Post-COVID-19 patients in geriatric rehabilitation substantially recover in daily functioning and quality of life

Abstract

COVID-19; Geriatric rehabilitation; Older people

COVID-19; Rehabilitación geriátrica; Personas mayores

COVID-19; Rehabilitació geriàtrica; Gent gran

Background After an acute infection, older persons may benefit from geriatric rehabilitation (GR). Objectives This study describes the recovery trajectories of post-COVID-19 patients undergoing GR and explores whether frailty is associated with recovery. Design Multicentre prospective cohort study. Setting 59 GR facilities in 10 European countries. Participants Post-COVID-19 patients admitted to GR between October 2020 and October 2021. Methods Patients’ characteristics, daily functioning (Barthel index; BI), quality of life (QoL; EQ-5D-5L) and frailty (Clinical Frailty Scale; CFS) were collected at admission, discharge, 6 weeks and 6 months after discharge. We used linear mixed models to examine the trajectories of daily functioning and QoL. Results 723 participants were included with a mean age of 75 (SD: 9.91) years. Most participants were pre-frail to frail (median [interquartile range] CFS 6.0 [5.0–7.0]) at admission. After admission, the BI first steeply increased from 11.31 with 2.51 (SE 0.15, P < 0.001) points per month and stabilised around 17.0 (quadratic slope: −0.26, SE 0.02, P < 0.001). Similarly, EQ-5D-5L first steeply increased from 0.569 with 0.126 points per month (SE 0.008, P < 0.001) and stabilised around 0.8 (quadratic slope: −0.014, SE 0.001, P < 0.001). Functional recovery rates were independent of frailty level at admission. QoL was lower at admission for frailer participants, but increased faster, stabilising at almost equal QoL values for frail, pre-frail and fit patients. Conclusions Post-COVID-19 patients admitted to GR showed substantial recovery in daily functioning and QoL. Frailty at GR admission was not associated with recovery and should not be a reason to exclude patients from GR.

This study was partly funded by the Leiden University Fund (Leiden Empowerment Fund, grant number LEF2106-2-47). This work was supported by Zorg Onderzoek Nederland en Medische Wetenschappen (ZonMw), first, to the COVID19 Outcomes in Older People (COOP) study (project number 10430102110005) under the COVID-19 programme, and second, to the University Network of the Care sector South-Holland (UNC-ZH) (grant number 640001003). Adam Gordon is part funded by the UK National Institute of Health Research Academic Research Collaboration-East Midlands (ARC-EM) and is an NIHR Senior Investigator. T he views expressed are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care. The funders had no role in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.