What Is the Impact of a Prior Acquired Brain Injury on Functional Outcomes in Individuals Receiving Inpatient Rehabilitation Services for COVID-19?

Research Objectives: To investigate the influence of COVID-19 on inpatient rehabilitation participants with a history of acquired brain injury (ABI) on their functional outcomes. Our hypothesis: Individuals with a prior history of ABI hospitalized for COVID-19 will have worse functional outcomes in acute rehabilitation.

Design: Retrospective analysis of an existing database between March 1, 2020, to December 31, 2020 examining functional outcomes of participants with COVID-19 admitted to inpatient rehabilitation. Those admitted within 14 days of Covid diagnosis were designated “active”. Those admitted beyond 14 days since Covid diagnosis were designated “recovered”. Data analysis included 280 participants. Covariates included current ABI, time since onset, and length of rehabilitation stay.

Setting: Multiple inpatient rehabilitation hospitals across the United States.

Participants: Individuals were categorized by type and history of ABI. Types of ABI were described by the following ICD 10 codes: Ischemic, Transient Ischemic Attack (TIA), Non-traumatic hemorrhagic, Traumatic, Anoxic, Neoplasm, and Encephalopathy. Groups were further categorized by Covid acuity (active or recovered) and history of ABI.

Interventions: Interventions: Not applicable.

Main Outcome Measures: The primary outcomes were scores from the Continuity Assessment Record and Evaluation (CARE) tool in self-care and mobility. Discharge dispositions were also compared between groups.

Results: Individuals with a history of ABI and active Covid had a significant difference in mean changes of mobility scores when compared to those without a history of ABI and active Covid, F (1,93) =9.49, p=0.003. Participants with a history of ABI in both COVID-recovered and active groups had a significant difference in mean changes of self-care scores when compared to those without a history of ABI respectively; F (1, 175) =7.093, p=0.008, and F (1,93) = 6.495, p =0.012. History of ABI had no significant effect on the odds of being discharged home OR= 0.45 (95%CI; 0.186,1.076) p= 0.072.

Conclusions: Based on our research findings, individuals hospitalized at inpatient rehabilitation facilities with a history of ABI and active Covid had worse functional gains in mobility. Individuals with a history of ABI in both active and Covid recovered groups had worse functional gains in self-care. Further analysis is warranted to provide insight into the reason behind worse functional performance for individuals with a history of ABI. To the best of our knowledge, this is the first retrospective study analyzing functional changes in individuals with a history of ABI and Covid during an acute inpatient rehabilitation stay.

Author(s) Disclosures: None.