Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic

Felipe González-Seguel; Evan Haezebrouck; Lindsey E. Fresenko; Carla M. Sevin; Stacey Slone; Ashley Montgomery-Yates; Anna G. Kalema; Lori Ginoza; Clarisa Martinez; Michelle Biehl; Soibhan R. Kelley; Joshua K. Johnson; Matthew F. Mart; Kirby P. Mayer

doi:10.1016/j.arrct.2025.100484

Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic

Felipe González-Seguel, Evan Haezebrouck, Lindsey E. Fresenko, Carla M. Sevin, Stacey Slone, Ashley Montgomery-Yates, Anna G. Kalema, Lori Ginoza, Clarisa Martinez, Michelle Biehl, Soibhan R. Kelley, Joshua K. Johnson, Matthew F. Mart, Kirby P. Mayer

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Article number	100484
Journal	Archives of Rehabilitation Research and Clinical Translation
Volume	7
Issue number	3
DOIs	https://doi.org/10.1016/j.arrct.2025.100484
State	Published - Sep 2025

Bibliographical note

Publisher Copyright:
© 2025 The Authors

Funding

This work was made possible by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23-AR079583 to K.P.M.) and the National Institutes of Health (NIH) National Center for Advancing Translational Sciences through grant number UL1TR001998. M.F.M. reports grants from the Department of Veterans Affairs Office of Research & Development (IK2RX004799-01A1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Funders	Funder number
National Institutes of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases	K23-AR079583
National Center for Advancing Translational Sciences (NCATS)	UL1TR001998
Biomedical Laboratory Research and Development, VA Office of Research and Development	IK2RX004799-01A1

Keywords

COVID-19
Critical illness
Occupational therapy
Patient-centered outcomes
Physical therapy
Post intensive care syndrome

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

Access to Document

10.1016/j.arrct.2025.100484

Cite this

González-Seguel, F., Haezebrouck, E., Fresenko, L. E., Sevin, C. M., Slone, S., Montgomery-Yates, A., Kalema, A. G., Ginoza, L., Martinez, C., Biehl, M., Kelley, S. R., Johnson, J. K., Mart, M. F., & Mayer, K. P. (2025). Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic. Archives of Rehabilitation Research and Clinical Translation, 7(3), Article 100484. https://doi.org/10.1016/j.arrct.2025.100484

@article{9b8a634a375e4c92a4e9479ac35a1b2b,

title = "Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic",

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.",

keywords = "COVID-19, Critical illness, Occupational therapy, Patient-centered outcomes, Physical therapy, Post intensive care syndrome",

author = "Felipe Gonz{\'a}lez-Seguel and Evan Haezebrouck and Fresenko, \{Lindsey E.\} and Sevin, \{Carla M.\} and Stacey Slone and Ashley Montgomery-Yates and Kalema, \{Anna G.\} and Lori Ginoza and Clarisa Martinez and Michelle Biehl and Kelley, \{Soibhan R.\} and Johnson, \{Joshua K.\} and Mart, \{Matthew F.\} and Mayer, \{Kirby P.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = sep,

doi = "10.1016/j.arrct.2025.100484",

language = "English",

volume = "7",

number = "3",

}

González-Seguel, F, Haezebrouck, E, Fresenko, LE, Sevin, CM, Slone, S, Montgomery-Yates, A , Kalema, AG, Ginoza, L, Martinez, C, Biehl, M, Kelley, SR, Johnson, JK, Mart, MF & Mayer, KP 2025, 'Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic', Archives of Rehabilitation Research and Clinical Translation, vol. 7, no. 3, 100484. https://doi.org/10.1016/j.arrct.2025.100484

Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic. / González-Seguel, Felipe; Haezebrouck, Evan; Fresenko, Lindsey E. et al.
In: Archives of Rehabilitation Research and Clinical Translation, Vol. 7, No. 3, 100484, 09.2025.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic

AU - González-Seguel, Felipe

AU - Haezebrouck, Evan

AU - Fresenko, Lindsey E.

AU - Sevin, Carla M.

AU - Slone, Stacey

AU - Montgomery-Yates, Ashley

AU - Kalema, Anna G.

AU - Ginoza, Lori

AU - Martinez, Clarisa

AU - Biehl, Michelle

AU - Kelley, Soibhan R.

AU - Johnson, Joshua K.

AU - Mart, Matthew F.

AU - Mayer, Kirby P.

PY - 2025/9

Y1 - 2025/9

N2 - 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.

AB - 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.

KW - COVID-19

KW - Critical illness

KW - Occupational therapy

KW - Patient-centered outcomes

KW - Physical therapy

KW - Post intensive care syndrome

UR - https://www.scopus.com/pages/publications/105011082751

UR - https://www.scopus.com/inward/citedby.url?scp=105011082751&partnerID=8YFLogxK

U2 - 10.1016/j.arrct.2025.100484

DO - 10.1016/j.arrct.2025.100484

M3 - Article

AN - SCOPUS:105011082751

SN - 2590-1095

VL - 7

JO - Archives of Rehabilitation Research and Clinical Translation

JF - Archives of Rehabilitation Research and Clinical Translation

IS - 3

M1 - 100484

ER -

Community-Based Rehabilitation and Patient-Centered Outcomes in Survivors of Critical COVID-19 Attending an Intensive Care Recovery Clinic

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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