Seven Domains of Persisting Problems after Hospital-treated Covid-19 Indicate a Need For a Multiprofessional Rehabilitation Approach.

Abstract

ObjectivesTo identify domains of persisting problems at 4 months after discharge in patients previously hospitalized due to COVID-19, with a focus on a subgroup of patients reporting symptoms to an extent indicative of rehabilitation needs.DesignAmbidirectional observational cohort study.PatientsAll patients with a laboratory-confirmed COVID-19 diagnosis admitted to hospital in a Swedish healthcare region during the period 1 March to 31 May 2020. After exclusion, 94% of all survivors (n = 433) participated in the study. Forty-three percent (n = 185) of these reported persisting problems indicating rehabilitation needs and formed a subgroup.MethodsExplorative factor analysis based on results from comprehensive telephone interviews covering persisting symptoms, including assessment of impact on daily life.ResultsSeven domains were identified, comprising problems related to vision, cognition, mental fatigue, swallowing, voice, sensorimotor dysfunction, and feeling anxious/depressed. The patients in the subgroup reported a median of 8 symptoms/limitations affecting everyday life, and two-thirds reported symptoms/limitations in 3 or more domains.ConclusionSeven problem domains corresponding to specific modalities of rehabilitative interventions were identified. A majority of patients reported problems from several domains, indicating the need for multiprofessional teams in post-COVID-19 rehabilitation. Screening of patients previously hospitalized due to COVID-19 should cover all 7 domains of persisting problems.LAY ABSTRACTMore than 70% of patients with COVID-19 have previously been shown to experience 1 or several of a multitude of persisting problems several months after infection. This study aimed to identify areas of persisting problems among a broad spectrum of self-reported problems. Survivors of COVID-19 who had been discharged from hospital 4 months previously participated in a telephone interview covering persisting problems, including assessment of impact on daily life. The persisting problems clustered into 7 functional areas. Mental fatigue, cognitive- and sensorimotor problems were reported most frequently. A potential rehabilitation need was seen in more than 40% of patients interviewed. These patients reported approximately 8 different problems affecting their everyday life, and a majority of these patients reported problems from 3 or more areas. These findings highlight the need for multiprofessional teams in post-COVID-19 rehabilitation. Screening of patients previously hospitalized due to COVID-19 should cover all 7 areas of persisting problems.