Optimizing Early Rehabilitation Intervention: Insights from Different Outcomes in 2 Patients with Severe COVID-19

Case series Patients: Male, 53-year-old • Male, 68-year-old Final Diagnosis: COVID-19 Symptoms: Cough • desaturation • paraparesis • shortness of breath Medication: — Clinical Procedure: — Specialty: Rehabilitation OBJECTIVE: Unusual setting of medical care BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease first reported in Wuhan, China in December 2019 that has subsequently become pandemic worldwide. The more severe the symptoms, the more comprehensive and complex are the methods needed to treat patients. The World Health Organization (WHO) has highlighted the role of rehabilitation as one of the pillars in COVID-19 management, considering its advantages. It has been implemented in some countries’ guidelines, but it is not stated in Indonesia’s guideline. Thus, rehabilitation intervention is sometimes neglected or delayed. This case report aims to describe the possible benefit of optimizing the rehabilitation program during hospitalization. CASE REPORTS: We describe 2 patients with severe COVID-19: Patient A was a 53-year-old man without comorbidities and Patient B was a 68-year-old man with several comorbidities. Patient A was discharged from the hospital with respiratory sequelae (dyspnea, cough, and desaturation) and muscle weakness in both limbs after 2 months of hospitalization without rehabilitation intervention. Then, he returned to work 3 months after rehabilitation. Patient B was discharged without any significant sequelae after undergoing rehabilitation during hospitalization. CONCLUSIONS: Early physical rehabilitation in severe cases of COVID-19 has several potential benefits, including improved muscle strength, physical function, and quality of life, as well as reduced health care costs and length of stay (LOS). We believe that an early rehabilitation program in severe cases of COVID-19 is needed, but the physician still has to consider the patients’ condition and capacity into to decide what kind of exercise should be programmed by the team.