Disclosures: Anne Ambrose, MD, MS: No financial relationships or conflicts of interest

Objective: Impact of mobilization on mortality among 990 hospitalized COVID-19 patients

Design: Single-site, retrospective cohort studySetting : Medicine units of community hospitalParticipants : Adults (18-88 years), hospitalized with Moderate-to-severe COVID-19, admitted between 03-01-2020 to 05-31-2020. Excluded-incidental positive PCR-test, discharged/died within 72 hours of admission.

Interventions: Physical Therapy (PT), 30 minutes, two times/week

Main Outcome Measures: Primary outcome was in-hospital mortality. Baseline covariates (demographics, LOS, BMI, comorbidities [obesity, pulmonary, cardiac, diabetes, hypertension, cancer, neurological, immunocompromised status], functional status, and COVID-19 related clinical and laboratory markers) were compared using t-tests/ Wilcoxon rank-sum tests for continuous variables, and chi-squared/Fisher’s exact tests for categorical variables. Logistic regression models were used to examine the association of rehabilitation with in-hospital mortality adjusted for the pre-specified baseline covariates, and reported as odds ratio (OR) with 95% confidence intervals (CI).

Results: 1,268 COVID-19 patients were admitted, 278 were excluded (24 pregnant, 226 discharged, 28 within 3 days). 990 patients were eligible. (mean age 67.77 ± 16.75 years, 42.4% women). 475 (47.9%) who received PT had more female, older, white ethnicity (p = 0.01), less healthy with a higher BMI (p = 0.003), and greater prevalence of diabetes, hypertension, heart disease, stroke or TIA and cancer (p = 0.01 to < 0.001). Patients who could walk premorbidly were less likely to receive rehabilitation (p < 0.001). There were 61 (12.8%) deaths in rehabilitation-group, and 165 (32.0%) in the non-therapy group (p < 0.001). Receiving rehabilitation was associated with decreased risk of in-hospital mortality (OR 0.11, 95% CI 0.06 – 0.19) even after accounting for multiple other mortality predictors as well as COVID-19 disease markers. Each additional rehabilitation session was associated with lower in-hospital mortality (OR per additional session 0.71, 95% CI 0.64-0.79) in the fully adjusted model.Conclusions: Mobilization can reduce mortality in hospitalized patients, even if the patients are older, with more co-morbidities and less independent at baseline. This effect was further enhanced by increasing the number of therapy sessions.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/impact-of-mobilization-on-mortality-among-990-hospitalized-covid-19-patients/