Rehabilitationsergebnisse bei Covid-19-Erkrankung: eine Fall-Kontroll-Studie

Zusammenfassung

Hintergrund Unterscheidet sich der Rehaverlauf von akut Covid-19-Erkrankten von genesenen Covid-19-Patienten und anderen Rehapatienten? Vergleich des Verlaufs zwischen akut Covid-19-Erkrankten, genesenen Patienten und Rehapatienten ohne Covid-19. Design: Fall-Kontroll-Studie.

Material und Methoden Einschluss von im Zeitraum 01.04. bis 30.06.2020 zugewiesenen Patienten mit aktiver Covid-19-Erkrankung (IG), genesenen Covid-19-Betroffenen (PCG) und einer gleichzeitig rehabilitierten, nach Alter, Geschlecht und Komorbidität gematchten Kontrollgruppe (Ko). Primärer Endpunkt war die Selbständigkeit im Alltag (FIM), weitere Endpunkte waren Lebensqualität (EQ5D-VAS), physische und mentale Gesundheit (PROMIS10) sowie Mobilität (TUG und 6MWT).

Ergebnisse 101 Patienten wurden eingeschlossen: IG=15; PCG=22; Ko=64. Die Selbständigkeit und Lebensqualität bei Eintritt waren in der IG signifikant am höchsten (FIM IG 95,3 vs. PCG 78,3, vs. Ko 79,6; ANOVA p=0,029; EQ5D-VAS IG 56.1 vs. PCG 36,6 vs. Ko 51,0; ANOVA p=0,010). Im PROMIS10 sowie in der Mobilität gab es keine Unterschiede. Alle drei Gruppen verbesserten sich von Ein- zu Austritt signifikant. Die IG schnitt bei Austritt im FIM am besten ab (IG 109,7 vs. PCG 97,2 vs. Ko 93,6; ANOVA p=0,039). Die Kontrollgruppe erreichte hinsichtlich Mobilität bei Austritt die schlechtesten Resultate (TUG Ko 19,3 Sek. vs. 9,6 Sek IG und 8,3 Sek PCG). Im 6MWT zeigte die PCG das beste Resultat (471 m vs. IG 416 m und Ko 389 m; Differenz n.s.).

Schlussfolgerung Alle drei Patientengruppen konnten sehr gut vom Rehaprogramm profitieren. Rehamassnahmen bringen auch für isolierte akut Covid-19-Erkrankte einen Benefit. Insbesondere genesene Covid-19-Patienten profitieren sehr von den Rehamassnahmen.

Abstract

Objective Does the rehab process of acutely ill Covid-19 patients differ from recovered Covid-19 patients and other rehab patients? Comparison of the reha-course between acutely ill Covid-19 patients, recovered patients and rehab patients without Covid-19. Design: case-control study.

Material and Methods Patients assigned to rehab in the period from 01.04 to 30.06.2020 with active Covid-19 disease (IG), recovered Covid-19 patients (PCG) and simultaneously rehabilitated persons matched by age, gender and comorbidity (Ko) were included. The primary endpoint was ADL- independence (FIM), secondary endpoints were quality of life (EQ5D-VAS), physical and mental health (PROMIS10) and mobility (TUG and 6MWT).

Results 101 patients were included: IG=15; PCG=22; Ko=64. At entry, ADL-independence and quality of life were significantly highest in the IG (FIM IG 95.3 vs. PCG 78.3, vs. Ko 79.6; ANOVA p=0.029; EQ5D-VAS IG 56.1 vs. PCG 36.6 vs. Ko 51.0; ANOVA p=0.010). There were no differences in PROMIS10 and mobility. All three groups improved significantly from entry to discharge. The IG performed best in the FIM (IG 109.7 vs. PCG 97.2 vs. Ko 93.6; ANOVA p=0.039). The control group achieved the worst results with regard to mobility at discharge (TUG Ko 19.3 sec vs. 9.6 sec IG and 8.3 sec PCG). In the 6MWT, the PCG showed the best result (471 m vs. IG 416 m and Ko 389 m; difference n.s.).

Conclusion All three patient groups benefited well from the rehab program. In addition, rehab measures bring a benefit also for isolated Covid-19 patients. In particular, recovered Covid-19 patients benefit greatly from the rehab program.

Schlüsselwörter

Sars-CoV-2 - Covid-19 - Rehabilitation - Therapie - Ergebnisse

Key words

Sars-CoV-2 - Covid-19 - rehabilitation - therapy - outcomes

Publication History

Received: 12 October 2021

Accepted: 16 December 2021

Article published online:
03 February 2022

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