Comparative efficacy of a day-stay hospital and telerehabilitation treatment: A retrospective study in 180 patients with COVID-19

BACKGROUND: Growing evidence indicates that coronavirus disease 2019 (COVID-19) is associated with long-term virus transmission by patients during the convalescence period. This fact required changes in the existing procedures of rehabilitation treatment while maintaining its staging. Particularly, the transformation of in-person rehabilitation to telerehabilitation is recommended. The previous experience allowed us to organize telerehabilitation for patients with COVID-19 in the early days of the pandemic. We have summarized the findings of our study in this article.

AIM: to compare the effectiveness of two technologies for the rehabilitation treatment of patients with post-COVID: an in-person treatment (a day-stay hospital) and telerehabilitation

MATERIALS AND METHODS: This retrospective single blind study included patients with post-COVID, who received day hospital or telerehabilitation treatment between May 2020 and February 2021. The efficacy was estimated by the intensity level of physical activity measured according to the Borg scale and by the generic quality of life by EQ-5 (European Quality of Life 5-Dimension Questionnaire). The choice of these metrics is justified by the possibility of their acquisition via a teleinterview.

RESULTS: 180 patients in total, including those who received a day hospital (DH) rehabilitation treatment (n=97; 64 women and 33 men; 55.1±11.9 years) and those who underwent telerehabilitation (TR) (n=83; 52 women and 31 men; 54.4±12.76 years) were included in the study. In the DH group, the mean patient-day was 12.6, mean number of sessions achieved 10. In these patients, a high compliance to the treatment was noted: only 5 (4.9%) of participants visited ≤5 sessions. As a result of treatment in the DH and the TR groups, a statistically significant improvement both according to the Borg score and to the EQ-5 was observed (p <0.05 compared to the beginning of the treatment). The mean improvement by the Borg scale achieved 3.65 in the DH group and 1.43 in the TR group (p=0.001). The between-group differences in the effectiveness of therapy by the EQ-5 were not statistically significant (p=0.341). The clinical form of COVID did not affect the effectiveness of the rehabilitation treatment. We also assessed the TR-patients' perception of the absence of a physical contact during the therapy: all the participants reported a high quality of medical care. Neither a patient’s age nor the treatment time affected the level of satisfaction. 12 patients expressed their desire to repeat the TR course. No stop-signs or adverse effects were registered during the rehabilitation period in both treatment groups.

CONCLUSIONS: The use of telerehabilitation in the medical rehabilitation care for post-COVID patients is not less effective than an in-person (day-stay hospital) treatment. Given the high risks of infection during the COVID pandemic, it is possible to use such a method of rehabilitation, without an in-person medical examination. However, we emphasize that in general practice a patient should be examined manually by specialists of a multidisciplinary team at least twice: at the beginning and at the end of the rehabilitation treatment course.