Role of Rehabilitation Department for Adult Individuals With COVID-19: The Experience of the San Raffaele Hospital of Milan
Role of Rehabilitation Department for Adult Individuals With COVID-19: The Experience of the San Raffaele Hospital of Milan
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DOI：
10.1016/j.apmr.2020.05.015
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发表时间：
2020-09-01
影响因子：
4.3
通讯作者：
Scarpellini, Paolo
中科院分区：
文献类型：
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作者：
Iannaccone, Sandro;Castellazzi, Paola;Scarpellini, Paolo
与严重急性呼吸综合征冠状病毒2的传播有关的突发卫生事件的迅速演变，需要制定2019年冠状病毒病（COVID-19）患者康复管理规范。COVID-19患者的症状演变分为两个阶段：急性期，以呼吸道症状为主；急性期后，患者可出现与长期不能活动、既往和当前呼吸功能障碍以及认知和情绪障碍相关的症状。因此，需要对这些患者进行专门的康复护理。本通报报告了米兰圣拉斐尔医院的经验，并建议为COVID-19患者的康复建立专门的临床途径。在这家医院，从2020年2月1日到3月2日，每天约有50名患者因COVID-19症状入院。在那些日子里，大约创建了400个急症护理床位（重症/传染病）。在接下来的30天里，从3月2日到4月中旬，尽管每天都有60名患者来到急诊科，但不同病房之间的患者流动组织进行了修改，并根据更准确地整合患者需求创建了几个不同的单元。根据这种新的组织方式，患者首先被送入COVID-19急性护理病房，然后被送入COVID-19康复病房、COVID-19后康复病房和/或隔离/观察病房。出院后，采用远程医疗在家对患者进行随访。这样的临床路径应该包括由肺科医生、物理医生、神经科医生、心脏病专家、物理治疗师、神经心理学家、职业治疗师、语言治疗师和营养学家组成的专门的多学科团队。(c) 2020年美国康复医学大会
The rapid evolution of the health emergency linked to the spread of severe acute respiratory syndrome coronavirus 2 requires specifications for the rehabilitative management of patients with coronavirus disease 2019 (COVID-19). The symptomatic evolution of patients with COVID-19 is characterized by 2 phases: an acute phase in which respiratory symptoms prevail and a postacute phase in which patients can show symptoms related to prolonged immobilization, to previous and current respiratory dysfunctions, and to cognitive and emotional disorders. Thus, there is the need for specialized rehabilitative care for these patients. This communication reports the experience of the San Raffaele Hospital of Milan and recommends the setup of specialized clinical pathways for the rehabilitation of patients with COVID-19. In this hospital, between February 1 and March 2, 2020, about 50 patients were admitted every day with COVID-19 symptoms. In those days, about 400 acute care beds were created (intensive care/infectious diseases). In the following 30 days, from March 2 to mid-April, despite the presence of 60 daily arrivals to the emergency department, the organization of patient flow between different wards was modified, and several different units were created based on a more accurate integration of patients' needs. According to this new organization, patients were admitted first to acute care COVID-19 units and then to COVID-19 rehabilitation units, post-COVID-19 rehabilitation units, and/or quarantine/observation units. After hospital discharge, telemedicine was used to follow-up with patients at home. Such clinical pathways should each involve dedicated multidisciplinary teams composed of pulmonologists, physiatrists, neurologists, cardiologists, physiotherapists, neuropsychologists, occupational therapists, speech therapists, and nutritionists. (c) 2020 by the American Congress of Rehabilitation Medicine