Introduction: The COVID-19 pandemic has led to approximately 3.5 million cases in Romania, causing systemic inflammation and over 200 symptoms affecting various body systems. This complexity has challenged rehabilitation systems, necessitating personalized plans tailored to each patient’s illness stage and impairment level. The ISPRM-developed ClinFIT COVID-19 instrument, aligned with the ICF categories, assists in assessing patients during acute, post-acute, and long-term phases. Objective: This study aimed to evaluate and assess functional impairments in post-COVID-19 patients in Romania, with a secondary goal of generating rehabilitation directions. Methods: Data were collected from patients at two Bucharest medical centers, including those with persistent symptoms post-acute phase. Participants were assessed using the adapted ClinFIT COVID-19 instrument, and descriptive statistics were applied. Conclusions: Findings revealed diverse functional impairments in physical, psychological, and social domains among post-COVID-19 patients, with severe impairments more common in those with long-term COVID-19. Complete impairment in complex movement and paid work was noted, affecting one-third of salaried employees and forcing some to retire. In the acute phase, the most frequent functional impairments were sleep, attention, pain sensation, and exercise tolerance functions. In contrast, the most severely affected functions were exercise tolerance and mobility joint functions. Age did not positively correlate with any of the analyzed functions. In the post-acute phase, sleep, energy, and drive functions remained the most frequently affected functions, while the most severely affected was, by far, the moving around function. In the post-acute period, respiratory and respiratory muscle functions strongly correlated with all tasks related to physical activity. In the long COVID-19 phase, remunerative employment was the most severely affected function, while attention functions remained the most frequently affected, similar to the acute phase. The ClinFIT COVID-19 instrument effectively captured these impairments, underscoring the need for comprehensive rehabilitation strategies.

Background/Objectives: Disability certification in Romania rests mainly on medical diagnosis. We examined whether documented standardized functional assessment in certification dossiers differs across diagnostic groups. Methods: We analyzed 460 anonymized adult dossiers collected in January 2023, ten from each of 46 disability assessment commissions in 41 of Romania’s 42 first-level administrative units. Because the commissions selected the files and at least half had to include a psychological evaluation, we compared diagnostic groups rather than estimating national rates and repeated the main comparison accounting for clustering. Results: Most files concerned older adults with neurocognitive or mental disorders; dementias accounted for 40.2% of primary diagnoses. An activity scale (ADL, IADL or Barthel Index) was documented in 69.0% of non-dementia neurological dossiers, 34.4% of dementia dossiers and 10.8% of other mental-disorder dossiers; the gradient persisted after accounting for clustering. Cognitive and global instruments were documented more often than activity scales. Conclusions: Functional evidence was scarcest in neurocognitive and mental disorders, in which diagnosis predicts functioning least well. The national criteria list activity scales for neurological conditions but only cognitive and global instruments for neurocognitive and mental disorders; adding activity scales for these groups, then ICF-based assessment such as WHODAS 2.0, would address the gap.