JMIR Publications

ABSTRACT

Background:

Multi-systemic complications post-COVID-19 infection are increasingly described in the literature, yet guidance on the management remains limited.

Objective:

To describe the findings from our situation analysis on post-COVID-19 rehabilitation, and the development of a context-adapted pilot intervention aimed to improve overall physical and mental health post-COVID-19 conducted in Johannesburg, South Africa.

Methods:

We conducted a cross-sectional mixed-methods situation analysis to assess the needs, preferences, challenges, and existing interventions for patients with post-COVID-19 symptoms. We used this information to develop a group intervention. We collected data through questionnaires, semi-structured in-depth interviews, and focus group discussions (FGDs) from individuals diagnosed with COVID-19 within the prior 18-month period and healthcare providers who managed patients with COVID-19 in both inpatient and outpatient settings. Quantitative data was summarized using descriptive statistics, and qualitative data was transcribed, and deductive analysis focused on suggestions for future interventions.

Results:

We conducted 60 questionnaires, 13 interviews and three FGDs. Questionnaires revealed limited knowledge of post-COVID-19 complications at 26.7% (16/60). Those who received any rehabilitation for COVID-19 (31.7%, 19/60), 94.7% (18/19) found it helpful for their recovery. Just over half (56%, 23/41) of those who did not receive rehabilitation reported that they would have liked to. The majority viewed rehabilitation as an important adjunct to post-COVID-19 care 93.3% (56/60) and that support groups would be helpful (88.3%, 53/60). Qualitative results highlighted mental health support, post-COVID-19 follow-up, and financial aid in post-COVID-19 care. Based on these insights, we designed a pilot support group and rehabilitation program for individuals with post-COVID-19 complications. Our main objective was to assess the change in physical and psychological well-being pre- and post-intervention. The intervention, guided by the theory of change, included eight weekly themed group sessions supplemented by home tasks. Effectiveness of the intervention was evaluated by questionnaires pre- and post-intervention on post-COVID-19 symptoms, quality of life with EQ-5D-5L, short Warwick-Edinburgh Mental Well-being Scale, and physical function by spirometry and one-minute sit-to-stand test. We also assessed the feasibility and acceptability of the intervention by questionnaires and semi-structured in-depth interviews. Outcome analysis for this intervention is yet to be conducted.

Conclusions:

Insights from patients and healthcare providers on the characteristics of post-COVID-19 complications helped guide the development of a context-adapted intervention program with potential to improve health and well-being post-COVID-19.