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BACKGROUND: Dubrava University Hospital, as a primary respiratory intensive care center in the Republic of Croatia for the care of acute patients with COVID-19, established a PostCovid Day Clinic for Physical and Rehabilitation Medicine. We review the evaluation and rehabilitation management of a patient with persistent symptoms after a critical form of COVID-19. MATERIALS AND METHODS: A 70-year-old patient presents to PostCovid Day Clinic with symptoms of Long COVID in the form of increased fatigue, dyspnea, shortened walking track, and gait instability. Diagnostic workup included HRCT of the chest, spirometry, diffusion capacity for carbon monoxide, arterial blood gas analysis, and functional testing with a 6-MWT, Modified Borg scale of dyspnea, SPPB, HAQ, Barthel Index, MMSE, and fist muscle strength assessment. The patient participated in an individualized outpatient rehabilitation program for 10 weeks with components including respiratory training, strengthening exercises, cardiorespiratory reconditioning, balance and proprioception exercises. A re-evaluation was performed after the completion of the rehabilitation program. RESULTS: The re-evaluation showed significant functional recovery in the 6-MWT, with no residual dyspnea. In the SPPB, HAQ, MMSE and Barthel index, the patient achieved the maximum score. Control spirometry confirmed recovery of lung function and residual decrease in diffusing capacity for CO. The patient reported no remaining limitations in performing activities of daily living. CONCLUSION: Adequate rehabilitation of patients with persistent symptoms after overcoming COVID-19 requires a multidimensional, holistic approach to the patient, which will be increasingly incorporated into clinical practice in the coming period. |
