Rehabilitation post-COVID-19: cross-sectional observations using the Stanford Hall remote assessment tool

Oliver O'Sullivan, R M Barker-Davies, K Thompson, S Bahadur, M Gough, S Lewis, M Martin, A Segalini, G Wallace, R Phillip, M Cranley, Oliver O'Sullivan, R M Barker-Davies, K Thompson, S Bahadur, M Gough, S Lewis, M Martin, A Segalini, G Wallace, R Phillip, M Cranley

Abstract

Introduction: The multisystem COVID-19 can cause prolonged symptoms requiring rehabilitation. This study describes the creation of a remote COVID-19 rehabilitation assessment tool to allow timely triage, assessment and management. It hypotheses those with post-COVID-19 syndrome, potentially without laboratory confirmation and irrespective of initial disease severity, will have significant rehabilitation needs.

Methods: Cross-sectional study of consecutive patients referred by general practitioners (April-November 2020). Primary outcomes were presence/absence of anticipated sequelae. Binary logistic regression was used to test association between acute presentation and post-COVID-19 symptomatology.

Results: 155 patients (n=127 men, n=28 women, median age 39 years, median 13 weeks post-illness) were assessed using the tool. Acute symptoms were most commonly shortness of breath (SOB) (74.2%), fever (73.5%), fatigue (70.3%) and cough (64.5%); and post-acutely, SOB (76.7%), fatigue (70.3%), cough (57.4%) and anxiety/mood disturbance (39.4%). Individuals with a confirmed diagnosis of COVID-19 were 69% and 63% less likely to have anxiety/mood disturbance and pain, respectively, at 3 months.

Conclusions: Rehabilitation assessment should be offered to all patients suffering post-COVID-19 symptoms, not only those with laboratory confirmation and considered independently from acute illness severity. This tool offers a structure for a remote assessment. Post-COVID-19 programmes should include SOB, fatigue and mood disturbance management.

Keywords: COVID-19; rehabilitation medicine; telemedicine.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Post-acute symptoms (dependent variable) occurring at the time of video-teleconference at a median of 13 weeks since COVID-19 symptom onset with laboratory confirmation as a predictor. *Statistically significant OR between subgroups. Con, concentration; SOB, shortness of breath (categories are mutually exclusive: on mild/moderate activity/at rest).

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Source: PubMed

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