Prehabilitation May Help Mitigate an Increase in COVID-19 Peripandemic Surgical Morbidity and Mortality

Abstract

As physicians specializing in rehabilitation medicine consider sequelae from the novel coronavirus pandemic that began in 2019, one issue that should be top of mind is the physiologic effect that large scale social distancing had on the health of patients in general, but more specifically on pre-operative patients who had their surgeries delayed or will have newly scheduled procedures during the peri-pandemic period. Predictably, as the virus becomes less prevalent, there will be a tremendous motivation to move forward with scheduling operations from both patient care and institutional perspectives. However, one can anticipate a pandemic-related increase in surgical morbidity and mortality above pre-pandemic levels, particularly in older or medically frail patients even if they did not have COVID-19. Therefore, now is the time to consider wider adoption of prehabilitation for patients awaiting surgery¹—physical and psychological assessments that establish a baseline functional level, identify impairments, and provide interventions that promote physical and psychological health to reduce the incidence and/or severity of future impairments.