Tan Tock Seng Hospital1
Individuals with severe COVID-19 infection continue to experience debilitating symptoms such as weakness and loss of function. As the number of hospital admissions increased, there was a need to triage and guide rehabilitation interventions to ensure that the patients’ rehabilitation needs are met without overwhelming the healthcare system and resources.
A clinical algorithm was developed at the National Centre for Infectious Diseases to triage patients with COVID-19. Patients with COVID-19 who were referred to Physiotherapy were stratified to the different rehabilitation services based on three criteria: respiratory function, presence of desaturation and functional status. The presence of exertional desaturation was evaluated using the 2-minute step test and 30-second sit to stand test. The final discharge destination and functional status at discharge to home were used to evaluate the algorithm’s effectiveness.
Nine patients (n=101) were discharged to the subacute rehabilitation centre before home, while seven patients were discharged with transitional care service, and five patients were referred to outpatient pulmonary rehabilitation respectively. All except one patient were discharged to their own home after rehabilitation. The majority of the patients (n=97) were also able to achieve their premorbid functional status.
Using this algorithm, patients continued with their rehabilitation at various locations and achieved good functional and discharge outcomes. However, further research is required to evaluate the outcomes of the algorithm, such as the duration of rehabilitation, timeliness of hospital discharge and the patients’ exercise tolerance.