https://doi.org/10.4081/monaldi.2021.1975

Respiratory rehabilitation for patients with COVID-19 infection and chronic respiratory failure: a real-life retrospective study by a Lombard network

Vol. 92 No. 3 (2022)
Submitted: June 14, 2021
Accepted: December 20, 2021
Published: December 28, 2021
disability, chronic respiratory failure, post COVID-19
Abstract Views: 1890
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Authors

Michele Vitacca
michele.vitacca@icsmaugeri.it
https://orcid.org/0000-0002-9389-7915
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.
Beatrice Salvi
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.
Marta Lazzeri
Department of Cardiothoracic and Vascular Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Elisabetta Zampogna
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Tradate (VA), Italy.
Giancarlo Piaggi
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Montescano (PV) , Italy.
Piero Ceriana
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Pavia, Italy.
Serena Cirio
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Pavia, Italy.
Luigino Rizzello
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Milan, Italy.
Grazia Lacala
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Milan, Italy.
Angelo Longoni
ASST Lariana – P.O. Sant’Antonio Abate, Cantù (MO), Italy.
Vittoria Galimberti
Hospital San Giuseppe, Milan, Italy.
Patrizia D'Ambrosio
Hospital San Giuseppe, Milan, Italy.
Enrica Pavesi
Hospital Santa Marta, Rivolta d’Adda (CR), Italy.
Giuseppe La Piana
Hospital Santa Marta, Rivolta d’Adda (CR), Italy.
Antonella Sanniti
Casa di Cura Ancelle della Carità, Fondazione Teresa Camplani, Cremona, Italy.
Alessandro Morandi
Casa di Cura Ancelle della Carità, Fondazione Teresa Camplani, Cremona, Italy.
Manoel Vallet
Casa di Cura Ancelle della Carità, Fondazione Teresa Camplani, Brescia, Italy.
Mara Paneroni
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.

The Lombardy region has been one of the areas most affected by the COVID-19 pandemic since the first months of 2020, providing real-life experiences in the acute phase. It is unclear how the respiratory rehabilitation network responded to this emergency. The aims of this retrospective study were: i) to analyze clinical, functional, and disability data at admission; ii) describe assessment tools and rehabilitative programs; iii) evaluate improvement after rehabilitation. The study was conducted on data collected from ten pulmonary rehabilitation centers in Lombardy, between the period of March 1st 2020 to March 1st 2021, in patients with respiratory failure recovering from COVID-19 both at admission and discharge. The study included demographics, comorbidities, nutritional status, risk of falls, disability status (Barthel index; Short Physical Performance Battery (SPPB); 6 minutes walking test (6MWT), symptoms (dyspnoea with Barthel Dyspnoea and MRC Dyspnoea Scale), length of stay, discharge destination, need for mechanical ventilation, respiratory function, assessment/outcomes indices, and prescribed rehabilitative programs. 413 patients were analyzed. Length of stay in acute and rehabilitative units was less than 30 days. Fifty % of patients used non-invasive ventilation during their stay. Functional status was mildly compromised for forced volumes and oxygenation, while severely compromised for diffusion capacity. Independency was low while physical performance status very low.  At discharge, 318 (77%) patients were sent home, 83 (20.1%) were transferred to an acute unit and 12 (2.9%) passed away. Barthel Index and 6MWT were the most used, while MRC score was the least used outcome parameter. The 5 main rehabilitative activities were walking (90.8 %), transfer from bed to armchair (77.5%), limb mobilization in bed (76%), balance (71.2%), and cycle-ergometer or treadmill (43.1%). A huge difference was found in admission, discharge, and delta change among different rehabilitative centers. When available, all outcomes showed a significant improvement. With the limitation of a retrospective study with a clear amount of missing data, COVID-19 subjects admitted to rehabilitative centers presented a reduced physical performance, symptoms of dyspnoea, and severe disability. The 6MWT and Barthel index were the most used measurement.

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How to Cite

Vitacca, Michele, Beatrice Salvi, Marta Lazzeri, Elisabetta Zampogna, Giancarlo Piaggi, Piero Ceriana, Serena Cirio, Luigino Rizzello, Grazia Lacala, Angelo Longoni, Vittoria Galimberti, Patrizia D’Ambrosio, Enrica Pavesi, Giuseppe La Piana, Antonella Sanniti, Alessandro Morandi, Manoel Vallet, and Mara Paneroni. 2021. “Respiratory Rehabilitation for Patients With COVID-19 Infection and Chronic Respiratory Failure: A Real-Life Retrospective Study by a Lombard Network”. Monaldi Archives for Chest Disease 92 (3). https://doi.org/10.4081/monaldi.2021.1975.
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