Cargando…

Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)

BACKGROUD: The sudden COVID-19 pandemic forced quick development of care pathways for patients with different needs. Trajectories of physical recovery in hospitalized patients for COVID-19 following different care pathways are unknown. We aimed to assess trajectories of physical recovery and levels...

Descripción completa

Detalles Bibliográficos
Autores principales: Berentschot, Julia C., Heijenbrok-Kal, Majanka H., Bek, L. Martine, Huijts, Susanne M., van Bommel, Jasper, van Genderen, Michel E., Aerts, Joachim G.J.V., Ribbers, Gerard M., Hellemons, Merel E., van den Berg-Emons, Rita J.G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402257/
https://www.ncbi.nlm.nih.gov/pubmed/36039177
http://dx.doi.org/10.1016/j.lanepe.2022.100485
_version_ 1784773134274002944
author Berentschot, Julia C.
Heijenbrok-Kal, Majanka H.
Bek, L. Martine
Huijts, Susanne M.
van Bommel, Jasper
van Genderen, Michel E.
Aerts, Joachim G.J.V.
Ribbers, Gerard M.
Hellemons, Merel E.
van den Berg-Emons, Rita J.G.
author_facet Berentschot, Julia C.
Heijenbrok-Kal, Majanka H.
Bek, L. Martine
Huijts, Susanne M.
van Bommel, Jasper
van Genderen, Michel E.
Aerts, Joachim G.J.V.
Ribbers, Gerard M.
Hellemons, Merel E.
van den Berg-Emons, Rita J.G.
author_sort Berentschot, Julia C.
collection PubMed
description BACKGROUD: The sudden COVID-19 pandemic forced quick development of care pathways for patients with different needs. Trajectories of physical recovery in hospitalized patients for COVID-19 following different care pathways are unknown. We aimed to assess trajectories of physical recovery and levels of physical function reached within the different care pathways. Additionally, we assessed differences in physical function across care pathways at follow-up visits. METHODS: This multicenter prospective cohort study of adults who had been hospitalized for COVID-19 was performed in 10 centers, including 7 hospitals (1 academic and 6 regional hospitals) and 3 rehabilitation centers (1 medical rehabilitation center and 2 skilled nursing facilities), located in the Netherlands. Study visits were performed at 3, 6, and 12 months post-hospital discharge and included assessment of cardiorespiratory fitness (6 min walk test [6MWT], 1 min sit-to-stand test [1MSTST]), muscle strength (maximum handgrip strength [HGS]) and mobility (de Morton Mobility Index [DEMMI]). FINDINGS: We report findings for 582 patients who had been discharged from hospital between March 24, 2020 and June 17, 2021. Patients had a median age of 60·0 years, 68·9% (401/582) were male, 94·6% (561/582) had received oxygen therapy, and 35·2% (205/582) mechanical ventilation. We followed patients across four different rehabilitation settings: no rehabilitation (No-rehab, 19·6% [114/582]), community-based rehabilitation (Com-rehab, 54·1% [315/582]), medical rehabilitation (Med-rehab, 13·7% [80/582]), and rehabilitation in a skilled nursing facility (SNF-rehab, 12·5% [73/582]). Overall, outcomes in 6MWT (14·9 meters [95% CI 7·4 to 22·4]), 1MSTST (2·2 repetitions [1·5 to 2·8]), and HGS (3·5 kg [2·9 to 4·0]) improved significantly (p<0·001) from 3 to 6 months and only HGS from 6 to 12 months (2·5 kg [1·8 to 3·1]; p<0·001). DEMMI scores did not significantly improve over time. At 3 months, percentage of normative values reached in 1MSTST differed significantly (p<0.001) across care pathways, with largest impairments in Med- and SNF-rehab groups. At 12 months these differences were no longer significant, reaching, overall, 90·5% on 6MWD, 75·4% on 1MSTST, and 106·9% on HGS. INTERPRETATION: Overall, physical function improved after hospitalization for COVID-19, with largest improvement within 6 months post-discharge. Patients with rehabilitation after hospital discharge improved in more than one component of physical function, whereas patients without rehabilitation improved solely in muscle strength. Patients who received rehabilitation, and particularly patients with Med- and SNF-rehab, had more severe impairment in physical function at 3 months, but reached equal levels at 12 months compared to patients without follow-up treatment. Our findings indicate the importance of rehabilitation. FUNDING: ZonMw, Rijndam Rehabilitation, Laurens (The Netherlands).
format Online
Article
Text
id pubmed-9402257
