Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance

Jolanda C M Van Haastregt,Leonoor Van Dam Van Isselt,Esther Roquer,Stefan Bachmann,Desmond O’Neill,Marije S Holstege,Frances Dockery,Adam L Gordon,Mirko Petrovic,Romke Van Balen,Francesco Landi,Martin Smalbrugge,Stefan Grund,Wilco P Achterberg,Irma H J Everink,Else P Poot,Finbarr C Martin,Laura M Pérez,Jos M G A Schols

doi:10.1007/s41999-021-00575-4

Abstract

Key summary pointsAimTo describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation.FindingsThis guidance addresses general requirements for post-acute COVID-19 geriatric rehabilitation and critical aspects for quality assurance during the COVID-19 pandemic. Furthermore, the guidance describes relevant care processes and procedures divided in five topics: patient selection; admission; treatment; discharge; and follow-up and monitoring.MessageThis guidance is designed to provide support to care professionals involved in the geriatric rehabilitation treatment of post-acute COVID-19 patients.

Highlights

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its attendant syndrome, COVID-19, [1] is causing high morbidity and mortality rates around the world
A number of other problems are evident post COVID-19, including critical illness polyneuropathy (CIP), critical illness myopathy (CIM), post-intensive care syndrome (PICS), severe deconditioning, acute sarcopenia, post-traumatic stress disorder (PTSD) and various other somatic, cognitive, emotional and psychosocial problems, which may result in prolonged functional decline and reduced quality of life [4,5,6,7,8,9,10,11,12,13]
It is proposed that the guidance will be a living document, updated on a regular basis based on additional evidence from practice and research including the results from the EU-COGER study, which explores the effects of geriatric rehabilitation on COVID-19 patients [34]

Summary

Background

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its attendant syndrome, COVID-19, [1] is causing high morbidity and mortality rates around the world. Within the group of COVID-19 patients with complex rehabilitation needs, a subgroup of vulnerable older patients can be distinguished This subgroup primarily consists of frail, multimorbid older people who have several premorbid long-term conditions and were often already (partly) dependent on formal and/or informal care before the onset of COVID-19. It includes older people who were relatively healthy before but who experienced severe functional decline and deterioration in activities of daily living alongside other phenotypic characteristics of frailty following COVID-19. It is proposed that the guidance will be a living document, updated on a regular basis based on additional evidence from practice and research including the results from the EU-COGER study, which explores the effects of geriatric rehabilitation on (post-acute) COVID-19 patients [34]. On a national level the recommendations can be further specified to tailor them to the local circumstances

Methods

Findings

Conclusion