COVID-19 and hospital restrictions: physical disconnection and digital re-connection in disorders of consciousness

Brain Inj. 2021 Aug 24;35(10):1134-1142. doi: 10.1080/02699052.2021.1972335. Epub 2021 Sep 8.

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) pandemic forced hospitals to adopt tighter restrictions, the most impacting is no access to visitors. Disorder of consciousness (DOC) due to severe acquired brain injury is a condition needing neurorehabilitation and the role of relatives is essential, hence besides physical "disconnection" digital "re-connection" is crucial. We aimed to assess whether digital communication benefits in patients with DOC, considering the sensorial and emotional deprivation due to the COVID-19 emergency lock-down.Methods: For eleven consecutive patients with DOC admitted to our Intensive Neurorehabilitation Care (mean age: 45; females: 9), two observers registered neurobehavioral changes during a video-calls with their relatives. Heart-rate variability was measured before and during the calls. The video-call was performed by using two displays of different sizes: tablet (T-video-call) and large screen (LS-Video-call).Results: The video-calls impacted on the patients' vigilance and in the relationship with relatives. Moreover, positively impacted on their relatives. The current results showed significant greater impact on patients during the LS-video-call than when they are exposed to T-video-call.Conclusions: During the COVID-19 pandemic, besides the physical disconnection to stop the contagion spread, a "digital re-connection" is needed for all and especially for fragile population groups as patients with DOC.

Keywords: COVID-19; disorder of consciousness; emotional deprivation; personalized medicine; rehabilitation.

MeSH terms

  • COVID-19*
  • Communicable Disease Control
  • Consciousness Disorders / etiology
  • Consciousness*
  • Female
  • Heart Rate
  • Hospitals
  • Humans
  • Middle Aged
  • Pandemics
  • SARS-CoV-2