COVID Rehabilitation Program at Hackensack Meridian JFK Johnson Rehabilitation Institute
Case study demonstrates program’s successful, multispecialty post-COVID symptom management
As part of the COVID Recovery Center, the COVID Rehabilitation Program at JFK Johnson Rehabilitation Institute offers an outpatient program that is tailored specifically to the needs of individuals who contracted COVID-19 and are no longer infected, but are experiencing ongoing post-COVID symptoms and side effects of COVID-19 treatment.
In July 2020, while Brian Kreger, 69, of Wildwood, New Jersey, was receiving care at an inpatient rehabilitation facility in Virginia after a motorcycle accident, he contracted COVID-19. This resulted in a two-month hospital stay where he received dialysis for kidney failure and extracorporeal membrane oxygenation (ECMO) for respiratory failure.
After being discharged from the hospital and returning to New Jersey to complete a month of inpatient rehabilitation, ongoing weakness and lung problems prevented Kreger from being able to navigate the stairs to enter his Wildwood home. Kreger sought outpatient care from the specialists at JFK Johnson Rehabilitation Institute’s Post-COVID Recovery Center Rehabilitation Program.
“[Brian] sought us out because he was experiencing a lot of instability and weakness in his left leg and knee that caused him to fall several times,” says Ofure Luke, M.D., a physical medicine and rehabilitation specialist at the Post-COVID Recovery Center.
Dr. Luke said when she first met Kreger in November 2020, he was using a walker, relied on a wheelchair for longer distances and was still experiencing shortness of breath. He also had pronounced weakness in his hands with a substantial loss of strength.
“We are finding that quite a few patients have a specific type of nerve involvement after a prolonged hospital stay for severe COVID-19,” says Dr. Luke. “However, we’re not sure if this is due to COVID-19 infection or the lengthy hospitalization.”
Dr. Luke coordinated Kreger’s care, including sending him to pulmonary rehabilitation to improve his lung health and connecting him with physical and occupational therapists well-versed in helping patients recovering from COVID to regain strength and stability.
Dr. Luke also referred Kreger to David P. Brown, D.O., medical director of Electrodiagnostics and Sports Medicine at JFK Johnson Rehabilitation Institute. After performing electromyography and nerve conduction velocity tests in December 2020, Dr. Brown diagnosed Kreger with a left femoral nerve injury caused by COVID.
“The testing showed Brian had very few motor neurons firing in his quadriceps muscles, which indicated that he had severe left femoral neuropathy,” says Dr. Brown. “We needed to keep an eye on Brian to make sure the nerve was coming back.”
In addition to receiving ongoing physical and occupational therapy, Dr. Brown recommended that Kreger work with Heikki Uustal, M.D., a physical medicine and rehabilitation physician who specializes in prosthetics and orthotics, to receive a leg brace to help with stability.
By March 2021, repeat testing with Dr. Brown showed improvement in the number of motor neurons firing in Kreger’s quadriceps. In June 2021, his leg strength was improving.
Although not yet at 100 percent, Kreger has improved greatly. He exercises caution when walking downhill or down stairs, but he can do almost all of his everyday activities.
Most COVID Rehabilitation Program patients participate for 3 to 6 months, but treatment may continue for a longer period depending on an individual patient’s needs. The rehabilitation program takes a comprehensive approach, as the COVID-19 virus affects the lungs, but also the heart and kidneys. COVID-related changes in the blood can also cause stroke and embolism. Some patients suffer cognitively and psychologically.
The program accepts individuals who received a positive test for COVID-19, are no longer positive and are still experiencing symptoms or complications after infection, with or without a history of COVID-related hospitalization.
Learn more about innovative rehabilitative care at JFK Johnson Rehabilitation Institute.
