Summary and introduction
By June 2021, 33.5 million people in the United States had been diagnosed with COVID-19. Although most patients infected with SARS-CoV-2, the virus that causes COVID-19, recover within a few weeks, some illnesses occur after COVID-19. These range from new or recurring to persistent health problems that can last longer than 4 weeks. Post-COVID-19 illnesses may also occur in people who were asymptomatic at the time of infection. Data is available on post-COVID-19 conditions and information on the rehabilitation needs of those recovering from COVID-19 is limited. Using data collected from Select Medical * outpatient rehabilitation clinics from January 2020 through March 2021, CDC compared patient-reported measures of health, physical endurance, and health care utilization among patients recovering from COVID-19 had (post-COVID-19 patients). and patients who need rehabilitation due to a current or previous diagnosis of neoplasm (cancer) who did not experience COVID-19 (control patients). All patients were referred to outpatient rehabilitation. Compared to control patients, post-COVID-19 patients had a higher age- and gender-adjusted probability of reporting poorer physical health (adjusted odds ratio [aOR] = 1.8), pain (aOR = 2.3) and difficulty in physical activity (aOR = 1.6). Post-COVID-19 patients also had poorer physical endurance as measured by the 6-minute walk testI (6MWT) (p
The data was obtained from electronic health records (EHRs) of patients referred to Select Medical outpatient rehabilitation clinics between January 2020 and March 2021. Epidemiological, clinical and functional data from 1,295 post-COVID-19 patients and 2,395 control patients were examined. Post-COVID-19 patients were defined as those referred to a selected medical facility for physical rehabilitation after COVID-19. Control patients, defined as patients in need of rehabilitation based on a current or previous cancer diagnosis without a medical history International Classification of Diseases, Tenth Revision (ICD-10) COVID-19 Diagnostic Code,§ were referred to a select medical cancer rehabilitation program. This control population was chosen because the patients in this group performed the same initial assessments as the patients referred for rehabilitation after COVID-19. Information on cancer type or interval since diagnosis was not available. Patient data were collected from EHRs and an initial clinical assessment that included self-reported health interventions and a 6 MWT. When ingested, self-reported measures and clinical assessments for health, physical endurance and health care were performed.
Using validated scales, CDC rated mental and physical health, functional health, social participation, applied cognition, and physical endurance using the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health (Version 1.2; National Institutes of Health ), PROMIS physical function, PROMIS ability,¶ Quality of life with neurological disorders (Neuro-QoL) ** and the 6MWT,I or For self-reported data at item level, 5-point Likert scales were recoded in proportions. T-scores were calculated for composite measures of physical and mental health, social participation and applied cognition, with the summed raw scores converted to T-scores based on standardized assessment tables; T-scores were designed with a mean of 50 and a standard deviation (SD) of 10 for the general adult population. Logistic regression analyzes, adjusted for age and gender, were used to examine differences in patient-reported measures of health and physical endurance and health care between post-COVID-19 and control patients.§§ All analyzes were carried out with SAS (version 9.4; SAS Institute). This activity has been verified by CDC and conducted in accordance with applicable federal law and CDC guidelines.¶¶
Post-COVID-19 patients referred for rehabilitation services differed from control patients in several characteristics, including gender, age, race, ethnicity, employment status, health insurance coverage, and U.S. census region (Table 1). Compared to control patients, post-COVID-19 patients were more likely to be male, younger, employed, covered by a commercial plan or an employee compensation plan, and less likely to be covered by Medicaid or Medicare (Table 1). Post-COVID-19 patients were more likely to have a diagnosis of generalized muscle weakness or fatigue (72.7% versus 42.3%) and patient-reported symptoms of generalized muscle weakness, malaise, and fatigue (69.0% versus 59%). 7%) (Table.) 2).
Compared to control patients, post-COVID-19 patients had a higher prevalence of reported good or poor general condition (32.9% versus 25.4%), poorer physical health (44.1% versus 32.6%) Pain level ≥7 (on a scale of 0.). -10) (40.4% versus 24.8%) and difficulty in physical activity (32.3% versus 24.2%) (Table 3). Post-COVID-19 patients also reported a higher prevalence of mediocre or poor overall mental health than control patients (19.1% versus 15.3%). Post-COVID-19 patients and control patients reported more applied cognition challenges as indicated by T-scores (42.2 versus 41.2), both roughly one SD below the normative sample used to develop the scale. Post-COVID-19 patients also showed decreased physical endurance on the 6MWT compared to control patients (distance of 303 m vs. vs. 18.3%), running errands or shopping (34.3% vs. 16.0%) and Walk for 15 minutes (38.2% versus 16.6%). Compared to control patients, post-COVID-19 patients also reported greater difficulty with normal work or work at home (37.2% vs. 20.4%) and difficulty participating in activities with friends (33.0% vs. 18.8%). Post-COVID-19 patients required significantly more visits for health care measurements (median = 9, interquartile range.) [IQR] = 4–20) as control patients (median = 5, IQR 1–11; p