Rehabilitation of severe neurological complications post SARS-CoV-2 infection

Abstract

Medical rehabilitation is a multi-professional / interdisciplinary process aimed at enhancing and restoring functional ability (activity and participation) and quality of life to people with im-pairments or disabilities. Rehabilitation is applied throughout the continuum of care. COVID-19 patients may develop a myriad of acute medical problems (linked to the virus per se, or as con-sequences of the invasive procedures), which can cause acute, post-acute and long-term conse-quences requiring rehabilitation. Information about short and long-term sequelae of COVID-19 indicate an increasing need for rehabilitation. The paper is focused on two main aspects: rehabil-itation of the severe neurological disabilities that occurred during the acute phase and continu-ing in the chronic phase (i.e., different neurological sensory-motor and cognitive deficits sec-ondary to stroke, encephalitis, seizures, encephalopathies). The other main issue is generated by the disruption of regular rehabilitation in people with neurological disabilities and chronic dis-eases (people living with sequels after stroke, Parkinson's disease, multiple sclerosis) due to quarantine, social isolation, movement restriction, and other healthcare systems ’disruptions. Methods Internet literature search (Lit Covid and PubMed) using the following keywords (Covid-19, Coronavirus, neurological complications, rehabilitation). During 2020-2021 were published 88 papers (in 2020 = 54, and in 2021= 54), with 21 reviewes (2020 = 15; 2021 = 8), and 2 systematic reviews, refearing neuroreabilitation in Covid-19 subacutre and long-term cas-es. Discussion REH-COVER Cochrane Rehabilitation WHO initiative (“Rapid Living Systematic Reviews Second Edition, called 2020”), contains the main cornerstones for a tailored rehabilita-tion programme, the best (current) available rehabilitation evidence on recovery interventions, for the patients living with sequelae of COVID-19. Conclusions More than two years since the outbreak of the COVID-19 pandemic, it is obvious that rehabilitation services play a crucial role in post-COVID recovery trajectories. A further achievement of research and evidence focussed on the clinical management, comprehensive treatments, and efficacy need to be targeted on short and long-term (neuro)-rehabilitation service models of care, for COVID-19 survivors. Keywords: Covid-19, rehabilitation, neurological disabilities, SARS-CoV-2