Declined Activities of Daily Living as Immobility Syndrome in an Uninfected Elderly Patient Amidst a Cluster of COVID-19 Infections

Although coronavirus disease 2019 can cause immobility syndrome in the patients positive for coronavirus disease 2019 and the survivors of coronavirus disease 2019, it is not described in elderly patients who are not positive for coronavirus disease 2019. A 90-year-old female with motor weakness of the lower extremities was admitted in the chronic care hospital. She had rehabilitation therapy for independent ambulation and toilet activities. Though she complained of irregular pulse related to atrial fibrillation during rehabilitation therapy, the symptom disappeared within a few minutes. Her ambulation and toilet activities became better with rehabilitation therapy. However, three weeks after initiating rehabilitation therapy, a cluster of coronavirus disease 2019 infections occurred. The patient was not infected, but rehabilitation therapy was discontinued for 25 days. The patient exhibited ambulation difficulty with shortness of breath and persistent irregular pulse, especially when rehabilitation therapy was reinitiated. These symptoms did not appear while the patient was outside of rehabilitation therapy. At the time of writing, she started to recover her declined ambulation with rehabilitation therapy, but was still dependent in toileting. Immobility syndrome in elderly patients negative for coronavirus disease 2019 can be aggravated following the occurrence of a low-level cluster of coronavirus disease 2019 infections. Medical workers should, therefore, always consider this hidden risk and should plan an adequate program in the early period of rehabilitation therapy for the elderly patients.