Rehabilitation care during the new COVID-19 coronavirus infection epidemic at first, second and third medical rehabilitation stages

Patients with a new coronavirus infection (COVID-19) need rehabilitation. Rehabilitation approaches of patients with another pathology also require to be reviewed under the conditions of the SARS-CoV-2 epidemic. It is necessary to develop clinical recommendations for the rehabilitation care delivery in patients with COVID-19 and other diseases during a pandemic. A group of experts analyzed the data of current reviews on rehabilitation with COVID-19, as well as previous studies on rehabilitation in patients with Post-intensive care syndrome (PICS) and acute respiratory distress syndrome of non-coronavirus etiology, and developed thereupon the main positions of clinical recommendations. We discuss the main rehabilitation problems in patients with COVID-19, in particular structures and functions impairments, leading to limitations and restrictions of self-care, mobility, domestic life, communication, interpersonal interactions and relationships, professional activities and those determining care requirement. The article also provides general recommendations on medical rehabilitation management in a pandemic at all three stages, including patients routing, ensuring the infectious safety of medical personnel and patients. The necessary individual rehabilitation program components for patients with COVID-19 at all stages of rehabilitation have been identified, including patients examination, nutritional deficiency correction, restoration of respiratory function, exercise tolerance, muscle strength, self-monitoring and training in new movement conditions, psychoemotional state disorders and cognitive functions, as well as independence in everyday life recovery. Medical rehabilitation during the COVID-19 epidemic should include all rehabilitation care components and helps to optimize vital functions, to prevent complications and to improve the patients life quality.