Post-Discharge rehabilitation  
Immediate and individually tailored post-acute ICU rehabilitation efforts should be targeted towards ameliorating problems across all three PICS domains (physical, mental and cognitive) based on findings from personalized evaluation. Specialist referral should be sought if need be.40 Cognitive rehabilitation41 and the use of ICU diaries42 are useful in managing PICS-related cognitive symptoms, thus improving psychosocial well-being. Post ICU rehabilitation also helps to improve critical illness-related depressive symptoms and mental health-related quality of life43. A recent report has also shown cardio-pulmonary rehabilitation for COVID 19 survivors to be safe and effective44. Tele-consultations using telephone, a seemingly feasible tele-health option in Africa45, is also an efficient and feasible alternative in providing psychosocial support to patients, family members and caregivers after their ICU stay46.
Although evidence for the efficacy of post ICU rehabilitation is rather inconclusive47, practice guidelines recommend its implementation considering the complexity of critical illness presentations and the need to optimize patient outcomes and improve survivorship35,39,48. Considering the peculiarity of the healthcare systems in Africa, different countries have put up guidelines to incorporate key considerations for rehabilitating COVID-19 patients in African settings35. There is hence a need for close collaboration amongst rehabilitation specialists, community health service providers and other multi-professional teams with experience in providing rehabilitation interventions for mental, cognitive and physical sequelae of critical illness.