Authors (including presenting author) :
Tsui AYY(1), Chan JSP(1), Woo CW(1), Wong EYW(1), Leung KKL(1), Chau RMW(1), Chan ACM(2)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital,(2)Physiotherapy Department, Queen Elizabeth Hospital
Introduction :
COVID-19 is an ongoing pandemic of coronavirus disease since 2019 with the manifestation of severe acute respiratory syndrome. In Hong Kong, the confirmed cases increase stepwise from wave to wave, putting stress to the public hospitals and running close to maximum capacity in the acute setting. Starting from the 3rd wave, most of the patients are elders with comorbidities, usually having medical problems and/or discharge problems to settle after their recovery from the acute COVID-19.
Objectives :
To review the continuum of rehabilitation for “recovered” COVID-19 patients.
Methodology :
Kowloon Hospital(KH) served as convalescent hospital in KCC starting to take up the COVID-related cases for inpatient rehabilitation starting from the 3rd wave. The “recovered” COVID-19 patients, had the SAR-CoV-2 antibody positive, requiring medical treatment and/or intense rehabilitation were transferred from Queen Elizabeth Hospital(QEH) and United Christian Hospital(UCH) to KH since July 2020. A retrospective cohort review was conducted.
Result & Outcome :
33 “recovered” COVID-19 patients were transferred to KH from 31 July to 6 Nov 2020 with 15 males and 18 females. Age ranged from 61 to 96(mean age:74±7.8 years). 54.5%(18 patients) were transferred for rehabilitation, 30.3%(10 patients) for medical management and rehabilitation, 12.1%(4 patients) for medical treatment only, and 12.1%(4 patients) having placement problem. The referral rate for Physiotherapy was 97.0%.
As at 20 December 2020, 87.9%(29 patients) were discharged, only 4 patients were still staying in KH under active rehabilitation. The inpatient patient days ranged from 3 to 59 days(mean: 24±12.7 days). For inpatient patient days subgroup analysis, 10.3%(3 patients) in the 1-10 days group, 34.5%(10 patients) in the 11-20 days group, 27.6%(8 patients) in the 21-30 days group. More than two-third of the patients were discharged within 1 month. For the mobility status, 55.2% of the patients with Modified Functional Ambulatory Classification(MFAC) increased by 1-4 levels, and 31% of the patients returned to the pre-morbid mobility status. COVID-19 is a global tough sustaining battle putting huge demand on acute hospital services. Timely transfer patients to convalescent hospitals for medical treatment with intense rehabilitation provide a gateway to relieve the stress in acute care, optimize patient’s functional outcomes and facilitate early discharge. The need for convalescent & sequential ambulatory rehabilitation in fighting the sequelae of the acute COVID-19 is prominent and anticipating.
