Effects of Early Physical and Pulmonary Rehabilitation for Severely and Critically ill COVID-19 Patients: A Retrospective, Cohort, and Multicenter Study

Abstract Background Effects of early rehabilitation therapy in severe and critical COVID-19 patients remains to be elucidated. Methods We recruited 80 severely and critically ill COVID-19 patients in Chongqing from January 21 to March 15, 2020, who had received rehabilitation therapies or standard treatments within 72 h of intensive care unit (ICU) admission. We analyzed mortality rates, length of stay in the ICU and hospital, ventilator-free days, and adverse events during hospitalization. Respiratory function, independent functional status, muscle strength, exercise capacity and life quality were measured at hospital discharge and during a three-month follow-up. Results We found no significant differences between the intervention and control groups in terms of ICU, hospital, and 28-day mortality rates, and lengths of stay in the ICU and hospital. Additionally, early rehabilitation enhanced the duration of ventilator-free days, with no increased adverse events and complications. Total lung capacity and carbon monoxide diffusion capacity, Barthel index, and functional independence measure for patients in the intervention group were all higher than those in the control group at hospital discharge and one month after discharge. Compared to the control group, patients in the intervention group had significantly higher Medical Research Council scores and greater walking distance capacities within 6 min at hospital discharge, as well as one month and three months after discharge. The St. George's Respiratory Questionnaire score was lower in the intervention group than in the control group at one month and three months after hospital discharge. Conclusions Early physical and pulmonary rehabilitation is safe and effective for severely and critically ill COVID-19 patients to promote their functional, physical, and psychological recovery.