Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic
Bibliographic record
Abstract
Objective To examine the occurrence of physical and cognitive impairments among survivors of critical coronavirus disease of 2019 (COVID-19) who attend an intensive care unit (ICU) recovery clinic and describe their utilization of community-based rehabilitation (physical and occupational therapy). Design Retrospective, observational cohort study and multisite practice analysis. Setting ICU recovery clinics at 4 academic medical centers. Participants Adults (median age 56 [interquartile range, {IQR}, 47–64] years, 60% female) surviving acute respiratory failure caused by COVID-19 who required advanced respiratory support. Main outcome measures Six-minute walk test (6MWT) and Montreal Cognitive Assessment (MoCA). Results Patients attended the ICU recovery clinic (n=163) in a median of 43 (IQR, 30-60) days after discharge. Ninety-four patients (58%) participated in at least 1 community-based rehabilitation session, 52 (32%) never participated, and 17 (10%) did not have data available. Patients walked a median [IQR] of 282 [150-390] meters on the 6MWT, and the median Short Physical Performance Battery (SPPB) score was 8 [4-11] with 63% of patients classified as physically frail (score ≤9/12). The median MoCA score was 26 [22-27], with 37% at least mild cognitive impairment (score of ≤26). Among patients who were driving before ICU admission, 44% had not returned to driving after hospitalization, and an additional 21% reported driving with new limitations. Patients who participated in at least 1 community-based rehabilitation session had longer ICU lengths of stay as well as worse performance on the 6MWT and SPPB at discharge compared with individuals not receiving postdischarge rehabilitation ( P <.001). Conclusions Survivors of acute respiratory failure caused by critical COVID-19 who attended an ICU recovery clinic are at high risk of physical and/or cognitive impairments. Two-thirds of survivors participated in physical or occupational therapy at home or an outpatient center after hospital discharge. Patients with longer lengths of stay and more physical impairments at discharge are more likely to participate in community-based rehabilitation interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".