Role of physical therapy in reducing length of stay and occurrence of post intensive care syndrome among COVID 19 patients admitted to the intensive care unit

Abstract

Post intensive care syndrome (PICS) is a debilitating co‐morbidity associated with prolonged stay in the intensive care unit (ICU). The symptomatology of PICS includes decreased muscle functioning, increased muscle weakness, increased states of delirium, and increased occurrence of ICU‐acquired weakness. Patients hospitalized with COVID‐19 are at high risk for developing PICS due to the debilitating nature of the disease, prolonged periods of inactivity with the use of mechanical ventilation, and muscle weakness after cessation of mechanical ventilation. With the sudden pandemic of COVID‐19, research on the appropriate physical therapy protocols to provide effective care for these patients during their stay in the ICU is limited. The purpose of the study was to determine if early mobilization and rehabilitation in patients with COVID‐19 can reduce PICS and length of hospital stay. Using PUBMed, Google Scholar, and other databases, a systematic review of literature was conducted and ranked using the Oxford Centre of Evidence‐based Medicine. Of the literature reviewed, 73% of the articles were found to have level 2B and 27% were level 1B. Preliminary results revealed that the majority of patients adhering to early intervention and mobilization yielded improvements in the form of decreased length of hospital stay in the ICU and enhanced functional mobility upon discharge. Based on the results, we can surmise that early mobilization administered to mechanically ventilated patients may provide the same benefits to patients with COVID‐19 in the form of decreased length of hospital stay and reduced likelihood of developing PICS.