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COVID-19 For the Rehab Therapist (Part 1/2): Pathophysiology and Presentation in the Acute and ICU Environment

CE Hours 2

About this course

The COVID-19 pandemic resulted in nearly 140 million people becoming infected with the SARS-COV-2 virus in the US from March of 2020 through July of 2023. The result was an influx in acutely and critically ill patients being treated in the hospital, advanced utilization of oxygen and life support devices, and prolonged lengths of hospitalizations. With variations in clinical presentation across the timespan of the pandemic, the COVID-19 pandemic seems to be a moving target for rehabilitation therapists to understand the needs of these patients both acutely and chronically. This course, in part one of two, will discuss the pathophysiology of variants of COVID-19, the acute presentation of ARDS and the acute-on-chronic presentation of COVID Fibrosis, with related medical and rehabilitation considerations. Case studies relating to each presentation will be discussed along the way including medical presentation, pharmacology, and laboratory markers as well as treatment strategies for each phase of illness.

Learning Objectives

  • Discuss the foundational physiology of COVID-19 and the underlying disease process.
  • Describe common mild, moderate, and severe COVID-19 patient presentations and related complications and the impact on physical functioning.
  • Differentiate when to initiate examination, evaluation, and/or interventions in the acute setting with considerations for likely impairments.
  • Discuss approaches to creatively optimize patient physical functioning post-COVID in the acute and ICU settings.

Learning Levels

  • Intermediate

Target Audience

This self-paced course is intended for Physical Therapists, Physical Therapy Assistants, Occupational Therapists, Occupational Therapy Assistants, and Nurses. (PT, PTA, OT, COTA, RN)

Course Instructor(s)

  • Katelyn Whitlock, PT, DPT, MEd, CCS

    Katelyn Whitlock is a Board-Certified Cardiovascular and Pulmonary Clinical Specialist currently serving as one of the ICU physical therapists on the Heart Transplant, Lung Transplant, LVAD and ECMO team at Emory University Hospital. She graduated from Emory University’s Doctor of Physical Therapy Program in May of 2018. Following her DPT she completed the Emory Acute Care Residency in 2019. Prior to her DPT she earned her bachelors and masters degrees in Exercise Physiology from the University of Virginia. In September of 2022 she joined the faculty at Brenau University teaching in the Doctor of Physical Therapy Program. She has ongoing research and has presented locally and nationally in the areas of ICU Physical Therapy, ECMO and advanced mechanical support and COVID-19.

Disclosure

DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS CE Learning Systems adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CE activity ― including faculty, planners, reviewers, or others ― are required to disclose all relevant financial relationships with ineligible entities (formerly known as commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity. The following relevant financial relationships have been disclosed by this activity’s planners, faculty, and the reviewer: PLANNERS AND REVIEWER The planners of this activity have reported that they have no relevant financial relationships. FACULTY The faculty of this activity have reported that they have no relevant financial relationships.

References

  • “Coronavirus Disease 2019 (Covid-19).” Coronavirus Disease 2019 (COVID-19) - Etiology | BMJ Best Practice US, bestpractice.bmj.com/topics/en-us/3000168/aetiology. Accessed 25 July 2023.
  • “CDC Covid Data Tracker.” Centers for Disease Control and Prevention, covid.cdc.gov/covid-data-tracker/#datatracker-home. Accessed 25 July 2023.
  • Gao, L., Zheng, C., Shi, Q., Xiao, K., Wang, L., Liu, Z., ... & Dong, X. (2022). Evolving trend change during the COVID-19 pandemic. Frontiers in public health, 10, 957265.
  • Yao, F., Li, X., Zhang, L., Wan, S., Zhang, L., & Zhou, F. (2022). SARS-CoV-2 Omicron variant: recent progress and future perspectives. Signal Transduction and Targeted Therapy, 7(1).
  • de Souto Barreto, P., Vellas, B., & Rolland, Y. (2021). Physical activity and exercise in the context of SARS-CoV-2: A perspective from geroscience field. Ageing Research Reviews, 66, 101258.
  • Eljilany, I., & Elzouki, A. N. (2020). D-dimer, fibrinogen, and IL-6 in COVID-19 patients with suspected venous thromboembolism: a narrative review. Vascular health and risk management, 455-462.
  • Tufan, Z. K., Kayaaslan, B., & Mer, M. (2021). COVID-19 and Sepsis. Turkish journal of medical sciences, 51(7), 3301-3311.
  • Debeuf, R., Swinnen, E., Plattiau, T., De Smedt, A., De Waele, E., Roggeman, S., ... & De Keersmaecker, E. (2022). Effect of physical therapy on impairments in COVID-19 patients from intensive care to home rehabilitation: a rapid review. Journal of rehabilitation medicine, 54.
  • Li, L., Yu, P., Yang, M., Xie, W., Huang, L., He, C., ... & Jones, A. Y. (2021). Physical therapist management of COVID-19 in the intensive care unit: the West China hospital experience. Physical therapy, 101(1), pzaa198.
  • Devlin, J. W., Skrobik, Y., Gélinas, C., Needham, D. M., Slooter, A. J., Pandharipande, P. P., ... & Alhazzani, W. (2018). Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical care medicine, 46(9), e825-e873.
  • Stolboushkin, C., Mondkar, R., Schwing, T., & Belarmino, B. (2022). Physical Therapy practice for critically ill patients with COVID-19 in the intensive care unit. Cardiopulmonary Physical Therapy Journal, 33(2), 60-69.