Michael Klein, Bernadette Einhäupl, Eva Grill, Gergana Drunin, Simone Schmidt, Cay Cordes, Marion Egger, Hans-Jürgen Gdynia, Anna Gorsler, Danae Götze, Jens Dieter Rollnik, Martin Justinus Rosenfelder, Ernst Walther, Daniel Wertheimer, Corinna Wimmer, Peter Young, Klaus Jahn, Andreas Bender
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引用次数: 0
Abstract
Background: Up to 80% of intensive care unit (ICU) patients suffer from neuromuscular disorders like critical illness polyneuropathy/myopathy (CIP/CIM), requiring further rehabilitation.
Objective: This study investigates differences in the clinical course between Coronavirus Disease 2019 (COVID-19) and non-COVID-19 patients with CIP/CIM undergoing post-acute neurological rehabilitation (PANR) and the impact of COVID-19 on rehabilitation outcomes.
Methods: A multicenter observational study was conducted in nine German PANR facilities. The clinical course and outcome were compared between COVID-19 and non-COVID-19 patients at rehabilitation admission and discharge. Functional outcomes were measured with the modified Ranking Scale (mRS) and the Barthel Index (BI). Functional independence was defined as either mRS Score < 3 or BI > 75 at discharge, discharged home without nursing support with a BI > 65, or discharged to further rehabilitation (phase D). To analyze outcome predictors, Cox regression was used.
Results: A total of 323 patients (COVID-19 n = 166) after an ICU stay were enrolled, and outcome measures were available for 298. 56 of them achieved functional independence at discharge. COVID-19 patients had better functional scores at admission and discharge and a shorter length of stay as the non-COVID group. Pre-existing diabetes was significantly negatively associated with functioning at discharge.
Conclusions: This analysis provides the first evidence for differences and predictors of the clinical course and outcome for COVID-19 and non-COVID-19 patients with CIP/CIM in the phase of post-acute rehabilitation. Our results offer valuable impulses for rehabilitation strategies for these patients. https://drks.de/search/de , German Clinical Trials Register, ID DRKS00022845, registered on September 1, 2020.
期刊介绍：
The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field.
In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials.
Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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