COVID REHABILITATION IN TWO MALAYSIAN TERTIARY HOSPITALS

Research

Objectives: To investigate the severity of COVID-19 infections and complications experienced during inpatient admission.
To study the patient outcomes after a 12 week outpatient rehabilitation program.

Design: A retrospective cohort study was conducted for a 12 month period from January 1st, 2021, to December 31st, 2021. COVID-19 patients who were referred to Rehabilitation Medicine team as inpatient or outpatient were included. Patient symptoms and outcome at 1 month and 3 month post initial contact were analysed.Setting: Sultan Ahmad Shah Medical Centre@IIUM) and Penang General Hospital are both tertiary hospitals and referral centers.Participants: 184 patients were selected for this study. By using IBM SPSS version 24, descriptive analysis was done to elaborate the demographic data and patient outcomes up to 3 months after the first contact with the Rehabilitation Medicine team.Interventions: Pulmonary rehabilitation by telerehabilitation or face to face method.Main Outcome Measures: Residual symptom report and Medical Research Council Dyspnea Scale.

Results: The mean age of patients in the study was 51.8 years (SD 16.0). Out of 184 patients, majority were male (58.7%), from Malay ethnicity (74.5%) and hypertensive (51.6%). 25.5% of patients received telerehabilitation review. Most patients were classified as category 4 and 5 COVID-19 infection (78.8 %). During inpatient admission, many patients received treatment with steroids (77.2%) and antibiotics (69.0%). 30.5% of patients received antiviral treatment. Three commonest COVID-19 complications were pulmonary complications (59.8%), pressure injury (28.8%), and nosocomial infections (23.4%). Dyspnea and fatigue were the main reported symptoms during initial rehabilitation contact and all outpatient follow ups. The mean Medical Research Council Dyspnea scale improved from 2.7 at baseline to 1.7 at 3 months follow up. 32.1% of patients were diagnosed with Long COVID syndrome. Default rates increased from 26.1% at 1 month to 36.4% at 3 month follow up.

Conclusions: COVID 19 patients who received inpatient rehabilitation input, followed by a 12 week outpatient follow up showed symptom improvement. Future studies need to establish long term outcomes of COVID-19 survivors in this region.Author(s) Disclosures: All authors have no disclosures.