Respiratory Physiotherapy in Severe COVID-19 Patients
Condition: COVID-19
MeSH terms: COVID-19
Study type: Observational

Summary: 
      COVID-19 is an infectious disease caused by SARS-CoV2 virus. COVID-19 patients can develop a
      severe disease that can lead to hypoxic respiratory failure and acute respiratory distress
      syndrome (ARDS). Severe patients can require access to intensive care unit (ICU). Early
      rehabilitation is known to be effective in critically ill patients and in ARDS.

      The role of respiratory physiotherapy in critical COVID-19 patients is still unclear.

      The aim of this study is to describe the bundle and the timing of respiratory physiotherapy
      used with severe COVID-19 patients from ICU to hospital discharge. Functional condition of
      patients at discharge will be assessed and described.
    

Detailed description: 
      COVID-19 is an infectious disease caused by SARS-CoV2 virus, that first appeared in China in
      2019 and in Italy in February 2020.

      Approximately 80% of people infected with COVID-19 have mild to moderate disease with few
      symptoms, while more than 10% develop a severe disease that can lead to hypoxic respiratory
      failure and acute respiratory distress syndrome (ARDS). Severe patients can require access to
      intensive care unit (ICU) needing invasive mechanical ventilation (IMV) and hospitalization
      for a long period.

      Early rehabilitation is known to be effective in critically ill patients and in ARDS, to
      reduce functional impairment due to the prolonged stay in ICU. Many works demonstrated that
      early rehabilitation programs in ICU correlated with faster recovery and discharge at home of
      ARDS patients and better outcomes in the walking test at discharge from the hospital.

      Due to the recent development of COVID-19, few data and guidelines to menage severe COVID-19
      patients are available and the role of respiratory physiotherapy is still unclear.

      The aim of this study is to describe the bundle and the timing of respiratory physiotherapy
      used with severe COVID-19 patients from ICU to hospital discharge. Functional condition of
      patients at discharge will be assessed and described.
    

Intervention name(s): Respiratory physiotherapy
Intervention type(s): Other
Intervention description(s): Respiratory physiotherapy consists of:
early mobilization (passive and active mobilization, muscle-strengthening exercises, mobilization out of bed, standing, walking, ADL)
patients positioning
non-invasive mechanical ventilation / CPAP
tracheostomy management
invasive mechanical ventilation weaning
airway clearance
oxygen titration
Observational model: Case-Only
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Investigators will study patients accessing acute hospital ICU with hypoxemic acute
        respiratory failure (hARF) due to laboratory confirmed COVID-19 pneumonia form March 1st to
        May 1st, that were treated by respiratory physiotherapists during the whole hospitalization
        period.
      
Keywords: ICU; Respiratory Physiotherapy; Early Rehabilitation