Oxygen Therapy During Activities of Daily Living Rehabilitation and Outcome in Patients With Severe-to-critical COVID-19

Shuen-Loong Tham; Koh Kuan Cheryl Tan; Na-Ling Lin; Alfred Wai Ping Seng

doi:10.1016/j.arrct.2023.100304

Oxygen Therapy During Activities of Daily Living Rehabilitation and Outcome in Patients With Severe-to-critical COVID-19

Arch Rehabil Res Clin Transl. 2023 Oct 11;5(4):100304. doi: 10.1016/j.arrct.2023.100304. eCollection 2023 Dec.

Authors

Shuen-Loong Tham¹, Koh Kuan Cheryl Tan², Na-Ling Lin², Alfred Wai Ping Seng¹

Affiliations

¹ Rehabilitation Medicine Department, Tan Tock Seng Hospital, Singapore.
² Rehab Allied Health, Tan Tock Seng Hospital, Singapore.

Abstract

Objective: To primarily study the duration of supplemental oxygen use while performing ADLs (activities of daily living) and associations leading to a more prolonged oxygen therapy during these tasks. Secondary objectives include (1) studying the presence of COVID-19 related complications during inpatient rehabilitation and after discharge and (2) describing functional outcomes of participants after supplemental oxygen liberation and hospital discharge.

Design: Explorative prospective observational cohort study.

Setting: Rehabilitation center within a tertiary hospital, caring for post-COVID patients.

Participants: Twenty-three (N=23) community-dwelling persons with severe-to-critical COVID-19 disease and ongoing oxygen therapy needs. There was a preponderance of men (69.6%), with mean age of 69.5 (range 46-85) years.

Interventions: Inpatient pulmonary rehabilitation.

Main outcome measures: The primary outcome was the duration of supplemental oxygen use (from initiation till wean) for ambulation, toileting, dressing, and showering. Secondary outcomes included the presence of COVID-19 related complications (during rehabilitation and after discharge) and post-discharge functional status.

Results: After rehabilitation center transfer, all subjects only required oxygen therapy during task(s) performance, and not at rest. ADLs that took the shortest and longest time for supplemental oxygen weaning were dressing (mean 38.4±SD 17.1 days) and showering (mean 47.7±SD 18.1 days), respectively. The mean duration of oxygen therapy application was 48.6±SD 18.3 days. On multivariable analysis, mechanical ventilation and exertional desaturation were significantly associated with prolonged duration for oxygen therapy in all ADLs.

Conclusion: The duration of needful oxygen therapy was dissimilar for different ADLs. Showering, which required the longest duration of supplemental oxygen wean, might prove to be the rate-limiting ADL for discharge home.

Keywords: ADL; COVID-19; Oxygen therapy; Rehabilitation.