Table 1: Rapid responses in the context of COVID-19 - Rehabilitation journey of the COVID + patient upon discharge from intensive care and/or OLS, in SRH then at home [7].

Conditions of transfer:

 

 

Quick response n°1

•      No direct admission to SSR from intensive care.

•      Criteria allowing the transfer of a COVID + patient from a "Medicine, Surgery, Obstetrics" (MCO) service to a Aftercare and Rehabilitation Unit (SSR):

- A patient can be admitted to a COVID-19 SSR unit:

o From the 10th day after the onset of symptoms or entry into intensive care, if he has presented a severe form,

o From the 7th day after the onset of symptoms after a stay in OLS alone for a non-serious form,

o If possible at least 48 hours after improvement of symptoms: reduction of dyspnea, respiratory rate < 22/min, temperature < 37.8 °C, oxygen (O2) requirements stabilized, hemodynamic stability.

- Prefer an SSR near a short stay if transfer < D7 or < D10 after the onset of symptoms (possible aggravation between D6 and D9).

•       Social problems, without being neglected, do not in themselves constitute a sufficient reason for addressing SSR, other avenues must therefore be sought.

Objectives of the SSR stay:

 

 

Quick response n°2

The rehabilitation needs of most COVID patients are related to exercise re-training, respiratory rehabilitation, overall muscle strengthening, re-empowerment in activities of daily living, treatment of psychomotor disorders, treatment possible complications, with the installation of:

HAS • Rapid responses in the context of COVID-19 - Rehabilitation pathway for the COVID + patient on discharge from intensive care and/or OLS, in SSR and then at home • June 2020

An adapted therapeutic education program, rehabilitation of perceptual-motor disorders, nutritional monitoring, and psychological support.

 

Quick response n°3

For rehabilitation and rehabilitation activities, the benefit/risk ratio must be assessed individually, prioritizing activities whose postponement would lead to a loss of opportunity for the patient or worsening of a comorbidity.

 

Reception conditions:

 

 

Quick response n°4

The COVID SSR unit must be equipped to meet the needs of the patient. An organization adapted to the risk of the virus circulating within the establishment must be respected. Access to the technical platform must be planned in order to offer different time slots for COVID patients in the post-isolation period (between D10 and D24 after the onset of symptoms) and COVID "cured on the infectious level" (> D24 after the onset of symptoms and > 14 days after discharge from intensive care).

 

Quick response n°5

Criterion allowing return home, regardless of the type of follow-up: Return to the functional level and to the previous state of autonomy, or approaching if sufficient home help can be organized upstream of the return. The patient's return home requires their active participation and often that of those around them.