Comparative efficacy of day-stay hospital and telerehabilitation treatment: a prospective parallel study in 180 patients with COVID-19

Background: Growing evidence indicates that coronavirus disease 2019 (COVID-19) is associated with a long-term virus infection carrier state. This required of change in the existing procedures of rehabilitation treatment while maintaining its staging. Particularly, a transformation of in-person rehabilitation to telerehabilitation is recommended. Previous experience allowed us to organize telerehabilitation for patients with COVID-19 in the early days of the pandemic. We summarized findings of our study in this article. Aims: The purpose of this article was to compare effectiveness of two technologies for the rehabilitation treatment in patients with post-COVID: in-person (day-stay hospital) and telerehabilitation. Materials and methods: This prospective, parallel group study included patients with post-COVID, who received day hospital or telerehabilitation treatment between May 2020 and February 2021. Efficacy points were physical activity intensity level measured by Borg scale and a measure of the generic quality of life by EQ-5 (European Quality of Life 5-Dimension Questionnare). The choice of these metrics is explained by the possibility of using in the form of teleinterview.Results: Overall 180 patients who received day hospital (DH) rehabilitation treatment (n = 97; 64 women and 33 men; 55,1 11,9 years) or underwent telerehabilitation (TR) (n = 83; 52 women and 31 men; 54,4 12,76 years) were included to study. In DH group mean patient-day was 12,6, mean number of sessions achieved 10. In these patients high compliance to treatment was noted: only 5 (4,9%) of participants visited 5 sessions. As a result of treatment in DH and TR groups, statistically significant improvement both on the Borg score and EQ-5 was observed (p 0,05 compared the treatment initiation). Mean improvement in Borg scale in patients of DH group achieved 3,65 and that in TR group was 1,43 (p = 0,001). Between-group differences in the effectiveness of therapy by EQ-5 were not statistically significant (p = 0,341). Form of COVID did not affect the effectiveness of rehabilitation treatment. We also assessed TR-patients' perception of the physical non-interaction during the therapy: all participants reported a high quality of medical care. Neither patients age nor treatment time did not affect the level of satisfaction: 12 patients expressed their desire to repeat the TR course. No stop-signs or adverse effects were registered during the rehabilition period in both treatment groups. Conclusions: The use of telerehabilitation in medical rehabilitation help of patients with post-COVID is not less effective than in-person (day-stay hospital) treatment. Given high risks of infection during the COVID pandemic, it is possible to use such a method of rehabilitation, without in-person medical examination. We draw attention that in general practice patients should be examined manually by specialists of multidisciplinary teams at least twice: at the beginning and end of rehabilitation treatment course.