# INPATIENT REHABILITATION FOR A PATIENT WITH COVID-19 EXACERBATION OF PULMONARY FIBROSIS: A CASE REPORT

## TL;DR

This case report shows how inpatient rehabilitation helped a man with severe lung issues caused by a flare-up of pulmonary fibrosis after a COVID-19 infection.

## Contribution

The paper presents a novel approach to rehabilitation for patients with post-COVID-19 pulmonary fibrosis exacerbations.

## Key findings

- The patient achieved his goal of returning home despite limited functional gains and ongoing high oxygen needs.
- Tailored rehabilitation strategies, including education and low-level activities, were effective for this medically fragile patient.
- Inpatient rehabilitation can be a viable option for managing post-COVID-19 pulmonary fibrosis exacerbations.

## Abstract

To evaluate the benefits of inpatient rehabilitation for a patient with post-COVID-19 pulmonary fibrosis and to provide guidance for rehabilitation professionals, as many conventional therapeutic interventions are not tolerated and are poorly defined.

A case report.

A 72-year-old man with a COVID-19-related idiopathic pulmonary fibrosis exacerbation.

The patient was admitted to inpatient rehabilitation with hypoxia and poor endurance for functional activities. Rehabilitation activities were focused on providing patient/family education, energy conservation, low level activities to build strength, problem solving for mobility, and discharge planning within safe medical parameters. Rehabilitation therapies were graded to meet the patient’s physiologic needs and focused on patient and family training. The patient made limited functional gains and continued to have high oxygen needs but achieved his goal of returning home.

Patients with COVID-19-related idiopathic pulmonary fibrosis exacerbations can be treated in acute rehabilitation effectively. With more patients developing post-COVID-19 pulmonary fibrosis, appropriate rehabilitation strategies are important for safe discharge planning. Prioritizing patient/family education may allow these more medically fragile patients to return home.

A 72-year-old man with a history of interstitial lung disease came to our inpatient rehabilitation facility after spending 21 days in the hospital with COVID-19 pneumonia. Upon admission to inpatient rehabilitation, he was on high amounts of oxygen and had very low oxygen readings on a pulse oximeter. He was unable to a transfer, walk, eat, or talk without his oxygen levels dropping, despite using 10 liters of oxygen per minute. The therapy team worked to tailor a program to this patient’s critical needs. Activities were focused on education, low level cardiovascular activities, modifications to activities of daily living, and even household mobility to be able to reach the goal of sending this patient home. This case study describes the program used and demonstrates how inpatient rehabilitation can help patients with an exacerbation of pulmonary fibrosis and pulmonary symptoms after COVID-19.