Beneficial effects of multi-disciplinary rehabilitation in postacute COVID-19: an observational cohort study

Eur J Phys Rehabil Med. 2021 Apr;57(2):189-198. doi: 10.23736/S1973-9087.21.06549-7. Epub 2021 Jan 15.


Background: The Coronavirus Disease 2019 (COVID-19) pandemic increases the demand for postacute care in patients after a severe disease course. Various long-term sequelae are expected and rehabilitation medicine is challenged to support physical and cognitive recovery.

Aim: We aimed to explore the dysfunctions and outcome of COVID-19 survivors after early postacute rehabilitation.

Design: Observational cohort study.

Methods: This study evaluated the postacute sequelae of patients hospitalized for SARS-CoV-2 infection and analyzed rehabilitative outcomes of a subgroup of patients included in the prospective observational multicenter CovILD study.

Results: A total of 23 subjects discharged after severe to critical COVID-19 infection underwent an individualized, multiprofessional rehabilitation. At the start of postacute rehabilitation, impairment of pulmonary function (87%), symptoms related to postintensive care syndrome, and neuropsychological dysfunction (85%) were frequently found, whereas cardiac function appeared to be largely unaffected. Of interest, multi-disciplinary rehabilitation resulted in a significant improvement in lung function, as reflected by an increase of forced vital capacity (P=0.007) and forced expiratory volume in one second (P=0.014), total lung capacity (P=0.003), and diffusion capacity for carbon monoxide (P=0.002). Accordingly, physical performance status significantly improved as reflected by a mean increase of six-minute walking distance by 176 (SD±137) meters. Contrarily, a considerable proportion of patients still had limited diffusion capacity (83%) or neurological symptoms including peripheral neuropathy at the end of rehabilitation.

Conclusions: Individuals discharged after a severe course of COVID-19 frequently present with persisting physical and cognitive dysfunctions after hospital discharge. Those patients significantly benefit from multi-disciplinary inpatient rehabilitation.

Clinical rehabilitation impact: Our data demonstrated the highly promising effects of early postacute rehabilitation in survivors of severe or critical COVID-19. This findings urge further prospective evaluations and may impact future treatment and rehabilitation strategies.

Publication types

  • Observational Study

MeSH terms

  • Austria / epidemiology
  • COVID-19 / epidemiology
  • COVID-19 / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Pandemics*
  • Physical and Rehabilitation Medicine / methods*
  • SARS-CoV-2*
  • Subacute Care / methods*
  • Treatment Outcome