Post-COVID-19 patients in geriatric rehabilitation substantially recover in daily functioning and quality of life
Authors: van Tol Lisa S , Haaksma Miriam L , Cesari Matteo , Dockery Frances , Everink Irma H J , Francis Bahaa N , Gordon Adam L , Grund Stefan , Matchekhina Luba , Bazan Laura Monica Perez , Schols Jos M G A , Topinková Eva , Vassallo Mark A , Caljouw Monique A A , Achterberg Wilco P ,   The EU-COGER consortium, Topinková Eva , Bautzká Lucie , Michaálková Helena , Grund Stefan , Mross Thomas , Feesche Lotte , Leonhardt Rebekka , Becker Clemens , Gerhardus Jan , Metz Brigitte R , Franke-Chowdhury Diana , Galvin Rose , McCarthy Aoife , Dockery Frances , McLoughlin Kara , Francis Bahaa , Cesari Matteo , Valentini Annalisa , Vassallo Mark , Bonnici Maria , Tkacheva Olga Nikolaevna , Eruslanova Ksenia , Matchekhina Luba , Perez Bazan Laura Monica , Fanlo Esther Roquer , Guiteras Anna Renom , Canchucaja Lizzeth Angela , Pallardo Beatriz , Zujeros Sergio Martínez , Viñuela Margarita , Miralles Resina Oriol , Dominguez Gema Isabel , Bragado Sarah Caro , Stasi Nadia , Cepeda Jennifer Garrillo , Arroyo-Huidobro Marta , Gonzalez Ana , Achterberg Wilco , Caljouw Monique , Haaksma Miriam , van Tol Lisa , Drijver Saskia , Vonk Paula , Sikken Liesbeth , Baars Irma , Deden Nathalie , Nijgh Gerda , van der Drift Sylvia , de Wever Heike , Calle Els , Karramass Kaoutar , Hendriks Josette , Ebbes Lauren , Hartman Anne , Koc Hatice , de Vries Laura , Bouwstra Hylco , Langendoen-Wigman Laura , Oldenbeuving Berber , Noordam-Hemeltjen Sabine , Lanting Liesbeth , Andela Lulu , Meerkerk Mathilde , Willemstein Lianne , Krasznai Krisztina , Wolting Janneke , Tazmi Janette , Keustermans Eveline , de Vries Janetta , van Weers Sanne , Boogaard Lenni , Been Simone , Termeer Danielle , te Pas Patricia , Lodewijks Eva , van den Berg Jeroen , Prent Sandra , Boontje Marloes , Harms Joël , Bakker Jeffrey , de Croon Carolien , van Schieveen Christa , Smit Ewout , van Berlo Patricia , Ruchtie Dionne , Manson Jane , Espasandin Maria , Abbott Lucy , Chadwick Sarah , Watts Rebecca , Dani Melani , McNicholas Jackie , Gordon Adam , Chau Vincent 
Published: May 2024

Abstract

Background
After an acute infection, older persons may benefit from geriatric rehabilitation (GR).

Objectives
This study describes the recovery trajectories of post-COVID-19 patients undergoing GR and explores whether frailty is associated with recovery.

Design
Multicentre prospective cohort study.

Setting
59 GR facilities in 10 European countries.

Participants
Post-COVID-19 patients admitted to GR between October 2020 and October 2021.

Methods
Patients’ characteristics, daily functioning (Barthel index; BI), quality of life (QoL; EQ-5D-5L) and frailty (Clinical Frailty Scale; CFS) were collected at admission, discharge, 6 weeks and 6 months after discharge. We used linear mixed models to examine the trajectories of daily functioning and QoL.

Results
723 participants were included with a mean age of 75 (SD: 9.91) years. Most participants were pre-frail to frail (median [interquartile range] CFS 6.0 [5.0–7.0]) at admission. After admission, the BI first steeply increased from 11.31 with 2.51 (SE 0.15, P &lt; 0.001) points per month and stabilised around 17.0 (quadratic slope: −0.26, SE 0.02, P &lt; 0.001). Similarly, EQ-5D-5L first steeply increased from 0.569 with 0.126 points per month (SE 0.008, P &lt; 0.001) and stabilised around 0.8 (quadratic slope: −0.014, SE 0.001, P &lt; 0.001). Functional recovery rates were independent of frailty level at admission. QoL was lower at admission for frailer participants, but increased faster, stabilising at almost equal QoL values for frail, pre-frail and fit patients.

Conclusions
Post-COVID-19 patients admitted to GR showed substantial recovery in daily functioning and QoL. Frailty at GR admission was not associated with recovery and should not be a reason to exclude patients from GR.