The impact of early rehabilitation in intensive care unit for COVID-19 patients.

Abstract

To evaluate the impact of early rehabilitation in intensive care unit (ICU) on the survival and functional outcomes of COVID-19 patients admitted to ICU at acute phase. We conducted a prospective quasi-experimental study including 346 eligible COVID-19 patients from all admitted cases in an ICU in Vietnam, divided into three groups: no rehabilitation (<i>n</i> = 32), late rehabilitation (<i>n</i> = 109), and early rehabilitation (<i>n</i> = 205). Baseline characteristics and survival information of patient were collected with BORG-CR10 scale and PFIT; the data were collected at different time points: before intervention, when switching to oxygen-therapy, and at discharge. The control group (patients not using rehabilitation therapy) has worse survival than both early rehabilitation group (hazard ratio [HR] 0.553; 95% confidence interval [CI] 0.380-0.806; <i>p</i> value < 0.001) and late rehabilitation group (HR 0.374; CI 0.235-0.594; <i>p</i> value < 0.001). Regarding functional improvement, during the first five days, rehabilitation did not make a significant impact on the patients (<i>p</i> value > 0.05), however if continued from day 5 to day 20, the early-rehabilitation patients obtained a statistically significant improvement for BORG-CR10 (<i>p</i> value < 0.01). No clear association was found for PFIT (<i>p</i> value > 0.05). The research emphasises the benefits of the early rehabilitation in ICU for COVID-19 patients.