European Journal of Physical and Rehabilitation Medicine 2021 April;57(2):199-207

DOI: 10.23736/S1973-9087.21.06699-5

language: English

Midterm functional sequelae and implications in rehabilitation after COVID-19: a cross-sectional study

Alessio BARICICH ^{1, 2} ✉, Margherita B. BORG ^{1, 2}, Daria CUNEO ^{1, 2}, Emanuela CADARIO ³, Danila AZZOLINA ³, Piero E. BALBO ⁴, Mattia BELLAN ^{3, 5}, Patrizia ZEPPEGNO ^{3, 6}, Mario PIRISI ^{3, 5}, Carlo CISARI ^{1, 2} No-more Covid Group

¹ Department of Health Sciences, University of Eastern Piedmont, Novara, Italy; ² Department of Physical Medicine and Rehabilitation, Maggiore della Carità University Hospital, Novara, Italy; ³ Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy; ⁴ Department of Pneumology, Maggiore della Carità University Hospital, Novara, Italy; ⁵ Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy; ⁶ Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy

HTML PDF

BACKGROUND: COVID-19 has been mainly investigated concerning the acute and subacute phase implications and management. Meanwhile, few studies focused on the midterm sequelae, which still remain largely unknown.
AIM: To assess the physical performance of COVID-19 survivors at 3 to 6 months from Hospital discharge.
DESIGN: A cross-sectional study focused on mid-term functional outcomes evaluation in COVID-19 survivors.
SETTING: Outpatients who had been previously hospitalized due to COVID-19 from March to May 2020 at the University Hospital of Novara, Italy.
POPULATION: We enrolled 204 patients, of which 60% were men, with the mean age of 57.9 years.
METHODS: Patients firstly underwent the short physical performance battery test (SPPB), which is composed of a series of physical tests assessing the lower limb function and the functional status of the subjects. Subsequently, based on SPPB results, patients’ cardiorespiratory fitness performance was further investigated. Patients with normal SPPB score (SPPB>10) underwent the 2-minute walking test (2MWT) whereas, in order to safely test the cardiorespiratory function, in patients with abnormal SPPB score (SPPB≤10) the 1-minute sit-to-stand test (1MSTST) was performed. It should be noted that the 1MSTST can be safely performed even by subjects with compromised walking ability.
RESULTS: Overall, 66 patients (32% of our sample) showed an impaired physical performance at 3 to 6 months after hospital discharge. In particular, 29 patients presented an SPPB score ≤10, and the 1MSTST confirmed this status in the whole group (100%) compared to the reference values for age and sex. Besides, among patients with a normal SPPB score, 37 showed a lower sex- and age-matched 2MWT score. Finally, a significant association between Intensive Care Unit hospitalization or mechanical ventilation and physical impairment was observed together with a significant association between the walking ability (measured with SPPB and 2MWT) and the number of comorbidities.
CONCLUSIONS: A residual physical and functional impairment was observed in COVID-19 survivors at mid-term evaluation after hospitalization.
CLINICAL REHABILITATION IMPACT: Considering the current COVID-19 epidemiology, we might expect a tremendous burden of disability in the next future. Thus, an appropriate clinical rehabilitation pathway must be implemented.

KEY WORDS: Coronavirus; Rehabilitation; Patient outcome assessment; COVID-19; Disability evaluation; Outpatients

top of page

Publication History

Issue published online: May 10, 2021
Article first published online: February 10, 2021
Manuscript accepted: February 9, 2021
Manuscript revised: February 3, 2021
Manuscript received: November 10, 2020

Cite this article as

Baricich A, Borg MB, Cuneo D, Cadario E, Azzolina D, Balbo PE, et al.; No-more Covid Group. Midterm functional sequelae and implications in rehabilitation after COVID-19: a cross-sectional study. Eur J Phys Rehabil Med 2021;57:199-207. DOI: 10.23736/S1973-9087.21.06699-5

No-more Covid Group

Gianluca AIMARETTI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Endocrinology, Maggiore della Carità University Hospital, Novara, Italy); Gian Carlo AVANZI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Emergency Department, Maggiore della Carità University Hospital, Novara, Italy); Giulia BALDON (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Giuseppe BARTOLOMEI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Marco BATTAGLIA (Department of Health Sciences, University of Eeastern Piedmont, Novara, Italy; Department of Physical Medicine and Rehabilitation, Maggiore della Carità University Hospital, Novara, Italy); Sofia BATTISTINI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Valeria BINDA (Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Vincenzo CANTALUPPI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Nephrology, Maggiore della Carità University Hospital, Novara, Italy); Luigi Mario CASTELLO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Emergency Department, Maggiore della Carità University Hospital, Novara, Italy); Elisa CLIVATI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Pneumology, Maggiore della Carità University Hospital, Novara, Italy); Martina COSTANZO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Alessandro CROCE (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Carla DE BENEDITTIS (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Simona DE VECCHI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Cardiology, Maggiore della Carità University Hospital, Novara, Italy); Alessandro FEGGI (Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Martina GAI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Eleonora GAMBARO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Eleonora GATTONI (Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Carla GRAMAGLIA (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Leonardo GRISAFI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Cardiology, Maggiore della Carità University Hospital, Novara, Italy); Chiara GUERRIERO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Eyal HAYDEN (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Amalia JONA (Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Marco INVERNIZZI (Department of Health Sciences, University of Eeastern Piedmont, Novara, Italy; Department of Physical Medicine and Rehabilitation, Maggiore della Carità University Hospital, Novara, Italy); Luca LORENZINI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Lucia LORETI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Maria MARTELLI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Erica MATINO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Antonio PANERO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Elena PARACCHINI (Department of Pneumology, Maggiore della Carità University Hospital, Novara, Italy); Filippo PATRUCCO (Department of Pneumology, Maggiore della Carità University Hospital, Novara, Italy); Giuseppe PATTI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Cardiology, Maggiore della Carità University Hospital, Novara, Italy); Alice PIROVANO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Pierluigi PROSPERINI (Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Riccardo QUAGLINO (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy); Cristina RIGAMONTI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Pier P. SAINAGHI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Daniele SODDU (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy); Camilla VECCHI (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Psychiatry, Maggiore della Carità University Hospital, Novara, Italy); Erika ZECCA (Department of Translational Medicine, University of Eeastern Piedmont, Novara, Italy; Department of Internal Medicine, Maggiore della Carità University Hospital, Novara, Italy).

Corresponding author e-mail

alessio.baricich@med.uniupo.it

YOUR ACCOUNT

YOUR ORDERS

SHOPPING BASKET

HOW TO ORDER

YOUR SUBSCRIPTIONS

YOUR ARTICLES

YOUR EBOOKS

COUPON