Region.

Abstract

Simple SummaryAnalyzing how healthcare institutions adapted to the first wave of the COVID-19 pandemic will make it possible to better prepare for future crises. Analyzing the characteristics of patients admitted to rehabilitation units during the first wave makes it possible to better understand rehabilitation needs during a pandemic crisis. The characteristics of all patients admitted to a single, large university hospital in Northeast France for SARS-CoV-2 infection during this period are described. The initial severity of infection and advanced age were associated with referral to inpatient rehabilitation units. The proportion of patients who had access to inpatient rehabilitation units was lower than expected in this study, which raises questions about the deployment of rehabilitation services. The availability and organization of rehabilitation plans in acute care units and post-acute care are key elements to anticipate in the event of a pandemic crisis.Background: Data describing patients hospitalized in medical rehabilitation wards after the acute phase of COVID-19 could help to better understand the rehabilitation needs in the current pandemic situation. Methods: Cohort including all patients with COVID-19 hospitalized in a single, large university hospital in Northeast France from 25 February to 30 April 2020. Results: 479 patients were admitted with COVID-19 during the study period, of whom 128 died (26.7%). Among the 351 survivors, 111 were referred to rehabilitation units, including 63 (17.9%) referred to physical and rehabilitation medicine (PRM) units. The median age of patients referred to rehabilitation units was 72 years. Patients who had been in intensive care, or who had had a long hospital stay, required referral to PRM units. Two biomarkers were associated with referral to rehabilitation units, namely, elevated troponin (p = 0.03) and impaired renal function (p = 0.03). Age was associated with referral to PRM units (p = 0.001). Conclusions: Almost one-third of COVID-19 patients required post-acute care, but only one-fifth had access to PRM units. The optimal strategy for post-acute management of COVID-19 patients remains to be determined. The need for rehabilitation wards during a pandemic is a primary concern in enabling the long-term functioning of infected patients.