The feasibility and patient-acceptability of a novel multidisciplinary COVID-19 Recovery Service in the Australian Capital Territory.

As ethical approval has been obtained, with a waiver of patient consent, all participants receiving the program will be included in the study. Patients will be referred to the program via GP or community referral pathways, if they are experiencing residual problems as a result of a previous COVID-19 infection. There is no specific timeframe stipulated, and the inclusion will be broad. Patients referred to the program will undergo comprehensive medical assessment and screening for their suitability to participate in rehabilitation. Where indicated, this will include assessment of the patient’s cardiopulmonary exercise capacity (VO2max and anaerobic threshold), as well as lung function testing (spirometry, maximum inspiratory pressure). Such tests have recently been shown to be safe and valuable in patients following COVID-19. The medical specialist will then advise the rehabilitation team of any specific exercise limitations based on this testing (e.g. SpO2 targets). This screening could take up to 2 - 3 hours, depending on the patient's need for rest breaks etc. Following a thorough patient-tailored individual assessment, the rehabilitation program received by a patient in the service could include any or all of the following, depending on the patient’s needs: -Specialized care planning and care coordination (including social work input where relevant) -Goal based short term rehabilitation interventions (e.g. supervised individually prescribed exercise therapy; inspiratory muscle training; functional retraining for activities of daily living) -Education to facilitate self-management -Group rehabilitation including pulmonary rehabilitation and semi supervised group therapies -Telehealth interventions as an adjunct to usual therapy where clinically safe and effective -Where necessary, home-based assessment and treatment for goals relating to essential activities of daily living -Individual therapy sessions involving clinical psychology, neuropsychology, dietetics, speech pathology etc as required The frequency and duration of sessions will vary between patients depending on their needs and services provided. This could range from 1 or 2 sessions of 30 - 60 minutes per week for a short period (e.g. 2 months), to several sessions per week for 6 months. This study will only analyse the first 6 months of the clinic's operation (June - December 2022) so this will limit the observation period, and it is highly likely that some patients will continue care beyond 6 months. Only a subgroup of participants will be included in the patient acceptability component of this study. All patients completing the study will be invited to participate in the acceptability survey and focus groups, but as participation is voluntary, not all may participate in this aspect. For the interviews, the first 10 participants to consent will be included, and ongoing sequential recruitment will only occur if quantitative analysis indicates that saturation of themes has not yet occurred. It is possible that a total of 10 - 15 patients may be required for interviews. Once saturation of themes is noted, recruitment to the interviews will cease, but acceptability surveys will still be offered to all participants who complete the program within the first 6 months. For the observational study (6 months), the data collected from the records will include the patient's age, sex, date of birth, COVID diagnosis and admission details (if relevant), past medical history, and attendance at clinic appointments (as outlined above), or non-attendance. Any deaths, re-hospitalisations or adverse events will also be recorded. All data will be directly collected from the program records, and participants are not actively involved.