Display options
Cite
Wahlgren C, Divanoglou A, Larsson M, et al. Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms. EClinicalMedicine. 2021;43:101219doi: 10.1016/j.eclinm.2021.101219.
Wahlgren, C., Divanoglou, A., Larsson, M., Nilsson, E., Östholm Balkhed, �. �., Niward, K., Birberg Thornberg, U., Lilliecreutz Gudmundsson, E., & Levi, R. (2022). Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms. EClinicalMedicine, 43101219. https://doi.org/10.1016/j.eclinm.2021.101219
Wahlgren, Carl, et al. "Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms." EClinicalMedicine vol. 43 (2022): 101219. doi: https://doi.org/10.1016/j.eclinm.2021.101219
Wahlgren C, Divanoglou A, Larsson M, Nilsson E, Östholm Balkhed Å, Niward K, Birberg Thornberg U, Lilliecreutz Gudmundsson E, Levi R. Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms. EClinicalMedicine. 2022 Jan;43:101219. doi: 10.1016/j.eclinm.2021.101219. Epub 2021 Dec 05. PMID: 34901798; PMCID: PMC8645256.
Copy Download .nbib Format: NLM
Share it on

EClinicalMedicine. 2022 Jan;43:101219. doi: 10.1016/j.eclinm.2021.101219. Epub 2021 Dec 05.

Rehabilitation needs following COVID-19: Five-month post-discharge clinical follow-up of individuals with concerning self-reported symptoms.

EClinicalMedicine

Carl Wahlgren, Anestis Divanoglou, Melanie Larsson, Emma Nilsson, Åse Östholm Balkhed, Katarina Niward, Ulrika Birberg Thornberg, Eva Lilliecreutz Gudmundsson, Richard Levi

Affiliations

  1. Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping S-58185, Sweden.
  2. Department of Infectious Diseases and Department of Biomedical and Clinical Sciences, Linköping University, Linköping S-58185, Sweden.

PMID: 34901798 PMCID: PMC8645256 DOI: 10.1016/j.eclinm.2021.101219

Abstract

BACKGROUND: This report describes and objectivizes reported problems among a cohort of previously hospitalized COVID-19 patients by clinical examination and determination of the required level of rehabilitation sevices.

METHODS: This report forms part of the Linköping COVID-19 Study (LinCoS) that included 745 individuals from one of 21 Swedish healthcare regions, Region Östergötland (RÖ), admitted to hospital for COVID-19 during March 1st-May 31st, 2020. In this descriptive ambidirectional cohort study, all 185 individuals who had reported concerning persisting symptoms were invited to a multi-professional clinical assessment of somatic, functional, affective, neuropsychological status and rehabilitation needs. Rehabilitation needs were assessed using three sub-scales of the Rehabilitation Complexity Scale-Extended.

FINDINGS: Among the 158 (85·4%) cases consenting and included in the analysis, we found a broad array of symptoms and signs attributable to COVID-19 involving respiratory, visual, auditory, motor, sensory and cognitive functions that could be confirmed clinically at five months post-discharge. This translated into 16% [95% CI 13-20] of survivors (70/433) of the total regional cohort of hospitalised patients requiring further rehabilitative interventions at follow-up. Weakness in extremities was reported in 28·5% [21·6, 36·2] (45/158). On examination, clinically overt muscle weakness could be corroborated in 15 individuals (10·5%) [6·1, 16·4]. 48% [40, 56] (76/158) reported cognitive symptoms, while the physician noted overt cognitive impairments in only 3% [1·1, 7·5]. In neuropsychological testing, 37% [28-46] (45/122) performed 1.5 SD below the norm, indicating neurocognitive deficits. Fifty-five individuals (34·8%) [27·4, 42·8] reported new or aggravated pain. In three fourths of them, it exerted a 'moderate' or worse detrimental effect on their ability to work.

INTERPRETATION: Our study underscores the importance of providing extensive examination of cases with persisting problems after COVID-19, especially since symptoms such as fatigue and breathlessness are highly nonspecific, but may represent significant underlying functional impairments. Robust neurocognitive testing should be performed, as cognitive problems may easily be overlooked during routine medical consultation. In the Swedish context, most rehabilitative interventions could be provided in a primary care setting. A substantial minority of patients should be triaged to specialized rehabilitation services.

© 2021 Published by Elsevier Ltd.

Keywords: Consequences; Long-term follow-up; PACS; Post-COVID-19; Rehabilitation; Residual symptoms; SARS-CoV-2

Conflict of interest statement

The authors declare no conflicts of interest.

Publication Types