Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance

Jolanda C M van Haastregt; Irma H J Everink; Jos M G A Schols; Stefan Grund; Adam L Gordon; Else P Poot; Finbarr C Martin; Desmond O'Neill; Mirko Petrovic; Stefan Bachmann; Romke van Balen; Leonoor van Dam van Isselt; Frances Dockery; Marije S Holstege; Francesco Landi; Laura M Pérez; Esther Roquer; Martin Smalbrugge; Wilco P Achterberg

doi:10.1007/s41999-021-00575-4

Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance

Eur Geriatr Med. 2022 Feb;13(1):291-304. doi: 10.1007/s41999-021-00575-4. Epub 2021 Nov 20.

Authors

Jolanda C M van Haastregt^#¹, Irma H J Everink^#², Jos M G A Schols^{2

3}, Stefan Grund⁴, Adam L Gordon⁵, Else P Poot⁶, Finbarr C Martin⁷, Desmond O'Neill⁸, Mirko Petrovic⁹, Stefan Bachmann^{10

11}, Romke van Balen¹², Leonoor van Dam van Isselt¹³, Frances Dockery¹⁴, Marije S Holstege¹⁵, Francesco Landi¹⁶, Laura M Pérez^{17

18}, Esther Roquer¹⁹, Martin Smalbrugge²⁰, Wilco P Achterberg^{21

22}

Affiliations

¹ Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. j.vanhaastregt@maastrichtuniversity.nl.
² Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
³ Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.
⁴ Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, Heidelberg, Germany.
⁵ School of Medicine, University of Nottingham, Derby, UK.
⁶ Verenso Dutch Association of Elderly Care Physicians, Utrecht, The Netherlands.
⁷ Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
⁸ Trinity College Dublin Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland.
⁹ Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
¹⁰ Department of Rheumatology and Internal Medicine, Kliniken Valens, Valens, Switzerland.
¹¹ Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹² Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.
¹³ Leiden University Medical Center, Leiden, The Netherlands.
¹⁴ Department of Geriatrics and Stroke Medicine, Beaumont Hospital, Dublin, Ireland.
¹⁵ Department of Research GRZPLUS, Omring and Zorgcirkel, Hoorn, The Netherlands.
¹⁶ Geriatric Internal Medicine Department, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
¹⁷ Clinical Head of Outpatient Clinic and Geriatric Home Care, Intermediate Care Hospital Parc Sanitari Pere Virgili, Barcelona, Spain.
¹⁸ Research Group on Aging, Frailty and Transitions in Barcelona (RE-FiT BCN), Vall d'Hebrón Institut de Recerca, Barcelona, Spain.
¹⁹ Geriatric Service, University Hospital Sant Joan de Reus, Reus, Spain.
²⁰ Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
²¹ Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
²² Chair of the Guidance Committee Post COVID-19 Geriatric Rehabilitation, Verenso Dutch Association of Elderly Care Physicians, Utrecht, The Netherlands.

^# Contributed equally.

Abstract

Purpose: To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation.

Methods: The guidance is based on guidelines for post-acute COVID-19 geriatric rehabilitation developed in the Netherlands, updated with recent insights from literature, related guidance from other countries and disciplines, and combined with experiences from experts in countries participating in the Geriatric Rehabilitation Special Interest Group of the European Geriatric Medicine Society.

Results: This guidance for post-acute COVID-19 rehabilitation is divided into a section addressing general recommendations for geriatric rehabilitation and a section addressing specific processes and procedures. The Sect. "General recommendations for geriatric rehabilitation" addresses: (1) general requirements for post-acute COVID-19 rehabilitation and (2) critical aspects for quality assurance during COVID-19 pandemic. The Sect. "Specific processes and procedures", addresses the following topics: (1) patient selection; (2) admission; (3) treatment; (4) discharge; and (5) follow-up and monitoring.

Conclusion: Providing tailored geriatric rehabilitation treatment to post-acute COVID-19 patients is a challenge for which the guidance is designed to provide support. There is a strong need for additional evidence on COVID-19 geriatric rehabilitation including developing an understanding of risk profiles of older patients living with frailty to develop individualised treatment regimes. The present guidance will be regularly updated based on additional evidence from practice and research.

Keywords: COVID-19; Geriatric rehabilitation; Guidance; Post-acute care; Quality assurance.

MeSH terms

Aged
COVID-19*
Frailty*
Geriatrics*
Humans
Pandemics
SARS-CoV-2