The British Thoracic Society survey of rehabilitation to support recovery of the Post Covid-19 population
Authors: Singh SJ , Barradell A , Greening N , Bolton CE , Jenkins G , Preston L , Hurst JR 
Published: May 2020

Objectives

Those discharged from hospital after treatment for Covid-19 are likely to have significant and ongoing symptoms, functional impairment and psychological disturbances. There is an immediate need to develop a safe and efficient discharge process and recovery programme. Pulmonary rehabilitation is well placed to deliver a rehabilitation programme for this group but will most likely need to be adapted for the post Covid-19 population. The purpose of this survey was to rapidly identify the components of a post-Covid-19 rehabilitation assessment and elements of a successful rehabilitation programme that would be required to deliver a comprehensive service for those post Covid-19 to inform service delivery.

Design

A survey comprising a series of closed questions and a free text comments box allowing for a qualitative analysis.

Setting

Online survey.

Participants

British Thoracic Society members and multi-professional clinicians, across specialities were invited to take part.

Results

1031 participants responded from a broad range of specialities over 6 days. There was overwhelming support for early post discharge from hospital phase of the recovery programme to advise patients about the management of fatigue (95% agreed/ strongly agreed), breathlessness (94%), and mood disturbances (including symptoms of anxiety and depression) 92%. At the 6-8-week time point an assessment was considered important, focusing on the assessment of a broad range of possible symptoms and the need to potentially return to work. Recommendations for the intervention described a holistic programme focusing on symptom management, return of function and return to employment. The free text comments added depth to the survey and the need ‘not to reinvent the wheel’ rather adapt well established (pulmonary rehabilitation) services to accommodate the needs of the post Covid-19 population.

Conclusion

The responses indicate the huge interest and the urgent need establish a programme to support and mitigate the long term impact of Covid-19.

Strengths and limitations

Large and comprehensive survey conducted to guide the provision of post Covid-19 rehabilitation.

The survey provides clear recommendations for the provision of advice and support immediately upon discharge, and recommendations for a programme of holistic rehabilitation 6-8 weeks post discharge based upon the existing pulmonary rehabilitation model.

The survey engaged a wide range of specialities and experiences managing Covid-19

The opinions of patients and carers be sought in an additional survey

Funding statement

This research received no specific grant funding from any funding agency in the public, commercial or not-for-profit sector.

Competing interests

All authors have completed the Unified Competing Interests Form at http://www.icmie.org.coi_disclosure.pdf

Dr. Singh reports grants from Actegy, grants from Pfizer, outside the submitted work.

Dr. Jenkins reports grants from Astra Zeneca, grants from Biogen, personal fees from Boehringer Ingelheim, personal fees from Daewoong, personal fees from Galapagos, grants from Galecto, grants from GlaxoSmithKline, personal fees from Heptares, non-financial support from NuMedii, grants and personal fees from Pliant, personal fees from Promedior, non-financial support from Redx, personal fees from Roche, other from Action for Pulmonary Fibrosis, outside the submitted work.

Data sharing statement

No additional data are available.