Introduction：Intracranial hemorrhage after severe coronavirus disease 2019 (COVID-19) is associated with increased mortality and unfavorable patient outcomes.Case：A man in his 60s with independent activities of daily living (ADL) was diagnosed with COVID-19, and placed on a ventilator on Day (D)-3 and VV-ECMO on D-5. On D-23, an emergency craniotomy was performed for a left acute subdural hematoma. The patient was weaned from VV-ECMO on D-27. On D-33, sitting was initiated. On D-36, the patient was weaned from the ventilator and began exercise therapy. The Glasgow coma score (GCS) was E2V1TM4. Basic movement as assessed by the Functional Status Score for ICU (FSS-ICU) and Barthel Index (BI), was 3 and 0 points, respectively. On D-40, wheelchair use commenced. He began standing with a long leg orthosis on D-50, and began walking on D-53.On D-67, the patient transferred to a convalescent hospital. His GCS was E4V4M6. Generalized cognitive decline and motor paralysis were noted. The right upper limb, hand, and lower limb were assessed as Brunnstrom recovery stage IV, V, and V, respectively. The patient's grip strength was 11.9 kg [right] and 18.3 kg [left]. His knee extensor strength was 0.13 kgf/kg [right] and 0.19 kgf/kg [left]. The FSS-ICU, walking speed, and BI were 21 points, 0.17 m/sec, and 40 points, respectively. The patient was discharged on D-240.Discussion：The Early Mobilization and Rehabilitation Expert Consensus reports that early mobilization and active exercise can improve ADL at discharge. Our patient was weaned from VV-ECMO as soon as possible and practiced standing and walking with a long leg orthosis, resulting in a better outcome.

Introduction：Intracranial hemorrhage after severe coronavirus disease 2019 (COVID-19) is associated with increased mortality and unfavorable patient outcomes.Case：A man in his 60s with independent activities of daily living (ADL) was diagnosed with COVID-19, and placed on a ventilator on Day (D)-3 and VV-ECMO on D-5. On D-23, an emergency craniotomy was performed for a left acute subdural hematoma. The patient was weaned from VV-ECMO on D-27. On D-33, sitting was initiated. On D-36, the patient was weaned from the ventilator and began exercise therapy. The Glasgow coma score (GCS) was E2V1TM4. Basic movement as assessed by the Functional Status Score for ICU (FSS-ICU) and Barthel Index (BI), was 3 and 0 points, respectively. On D-40, wheelchair use commenced. He began standing with a long leg orthosis on D-50, and began walking on D-53.On D-67, the patient transferred to a convalescent hospital. His GCS was E4V4M6. Generalized cognitive decline and motor paralysis were noted. The right upper limb, hand, and lower limb were assessed as Brunnstrom recovery stage IV, V, and V, respectively. The patien's grip strength was 11.9 kg [right] and 18.3 kg [left]. His knee extensor strength was 0.13 kgf/kg [right] and 0.19 kgf/kg [left]. The FSS-ICU, walking speed, and BI were 21 points, 0.17 m/sec, and 40 points, respectively. The patient was discharged on D-240.Discussion：The Early Mobilization and Rehabilitation Expert Consensus reports that early mobilization and active exercise can improve ADL at discharge. Our patient was weaned from VV-ECMO as soon as possible and practiced standing and walking with a long leg orthosis, resulting in a better outcome.

Objective：Independent walking is crucial for critically ill intensive care unit (ICU) patients to return home. We aimed to investigate the characteristics of patients with severe COVID-19 who could walk independently upon discharge.Methods：This study included 26 patients with severe COVID-19 who were admitted to our ICU between April 2020 and September 2023. Patient background, ICU progress, and outcome-related events were compared between the independent and dependent groups.Results：Compared to the dependent group, the independent group had a lower pre-admission clinical frailty scale score (2.0 [2.0-2.5] vs. 3.0 [2.5-3.0]) and shorter time to start standing (seven days [6-9] vs. 13 days [11-17]) and walking (10 days [8-11] vs. 20 days [13-50]). Functional status scores in the ICU (28±5. vs. 12±9) and ICU mobility scale (8 [8-10] vs. 5 [3-7]) were higher upon ICU discharge, while the duration of ventilator management (seven [4-9] vs. nine [8-18] days) and ICU length of stay (10 [10-14] vs. 17 [15-23] days) were shorter. They had fewer complications (two [18.2％] vs. 12 [80.0％]) and higher return-to-home rates (10 [90.9％] vs. two [13.3％]).Conclusion：Patients with severe COVID-19 who walked independently upon discharge had lower pre-admission frailty, fewer complications, shorter ventilator management duration, early mobilization, higher physical activity upon ICU discharge, shorter ICU stay, and higher return-to-home rates.

Objective：Independent walking is crucial for critically ill intensive care unit (ICU) patients to return home. We aimed to investigate the characteristics of patients with severe COVID-19 who could walk independently upon discharge.Methods：This study included 26 patients with severe COVID-19 who were admitted to our ICU between April 2020 and September 2023. Patient background, ICU progress, and outcome-related events were compared between the independent and dependent groups.Results：Compared to the dependent group, the independent group had a lower pre-admission clinical frailty scale score (2.0 [2.0-2.5] vs. 3.0 [2.5-3.0]) and shorter time to start standing (7 days [6-9] vs. 13 days [11-17]) and walking (10 days [8-11] vs. 20 days [13-50]). Functional status scores in the ICU (28±5. vs. 12±9) and ICU mobility scale (8 [8-10] vs. 4 [3-7]) were higher upon ICU discharge, while the duration of ventilator management (7 [4-9] vs. 9 [8-19] days) and ICU length of stay (10 [10-14] vs. 17 [15-23] days) were shorter. They had fewer complications (2 [18.2％] vs. 12 [80.0％]) and higher return-to-home rates (10 [90.9％] vs. 2 [13.3％]).Conclusion：Patients with severe COVID-19 who walked independently upon discharge had lower pre-admission frailty, fewer complications, shorter ventilator management duration, early mobilization, higher physical activity upon ICU discharge, shorter ICU stay, and higher return-to-home rates.