Descriptive retrospective cross-sectional study of rehabilitation care for poststroke users in Québec during the COVID-19 pandemic.

Abstract

Objectives: During the COVID-19 pandemic, designated rehabilitation centres were established in the province of Québec, where strict sociosanitary measures such as isolation and mandatory personal protection equipment requirements were followed. This study aimed to describe the impact of the pandemic on rehabilitation care indicators for poststroke users with (COV+) and without (COV-) COVID-19 infection in designated rehabilitation centres compared with those admitted in the previous year (pre-COV).

Method: A retrospective analysis of 292 medical files was performed in 3 rehabilitation centres. Demographic characteristics were collected, as well as indicators routinely collected in acute care and rehabilitation such as length of stay (LOS), the Functional Independence Measure and a number of physical/occupational therapy (PT/OT) sessions. Non-parametric statistical tests were used to compare variables among the three groups.

Results: COV+ users were older than COV- and pre-COV ones (p<0.01) and were more disabled on admission to a rehabilitation centre (p<0.01). They also exhibited longer LOS in acute care prior to rehabilitation (p<0.001) and were more often rehospitalised (p<0.002) during the course of their stay in the rehabilitation centre. Despite longer rehabilitation stays (p<0.001) and more PT/OT sessions, COV+ users remained more disabled at discharge (p<0.002). COV- users showed rehabilitation care indicators resembling the ones of pre-COV despite spending less time in rehabilitation.

Conclusions: Patients who had a stroke infected with COVID-19 exhibited greater vulnerability on admission to rehabilitation. They required more care and services during their rehabilitation period. However, this additional support did not enable them to achieve the same level of recovery as COV- and pre-COV users. This underscores the added impact of the disease on already impaired patients and highlights the specific needs of COV+ users undergoing rehabilitation.