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  1. Article ; Online: Recovery after prolonged ICU treatment in patients with COVID-19.

    Parotto, Matteo / Myatra, Sheila Nainan / Munblit, Daniel / Elhazmi, Alyaa / Ranzani, Otavio T / Herridge, Margaret S

    The Lancet. Respiratory medicine

    2021  Volume 9, Issue 8, Page(s) 812–814

    MeSH term(s) Activities of Daily Living ; COVID-19/complications ; COVID-19/epidemiology ; COVID-19/etiology ; COVID-19/physiopathology ; COVID-19/rehabilitation ; COVID-19/therapy ; Cognition ; Critical Illness/epidemiology ; Critical Illness/rehabilitation ; Duration of Therapy ; Functional Status ; Global Health ; Humans ; Intensive Care Units/statistics & numerical data ; Needs Assessment ; Return to Work ; SARS-CoV-2 ; Severity of Illness Index
    Language English
    Publishing date 2021-07-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(21)00318-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 7041: Show issues Location:
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  2. Article ; Online: Early Neurorehabilitation and Recovery from Disorders of Consciousness After Severe COVID-19.

    Gurin, Lindsey / Evangelist, Megan / Laverty, Patricia / Hanley, Kaitlin / Corcoran, John / Herbsman, Jodi / Im, Brian / Frontera, Jennifer / Flanagan, Steven / Galetta, Steven / Lewis, Ariane

    Neurocritical care

    2021  Volume 36, Issue 2, Page(s) 357–371

    Abstract: ... Twenty-one patients with delayed recovery of consciousness after severe COVID-19 participated in a pilot ... in the intensive care unit (ICU) and evaluate factors associated with recovery.: Methods: During the initial COVID-19 ... implementing an early neurorehabilitation protocol for patients with COVID-19-associated DoC ...

    Abstract Background: Early neurorehabilitation improves outcomes in patients with disorders of consciousness (DoC) after brain injury, but its applicability in COVID-19 is unknown. We describe our experience implementing an early neurorehabilitation protocol for patients with COVID-19-associated DoC in the intensive care unit (ICU) and evaluate factors associated with recovery.
    Methods: During the initial COVID-19 surge in New York City between March 10 and May 20, 2020, faced with a disproportionately high number of ICU patients with prolonged unresponsiveness, we developed and implemented an early neurorehabilitation protocol, applying standard practices from brain injury rehabilitation care to the ICU setting. Twenty-one patients with delayed recovery of consciousness after severe COVID-19 participated in a pilot early neurorehabilitation program that included serial Coma Recovery Scale-Revised (CRS-R) assessments, multimodal treatment, and access to clinicians specializing in brain injury medicine. We retrospectively compared clinical features of patients who did and did not recover to the minimally conscious state (MCS) or better, defined as a CRS-R total score (TS) ≥ 8, before discharge. We additionally examined factors associated with best CRS-R TS, last CRS-R TS, hospital length of stay, and time on mechanical ventilation.
    Results: Patients underwent CRS-R assessments a median of six (interquartile range [IQR] 3-10) times before discharge, beginning a median of 48 days (IQR 40-55) from admission. Twelve (57%) patients recovered to MCS after a median of 8 days (IQR 2-14) off continuous sedation; they had lower body mass index (p = 0.009), lower peak serum C-reactive protein levels (p = 0.023), higher minimum arterial partial pressure of oxygen (p = 0.028), and earlier fentanyl discontinuation (p = 0.018). CRS-R scores fluctuated over time, and the best CRS-R TS was significantly higher than the last CRS-R TS (median 8 [IQR 5-23] vs. 5 [IQR 3-18], p = 0.002). Earlier fentanyl (p = 0.001) and neuromuscular blockade (p = 0.015) discontinuation correlated with a higher last CRS-R TS.
    Conclusions: More than half of our cohort of patients with prolonged unresponsiveness following severe COVID-19 recovered to MCS or better before hospital discharge, achieving a clinical benchmark known to have relatively favorable long-term prognostic implications in DoC of other etiologies. Hypoxia, systemic inflammation, sedation, and neuromuscular blockade may impact diagnostic assessment and prognosis, and fluctuations in level of consciousness make serial assessments essential. Early neurorehabilitation of these patients in the ICU can be accomplished but is associated with unique challenges. Further research should evaluate factors associated with longer-term neurologic recovery and benefits of early rehabilitation in patients with severe COVID-19.
    MeSH term(s) COVID-19/complications ; Consciousness ; Consciousness Disorders/etiology ; Humans ; Neurological Rehabilitation ; Recovery of Function ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2021-10-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2381896-7
    ISSN 1556-0961 ; 1541-6933
    ISSN (online) 1556-0961
    ISSN 1541-6933
    DOI 10.1007/s12028-021-01359-1
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    Zs.A 6538: Show issues Location:
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  3. Article ; Online: Recovery of skeletal muscle strength and physical function in a patient with (post) COVID-19 requiring extra-corporeal membrane oxygenation.

