LAUSR

Dear Editor, We have read with a passionate interest in the manuscript of Li et al., which revealed some essential concerns that critical care medicine should learn during of the coronavirus disease-19 (COVID-19) pandemic [1]. Amongst their suggestions, the authors underlined that intensivists should extensively cooperate with multiple disciplines to respond to this public health crisis. Nonetheless, similar to the other voluminous dissertations focused on the treatment of severe COVID-19, Li et al. regrettably neglected the field of the rehabilitation of critically ill patients. However, growing evidence has indicated that critical illness often leads to the impairment of physical, mental, psychological, and social function in the survivors [2, 3]. Among the 41 patients confirmed with COVID-19 that our team cured in the central hospital of Wuhan, there were 14 severe cases and four critical cases. The Medical Research Council Scales in 65.8% of patients were lower than 48 and lower than 35 in severe and critical individuals. Meanwhile, 93% of patients displayed varying degrees of anxiety, 96% of patients fell into a sleep disorder, and more than 90% of patients exhibited panic attacks of the disease uncertainties (detailed unpublished data). To triumph over these secondary damages from COVID-19, we have developed one generalized rehabilitation strategy characterized as a hierarchy, upgrade, and integration of traditional and western medicine. One multidisciplinary team performs rehabilitation treatment. First, physicians of western medicine and traditional Chinese medicine collectively assess the clinical situation of the patient. Second, the physical therapists and psychiatric nurses evaluate the physical and mental function, respectively. Third, there should be a panel meeting to decide the timely rehabilitation scheme that includes physiotherapy interventions and psychological counseling. There are some successful experiences of overcoming the shortage of professional resources in the isolation ward. Heightening the health workers’ comprehension of the rehabilitation facilitates early recognition of asthenia or mental dysfunction. Fast popularization of the physiotherapy skills among the nurses could lighten the workload of physiotherapists. Using social applications such as WeChat to connect the patients, families with medical staff play a role in psychological intervention. Moreover, Tai Chi Chuan and Baduanjin, two kinds of mind-body exercise origin from Chinese traditional medicine, characterized as easy-learning, improvements in motion, strength, emotional, and social attributes, are worth promoting in selective patients [4]. Based on our experiences, the tissue of timely rehabilitation for these patients should not be ignored at the moment of the continuous COVID-19 epidemic worldwide.