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Rehabilitation Outcomes in Patients with Bilateral Lung Transplant Secondary to COVID-19: A Case Series

Moizz Syed, DO (Northwestern Medicine Marianjoy Rehabilitation Hospital, Glendale Heights, Illinois); Liridon Zendeli, MD; Melanie A. Stearns, MD; Linh Ngo, DO, MS

Meeting: AAPM&R Annual Assembly 2021

Categories: General Rehabilitation (2021)

Session Information

Session Title: AA 2021 Virtual Posters - General Rehabilitation

Session Time: None. Available on demand.

Disclosures: Moizz Syed, DO: No financial relationships or conflicts of interest

Case Diagnosis: Bilateral Lung Transplant Secondary to COVID-19

Case Description: 4 patients presented with acute respiratory distress syndrome (ARDS) secondary to COVID-19. Patients were treated with medical and respiratory support with limited improvement, eventually requiring extracorporeal membrane oxygenation. Due to irreversible lung damage, bilateral lung transplants were performed. All patients were discharged to an inpatient rehabilitation facility (IRF).

Setting: Inpatient rehabilitation facility.Assessment/

Results: All patients underwent a multidisciplinary inpatient rehabilitation program with physical, occupational, and speech therapy, nursing care, psychological and nutritional services, and medical oversight by a physiatrist. Functional Independence Measure (FIM) scores, ambulation distance, and manual muscle strength were collected upon admission and at discharge. Patients had a mean length of stay of 23 days. Despite high risk for major complications, there were no significant adverse events. All demonstrated significant functional improvement with gains most notable in transfers, ambulation distance, endurance, and activities of daily living (ADL). All patients discharged to home at the modified-independent level for basic ADLs and ambulated at least household distances.

Discussion: Bilateral lung transplants in patients with severe ARDS secondary to COVID-19 offer survival when all other modalities have failed. Several concerns limit total transplants performed. One involves severe deconditioning due to prolonged ventilation, sedation, and neuromuscular blockade, raising concern for post-operative recovery. Admission to a multidisciplinary inpatient rehabilitation program can mitigate this concern and provides an excellent avenue for functional recovery.

Conclusion: COVID-19 patients status post bilateral lung transplant may achieve functional independence when undergoing an inpatient rehabilitation program.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Syed M, Zendeli L, Stearns MA, Ngo L. Rehabilitation Outcomes in Patients with Bilateral Lung Transplant Secondary to COVID-19: A Case Series [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/rehabilitation-outcomes-in-patients-with-bilateral-lung-transplant-secondary-to-covid-19-a-case-series/. Accessed May 24, 2025.
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