Step-by-step inpatient rehabilitation for critical illness after coronavirus disease 2019 A CARE-compliant case report

Abstract

Introduction: Since the coronavirus disease (COVID-19) outbreak in Wuhan, China, in December 2019, COVID-19 has become a worldwide pandemic. Muscle weakness and deconditioning caused by COVID-19-induced critical illness requires rehabilitation. Patient concerns: A 74-year-old male patient complained of general weakness after COVID-19, requiring ventilator treatment. Diagnosis: He was confirmed as having COVID-19 using a polymerase chain reaction test. Interventions: During admission in the intensive care unit, medical staff wearing level D protective equipment performed the bedside manual range of motion exercise. After a negative COVID-19 test, the patient was transferred to a general ward, where sitting balance training and pulmonary rehabilitation were additionally performed by rehabilitation therapists wearing protective gear. When the patient was able to stand up with support, standing balance training and sit-to-stand training were performed. Outcomes: After a month of rehabilitation, the patient could sit alone, but he needed help with standing balance. The Berg Balance Scale score improved from 0 to 4, and the Modified Barthel Index score improved from 8 to 18. He was able to breathe in room air without an oxygen supply. Lessons: This case report shows an example of how safe and effective rehabilitation can be provided to COVID-19 patients. Abbreviations: COVID-19 = Coronavirus disease, FVC = forced vital capacity, ICU = intensive care unit, MRC = Medical Research Council, PCR = polymerase chain reaction, PFT = pulmonary function test, ROM = range of motion.