PURPOSE: There is variation in organization of geriatric rehabilitation across Europe. The purpose of this study was to describe the selection criteria for referral to geriatric rehabilitation, care provided, and recovery trajectories of post-COVID-19 patients referred to geriatric rehabilitation in Europe. METHODS: This observational cohort study included 723 patients in 59 care facilities for geriatric rehabilitation across 10 countries. Patient data were collected from medical records on admission to geriatric rehabilitation (between September 2020 and October 2021), discharge, 6 weeks and 6 months follow-up. The primary and secondary outcomes were recovery in daily functioning (Barthel Index) and Quality of Life (EQ-5D-5L) from admission to discharge. These were examined using linear mixed models with two levels (measurements nested in patients) and country as an independent variable. Random intercept and random linear slope parameters were added when they improved model fit. A survey about organization of geriatric rehabilitation for post-COVID-19 patients was filled out by country coordinators and data were analyzed using descriptive statistics and inductive coding of answers to open questions. RESULTS: Patients had a mean age of 75.7 years old and 52.4% were male. Many countries used various combinations of the selection criteria, such as functional status, age, frailty, Comprehensive Geriatric Assessment, comorbidities, and cognitive impairments. Most patients received physiotherapy (88.8%) and occupational therapy (69.7%), but there was substantial variance between countries in the percentages of patients that received protein or calorie enriched diets, oxygen therapy, and other treatment components. In all countries, patients showed recovery in daily functioning and quality of life, although there was variation in between countries in rate of recovery. Daily functioning seemed to increase most rapidly in the Czech Republic, Germany, and Russia. The steepest increases in quality of life were seen in the Czech Republic, Germany, and Spain. CONCLUSION: Post-COVID-19 patients showed recovery during geriatric rehabilitation, albeit at variable rates. The observed variation may be explained by the heterogeneity in selection criteria and care provided. This study highlights the need for harmonization of measurements in geriatric rehabilitation order to perform explanatory research and optimize geriatric rehabilitation throughout Europe to ensure optimal patient recovery.

Academic Unit of Injury Recovery and Inflammation Sciences School of Medicine University of Nottingham Nottingham 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 Physical Medicine and Rehabilitation Sir Run Run Shaw Hospital Hangzhou China

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 Center Haifa 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

NIHR Applied Research Collaboration East Midlands Nottingham UK

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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