Le 15/10/2021 de 11:00 à 12:30

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Typologie des patients admis en Médecine Physique et de Réadaptation après une infection au SARS-Cov2 (première vague)

Amandine Rapin (Reims, France), Charles Pradeau (Strasbourg, France), Jean-François Kaux (Liège, Belgique), Marie-Eve Isner-Horobeti (Strasbourg, France), François Constant Boyer (Reims, France)

Objective : The aim of this work was to describe the typology of patient admitted in the physical and rehabilitation medicine (PRM) department at the beginning of the COVID19 pandemic.

Material / Patients and Methods : We conducted a retrospective cross-sectional study on patients admitted in PRM departments, between 30 March and 20 May 2020, in two French University PRM centres in Reims and Strasbourg. The announcement of the pandemic arrival allowed us to prepare and harmonise systematic clinical evaluation. 
All patients had SARS-Cov2 infection confirmed by RT-PCR test and/or consistent CT-scan results. We compare patients requiring intensive care unit (ICU) hospitalisation with those who did not.

Results : Of the 74 patients evaluated, 42 required ICU hospitalisation. No-ICU patients were older (79.9±8.8 vs 62.7±10.1 y.o.), had more comorbidity (Charlston index 2.0±1.6 vs 0.67±0.8) and more functional limitations before infection. At admission, post-ICU patients had a worse MRC-SS testing (52.1±6.3 vs 55.2±5.5). Timed 10 sit-to-stand test (STS) was not discriminating, while the 1-minute STS shows a greater deviation from norms (deviation from 24.6±8.4 repetitions in ICU vs 17.44±7.0 in Non-ICU). Questionnaires showed more anxiety, depression and poorer quality of life in post-ICU patients.

Discussion - Conclusion : After ICU hospitalisation, functional capacities of younger patients were similar to those of older and comorbid patients. The 1-minute STS seems to be the more discriminating test when the 10 STS does not differ.  
Knowing the patients’ characteristics is necessary for PRM care organization. Two types of patients are admitted after SARS-Cov2 infection, with different rehabilitation goals and perspectives. Special attention should be paid to the psychological consequences.

Keywords : SARS-Cov2, COVID-19, patient cre management, rehabilitation

Disclosure of interest : aucun