Objective: to report on the development and global testing of the COVID-19 version of the International Classification of Functioning, Disability and Health-based Clinical Functioning Information Tool called “ClinFIT COVID-19” to collect functioning data of rehabilitation patients across the care continuum to establish an interval-scaled functioning score. Design: Multicentre, cross-sectional observational study. Subjects/Patients: Rehabilitation patients in acute, post-acute, and long-term settings. Methods: Three context-specific versions (13–16 ICF categories) of ClinFIT-COVID-19 were administered to collect information on patient functioning. Rasch analysis examined psychometric properties and generated conversion tables from ordinal raw scores to a 0–100 interval metric. Results: Twenty-six study centres in 17 countries across the globe collected data from 1,747 patients. Problems in exercise tolerance functions were most frequently reported in the acute and post-acute settings (74.2%; 87.6%), while long-term care patients most frequently reported pain as problematic (71.1%). With a testlets approach and item splitting, all 3 ClinFIT COVID-19 versions satisfied Rasch model expectations (item-trait χ² p > 0.05; PSI 0.742–0.812), making it feasible to develop respective transformation tables. Conclusion: This study found the psychometric properties of ClinFIT COVID-19 acceptable. Future studies are needed to validate the use of the transformation tables to monitor functioning and evaluate intervention impact.
Dysautonomia in the post-COVID-19 condition appears to affect a significant number of patients, with reports raising the incidence up to 61%, having an overlap with myalgic encephalomyelitis/chronic fatigue syndrome. Quality of life and daily function are significantly impacted and conservative management interventions, despite the lack of high-quality evidence to date, are needed to ameliorate disability. A total of 50 adults with a dysautonomia post-COVID-19 diagnosis based on the Ewing battery and a NASA lean test will be enrolled in a randomized single blinded controlled trial with a crossover design. Feasibility and lack of definite dysautonomia diagnosis will be the primary outcomes, while secondary outcomes will be health-related, clinical and cardiopulmonary exercise test indicators. Safety and acceptance will also be checked, primarily excluding participants with post-exertional malaise. The Long-COVID patients Causal Diagnosis and Rehabilitation study in patients with Dysautonomia (LoCoDiRE-Dys) intervention will consist of an educational module, breathing retraining and an individualized exercise intervention of biweekly sessions for two months with regular assessment of both groups. LoCoDiRe-Dys aims to be the first post-COVID-19 randomized study in people with dysautonomia offering a multimodal intervention both in diagnosis and management. The need for evidence in effectively supporting patients is eminent.