As growing numbers of people in our community become infected and recover from COVID-19, how do they rebuild their health?
At Sunnybrook’s St. John’s Rehab, an expert team of specialists works together to develop unique care plans for their patients. In this video, they share the approaches that can help patients both in the hospital and at home rebuild strength after prolonged bed rest.
– Video by Monica Matys
Rehabilitation is essential to recovery – during and after COVID-19
– Story by Katherine Nazimek
Large numbers of people are predicted to become critically ill with acute respiratory distress syndrome (ARDS) as a result of COVID-19, and will require rehabilitation to recover, according to a paper published in the American Journal of Physical Medicine & Rehabilitation.
“Given the high proportion of hospitalized patients requiring ICU level care, it is likely that in the weeks and months following the surge in patients being admitted to acute hospitals and critical care units, there will be considerable number of critical illness survivors requiring rehabilitation,” says lead author Dr. Robert Simpson, physiatrist at Sunnybrook Health Sciences Centre.
Critical illness for any reason has major long-term side effects, prompting the characterization of “post-ICU syndrome” where patients experience physical, cognitive and mental health impairments following a stay in the intensive care unit (ICU).
“We commonly see a range of bio-psycho-social impairments following critical illness,” explains Dr. Simpson. “These can include muscle weakness following prolonged immobility, impairments of attention, memory and higher order cognitive processes, besides anxiety, depression and post-traumatic stress disorder. Left untreated, these issues can persist well beyond discharge from the hospital and can be profoundly disabling.”
The paper suggests rehabilitation should begin in the ICU and can involve assessing and treating pain, minimizing time on a ventilator with frequent sedation breaks, pre-emptively screening for delirium, promoting early mobilization, and involving the patient and family in care as much as possible.
Because the disabling effects from critical illness are typically both complex and long-lasting, follow-up with inpatient and outpatient multidisciplinary rehabilitation is likely needed. Rehabilitation services have been actively planning to receive large numbers of such patients and are exploring innovative care models to meet demand, including providing virtual rehabilitation.
“Rehabilitation is a key component of the continuum of care for people surviving critical illness,” says Dr. Simpson. “We will have a pivotal role to play in helping patients and their families recover, make sense of their experiences and help them re-integrate back into the community.”