BACKGROUND: After an acute infection, older persons may benefit from geriatric rehabilitation (GR). OBJECTIVES: This study describes the recovery trajectories of post-COVID-19 patients undergoing GR and explores whether frailty is associated with recovery. DESIGN: Multicentre prospective cohort study. SETTING: 59 GR facilities in 10 European countries. PARTICIPANTS: Post-COVID-19 patients admitted to GR between October 2020 and October 2021. METHODS: Patients' characteristics, daily functioning (Barthel index; BI), quality of life (QoL; EQ-5D-5L) and frailty (Clinical Frailty Scale; CFS) were collected at admission, discharge, 6 weeks and 6 months after discharge. We used linear mixed models to examine the trajectories of daily functioning and QoL. RESULTS: 723 participants were included with a mean age of 75 (SD: 9.91) years. Most participants were pre-frail to frail (median [interquartile range] CFS 6.0 [5.0-7.0]) at admission. After admission, the BI first steeply increased from 11.31 with 2.51 (SE 0.15, P < 0.001) points per month and stabilised around 17.0 (quadratic slope: -0.26, SE 0.02, P < 0.001). Similarly, EQ-5D-5L first steeply increased from 0.569 with 0.126 points per month (SE 0.008, P < 0.001) and stabilised around 0.8 (quadratic slope: -0.014, SE 0.001, P < 0.001). Functional recovery rates were independent of frailty level at admission. QoL was lower at admission for frailer participants, but increased faster, stabilising at almost equal QoL values for frail, pre-frail and fit patients. CONCLUSIONS: Post-COVID-19 patients admitted to GR showed substantial recovery in daily functioning and QoL. Frailty at GR admission was not associated with recovery and should not be a reason to exclude patients from GR.

Academic Unit of Injury Recovery and Inflammation Sciences School of Medicine University of Nottingham Medical School Nottingham NG7 2UH UK

Beaumont Hospital and Royal College of Surgeons in Ireland Dublin Ireland

Center for Geriatric Medicine Agaplesion Bethanien Hospital Heidelberg Geriatric Center at the Heidelberg University Heidelberg Germany

Center for Medicine for Older People Leiden University Medical Center Leiden The Netherlands

Department of Geriatrics 1st Faculty of Medicine Charles University and General Faculty Hospital Prague Czech Republic

Department of Health Services Research Maastricht University Maastricht The Netherlands

Department of Public Health and Primary Care Leiden University Medical Center Leiden The Netherlands

Faculty of Health and Social Sciences University of South Bohemia Ceske Budejovice Czech Republic

Fliman Geriatric Rehabilitation Hospital Zalman Shneur Street Haifa 31021 Israel

Geriatric Division Holy Family Hospital Bar Ilan University Safad Israel

IRCCS Istituti Clinici Maugeri University of Milan Milan Italy

Karin Grech Hospital Pieta Malta

RE FiT Barcelona Research Group Parc Sanitari Pere Virgili Hospital and Vall d'Hebron Institut de Recerca Barcelona Spain

Russian Gerontology Research and Clinical Centre Pirogov Russian National Research Medical University Moscow Russia

University Network for the Care sector South Holland Leiden University Medical Center Leiden The Netherlands

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