Rehabilitation and In-Hospital Mortality in COVID-19 Patients

Anne Felicia Ambrose, Anupama Kurra, Lana Tsirakidis, Kate Collins Hunt, Emmeline Ayers, Andrew Gitkind, Sandeep Yerra, Yungtai Lo, Nicole Ortiz, Faraz Jamal, Vikram Madan, Matthew N. Bartels, Joe Verghese

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Coronavirus disease 2019 (COVID-19) guidelines endorse early rehabilitation to improve outcomes in hospitalized patients, but the evidence base to support this recommendation is lacking. We examined the association between early rehabilitation and in-hospital deaths in COVID-19 patients. Method: A single-center retrospective study, involving 990 COVID-19 patients (42.4% women, mean age 67.8 years) admitted between March 1, 2020 and May 31, 2020 to a community hospital, was conducted. Association of rehabilitation during hospitalization with in-hospital mortality was examined using logistic regression analysis adjusted for demographics, length of stay, body mass index, comorbid illnesses, functional status as well as for COVID-19 presentations, treatments, and complications. Results: Over the 3-month study period, 475 (48.0%) inpatients were referred for rehabilitation. Patients who received rehabilitation were older (73.7 ± 14.0 vs 62.3 ± 17.2). There were 61 hospital deaths (12.8%) in the rehabilitation group and 165 (32.0%) in the nonrehabilitation group. Receiving rehabilitation was associated with an 89% lower in-hospital mortality (odds ratio [OR]: 0.11, 95% confidence interval [CI]: 0.06-0.19) after adjusting for multiple confounders and COVID-19 disease markers. In sensitivity analyses, the results were significant in subpopulations defined by age group, sex, race, length of hospitalization, or pulmonary presentations. Each additional rehabilitation session was associated with a 29% lower risk of in-hospital mortality (OR per session: 0.71, 95% CI: 0.64-0.79) in the fully adjusted model. Conclusion: Among hospitalized COVID-19 patients, receiving early rehabilitation was associated with lower in-hospital mortality. Our findings support implementation of rehabilitation services for COVID-19 patients in acute care settings, but further research from randomized clinical trials is needed.

Original languageEnglish (US)
Pages (from-to)E148-E154
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume77
Issue number4
DOIs
StatePublished - Apr 1 2022

Keywords

  • COVID-19
  • Epidemiology
  • Mortality
  • Rehabilitation

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

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