    Lugthart, Annefleur / Sandker, Stefan / Maas, Jacinta / López Matta, Jorge / Henneman, Marlies / Elzo Kraemer, Carlos / Werkman, Maarten

    Physiotherapy theory and practice

    2022  Volume 40, Issue 1, Page(s) 190–196

    Abstract: ... A 54 year old female patient was diagnosed with COVID-19 pneumonia, and ultimately needed ICU treatment ... with prolonged ECMO treatment and facilitates functional recovery during ICU stay. This single case observation ... of skeletal muscle strength and physical function in a patient (post) COVID-19 during ICU stay.: Case description ...

    Abstract Background: The ongoing coronavirus-19 disease (COVID-19) has taught us that early mobilization is essential for functional recovery during and after prolonged intensive care unit (ICU) stay. This especially applies for patients receiving a challenging combination of prolonged invasive treatments such as mechanical ventilation (MV) and extra-corporeal membrane oxygenation (ECMO). This case report describes the recovery of skeletal muscle strength and physical function in a patient (post) COVID-19 during ICU stay.
    Case description: A 54 year old female patient was diagnosed with COVID-19 pneumonia, and ultimately needed ICU treatment with MV and ECMO for 69 days during which she received physiotherapy treatment.
    Outcomes: The patient recovered from intensive care acquired muscle weakness (ICUAW) at day 53, resulting in the ability to walk at day 62. She was discharged from the ICU after 69 days with the ability to walk 20 meters with support of one person and a mobility aid. No evident adverse events were noted during or after physiotherapy sessions.
    Discussion: Early mobilization is feasible and safe in a patient (post) COVID-19 with prolonged ECMO treatment and facilitates functional recovery during ICU stay. This single case observation should be handled with caution and needs further validation.
    MeSH term(s) Female ; Humans ; Middle Aged ; COVID-19 ; Intensive Care Units ; Muscle, Skeletal ; Critical Care ; Muscle Strength ; Critical Illness
    Language English
    Publishing date 2022-08-09
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1045333-7
    ISSN 1532-5040 ; 0959-3985
    ISSN (online) 1532-5040
    ISSN 0959-3985
    DOI 10.1080/09593985.2022.2107966
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    Zs.A 2190: Show issues Location:
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  4. Article ; Online: Patients' perspective about speech, swallowing and hearing status post-SARS-CoV-2 (COVID-19) recovery: E-survey.

    Verma, Himanshu / Shah, Jyoti / Akhilesh, Kumar / Shukla, Bhanu

    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

    2022  Volume 279, Issue 5, Page(s) 2523–2532

    Abstract: ... swallowing, and hearing-related issues post-COVID-19. We further investigate the recovery duration for speech ... 19 treatment and prolonged hospital stay were at higher risk of developing speech, swallowing, and ... subjects reported symptoms related to speech, swallowing, and hearing issues 15 days of post-COVID recovery ...

    Abstract Objective: The present study investigates the COVID-19 survivors' perspective on speech, swallowing, and hearing-related issues post-COVID-19. We further investigate the recovery duration for speech, swallowing, and hearing-related symptoms post-COVID.
    Design: Survey study; E-survey.
    Methodology: A total of 78 subjects (35.78 years ± 11.93) participated in the survey. All the participants were diagnosed with the RTPCR method. To understand the recovery duration for the speech, swallowing and hearing issues post-COVID-19, we conducted a three-phase study.
    Results: In the first phase of the survey, 68 subjects reported symptoms related to speech, swallowing, and hearing issues 15 days of post-COVID recovery. A total of 76.4% of subjects reported only swallowing-related issues, 4.41% only speech-related issues, whereas 1.47% reported the problem in speech and hearing functions. The 2nd phase of the study was conducted after the first phase of the study. Only 22 subjects reported the presence of swallowing, speech and hearing-related issues from the 68 subjects. During the last phase, only 12 subjects reported speech, swallowing, and hearing issues. All subjects recovered from the olfaction and gustation impairment, whereas 50% of subjects reported the presence of xerostomia.
    Conclusion: From the present study, we conclude that the SARC-CoV-2 virus directly affects the respiratory system and affects the aero-digestive system and laryngeal system physiology. Individuals with comorbid conditions admitted in ICU during COVID-19 treatment and prolonged hospital stay were at higher risk of developing speech, swallowing, and hearing-related issues post-COVID-19. The present study indicated that all COVID-19 survivors should be screened for speech, swallowing, and hearing-related issues for early rehabilitation if needed.
    MeSH term(s) COVID-19/drug therapy ; COVID-19/epidemiology ; Deglutition ; Hearing ; Humans ; SARS-CoV-2 ; Speech
    Language English
    Publishing date 2022-01-21
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1017359-6
    ISSN 1434-4726 ; 0937-4477
    ISSN (online) 1434-4726
    ISSN 0937-4477
    DOI 10.1007/s00405-021-07217-2
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