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-94022572022-08-25 Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW) Berentschot, Julia C. Heijenbrok-Kal, Majanka H. Bek, L. Martine Huijts, Susanne M. van Bommel, Jasper van Genderen, Michel E. Aerts, Joachim G.J.V. Ribbers, Gerard M. Hellemons, Merel E. van den Berg-Emons, Rita J.G. Lancet Reg Health Eur Articles BACKGROUD: The sudden COVID-19 pandemic forced quick development of care pathways for patients with different needs. Trajectories of physical recovery in hospitalized patients for COVID-19 following different care pathways are unknown. We aimed to assess trajectories of physical recovery and levels of physical function reached within the different care pathways. Additionally, we assessed differences in physical function across care pathways at follow-up visits. METHODS: This multicenter prospective cohort study of adults who had been hospitalized for COVID-19 was performed in 10 centers, including 7 hospitals (1 academic and 6 regional hospitals) and 3 rehabilitation centers (1 medical rehabilitation center and 2 skilled nursing facilities), located in the Netherlands. Study visits were performed at 3, 6, and 12 months post-hospital discharge and included assessment of cardiorespiratory fitness (6 min walk test [6MWT], 1 min sit-to-stand test [1MSTST]), muscle strength (maximum handgrip strength [HGS]) and mobility (de Morton Mobility Index [DEMMI]). FINDINGS: We report findings for 582 patients who had been discharged from hospital between March 24, 2020 and June 17, 2021. Patients had a median age of 60·0 years, 68·9% (401/582) were male, 94·6% (561/582) had received oxygen therapy, and 35·2% (205/582) mechanical ventilation. We followed patients across four different rehabilitation settings: no rehabilitation (No-rehab, 19·6% [114/582]), community-based rehabilitation (Com-rehab, 54·1% [315/582]), medical rehabilitation (Med-rehab, 13·7% [80/582]), and rehabilitation in a skilled nursing facility (SNF-rehab, 12·5% [73/582]). Overall, outcomes in 6MWT (14·9 meters [95% CI 7·4 to 22·4]), 1MSTST (2·2 repetitions [1·5 to 2·8]), and HGS (3·5 kg [2·9 to 4·0]) improved significantly (p<0·001) from 3 to 6 months and only HGS from 6 to 12 months (2·5 kg [1·8 to 3·1]; p<0·001). DEMMI scores did not significantly improve over time. At 3 months, percentage of normative values reached in 1MSTST differed significantly (p<0.001) across care pathways, with largest impairments in Med- and SNF-rehab groups. At 12 months these differences were no longer significant, reaching, overall, 90·5% on 6MWD, 75·4% on 1MSTST, and 106·9% on HGS. INTERPRETATION: Overall, physical function improved after hospitalization for COVID-19, with largest improvement within 6 months post-discharge. Patients with rehabilitation after hospital discharge improved in more than one component of physical function, whereas patients without rehabilitation improved solely in muscle strength. Patients who received rehabilitation, and particularly patients with Med- and SNF-rehab, had more severe impairment in physical function at 3 months, but reached equal levels at 12 months compared to patients without follow-up treatment. Our findings indicate the importance of rehabilitation. FUNDING: ZonMw, Rijndam Rehabilitation, Laurens (The Netherlands). Elsevier 2022-08-24 /pmc/articles/PMC9402257/ /pubmed/36039177 http://dx.doi.org/10.1016/j.lanepe.2022.100485 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Articles
Berentschot, Julia C.
Heijenbrok-Kal, Majanka H.
Bek, L. Martine
Huijts, Susanne M.
van Bommel, Jasper
van Genderen, Michel E.
Aerts, Joachim G.J.V.
Ribbers, Gerard M.
Hellemons, Merel E.
van den Berg-Emons, Rita J.G.
Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)
title Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)
title_full Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)
title_fullStr Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)
title_full_unstemmed Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)
title_short Physical recovery across care pathways up to 12 months after hospitalization for COVID-19: A multicenter prospective cohort study (CO-FLOW)
title_sort physical recovery across care pathways up to 12 months after hospitalization for covid-19: a multicenter prospective cohort study (co-flow)
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402257/
https://www.ncbi.nlm.nih.gov/pubmed/36039177
http://dx.doi.org/10.1016/j.lanepe.2022.100485
work_keys_str_mv AT berentschotjuliac physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT heijenbrokkalmajankah physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT beklmartine physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT huijtssusannem physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT vanbommeljasper physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT vangenderenmichele physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT aertsjoachimgjv physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT ribbersgerardm physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT hellemonsmerele physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT vandenbergemonsritajg physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow
AT physicalrecoveryacrosscarepathwaysupto12monthsafterhospitalizationforcovid19amulticenterprospectivecohortstudycoflow