A Proposal for Multidisciplinary Tele-Rehabilitation in the Assessment and Rehabilitation of COVID-19 Survivors

Abayomi Salawu, Angela Green, Michael G Crooks, Nina Brixey, Denise H Ross, Manoj Sivan, Abayomi Salawu, Angela Green, Michael G Crooks, Nina Brixey, Denise H Ross, Manoj Sivan

Abstract

A global pandemic of a new highly contagious disease called COVID-19 resulting from coronavirus (severe acute respiratory syndrome (SARS)-Cov-2) infection was declared in February 2020. Though primarily transmitted through the respiratory system, other organ systems in the body can be affected. Twenty percent of those affected require hospitalization with mechanical ventilation in severe cases. About half of the disease survivors have residual functional deficits that require multidisciplinary specialist rehabilitation. The workforce to deliver the required rehabilitation input is beyond the capacity of existing community services. Strict medical follow-up guidelines to monitor these patients mandate scheduled reviews within 12 weeks post discharge. Due to the restricted timeframe for these events to occur, existing care pathway are unlikely to be able to meet the demand. An innovative integrated post-discharge care pathway to facilitate follow up by acute medical teams (respiratory and intensive care) and a specialist multidisciplinary rehabilitation team is hereby proposed. Such a pathway will enable the monitoring and provision of comprehensive medical assessments and multidisciplinary rehabilitation. This paper proposes that a model of tele-rehabilitation is integrated within the pathway by using digital communication technology to offer quick remote assessment and efficient therapy delivery to these patients. Tele-rehabilitation offers a quick and effective option to respond to the specialist rehabilitation needs of COVID-19 survivors following hospital discharge.

Keywords: COVID-19; multi-disciplinary tele-rehabilitation; pulmonary rehabilitation.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Proposed post-COVID-19 follow-up pathways. CPAP: continuous positive airway pressure; NIV: non-invasive ventilation; MDT: multi-disciplinary team; CXR: chest X-ray; ICU: intensive care unit; CT: computerized tomography; CTPA: computerized tomography pulmonary angiogram; and HUTH: Hull University teaching hospitals. * Specialist rehabilitation needs include but not limited to cognitive impairment, speech and swallowing difficulties, severe mobility and balance issues, and severe mood (anxiety and depression) issues.
Figure 2
Figure 2
Multidisciplinary tele-rehabilitation model.

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