We read with great interest the timely review and recommendations presented by Cheng et al. outlining the rehabilitation of COVID-19 patients in Taiwan. 1 Survivorship and quality of life after a critical illness is an increasingly important healthcare concern. This gains even more importance when the magnitude of patients affected in the pandemic rise to an enormous level. To maintain the appropriate level of functionality, prevention of morbidity and loss of function should be of a part of healthcare planning. In this review article, the authors have meticulously delineated the evidence based recommendations for the rehabilitation of patients suffering major cardiac and pulmonary insult from the disease. However, upon careful reading, certain aspects warrant additional comments and considerations.

Understandably as the evidence is evolving around the disease, especially with regards to the critically ill patients require invasive mechanical ventilator support major landmark trials now have shown that the use of dexamethasone provides survival benefit as well as more mechanical ventilator free days. 2, 3 It is expected that more and more patients in the intensive care units will be exposed to steroids and sometimes the use may not be completely judicious. It is well established that critically ill patients requiring neuromuscular blockage and steroids in the ICU have a protracted course of recovery and need intense rehabilitation after the stage of acute survival. 4e7 It would be helpful to the readers of the Journal if the authors recommend careful screening of patients that required steroids and neuromuscular blocking agents in the critically ill state in the ICU. In addition, the particular subset of survivors of critical illness that were exposed to neuromuscular blocking agents and steroids that may require additional rehabilitation strategy to identify and treat ICU acquired weakness (ICUAW).