tetano
Editor, Senior Moderator
Respiration
. 2022 Feb 24;1-9.
doi: 10.1159/000522118. Online ahead of print.
Outpatient Pulmonary Rehabilitation in Patients with Long COVID Improves Exercise Capacity, Functional Status, Dyspnea, Fatigue, and Quality of Life
Stephan Nopp[SUP] 1 [/SUP], Florian Moik[SUP] 1 [/SUP], Frederikus A Klok[SUP] 2 [/SUP], Dietlinde Gattinger[SUP] 3 [/SUP], Milos Petrovic[SUP] 3 [/SUP], Karin Vonbank[SUP] 4 [/SUP], Andreas R Koczulla[SUP] 5 6 [/SUP], Cihan Ay[SUP] 1 [/SUP], Ralf Harun Zwick[SUP] 3 7 [/SUP]
Affiliations
Abstract
Background: COVID-19 survivors face the risk of long-term sequelae including fatigue, breathlessness, and functional limitations. Pulmonary rehabilitation has been recommended, although formal studies quantifying the effect of rehabilitation in COVID-19 patients are lacking.
Methods: We conducted a prospective observational cohort study including consecutive patients admitted to an outpatient pulmonary rehabilitation center due to persistent symptoms after COVID-19. The primary endpoint was change in 6-min walk distance (6MWD) after undergoing a 6-week interdisciplinary individualized pulmonary rehabilitation program. Secondary endpoints included change in the post-COVID-19 functional status (PCFS) scale, Borg dyspnea scale, Fatigue Assessment Scale, and quality of life. Further, changes in pulmonary function tests were explored.
Results: Of 64 patients undergoing rehabilitation, 58 patients (mean age 47 years, 43% women, 38% severe/critical COVID-19) were included in the per-protocol-analysis. At baseline (i.e., in mean 4.4 months after infection onset), mean 6MWD was 584.1 m (±95.0), and functional impairment was graded in median at 2 (IQR, 2-3) on the PCFS. On average, patients improved their 6MWD by 62.9 m (±48.2, p < 0.001) and reported an improvement of 1 grade on the PCFS scale. Accordingly, we observed significant improvements across secondary endpoints including presence of dyspnea (p < 0.001), fatigue (p < 0.001), and quality of life (p < 0.001). Also, pulmonary function parameters (forced expiratory volume in 1 s, lung diffusion capacity, inspiratory muscle pressure) significantly increased during rehabilitation.
Conclusion: In patients with long COVID, exercise capacity, functional status, dyspnea, fatigue, and quality of life improved after 6 weeks of personalized interdisciplinary pulmonary rehabilitation. Future studies are needed to establish the optimal protocol, duration, and long-term benefits as well as cost-effectiveness of rehabilitation.
Keywords: Coronavirus disease 2019; Dyspnea; Exercise training; Long coronavirus disease; Outpatient; Pulmonary rehabilitation; Quality of life; Sequelae; Severe acute respiratory syndrome coronavirus 2.
. 2022 Feb 24;1-9.
doi: 10.1159/000522118. Online ahead of print.
Outpatient Pulmonary Rehabilitation in Patients with Long COVID Improves Exercise Capacity, Functional Status, Dyspnea, Fatigue, and Quality of Life
Stephan Nopp[SUP] 1 [/SUP], Florian Moik[SUP] 1 [/SUP], Frederikus A Klok[SUP] 2 [/SUP], Dietlinde Gattinger[SUP] 3 [/SUP], Milos Petrovic[SUP] 3 [/SUP], Karin Vonbank[SUP] 4 [/SUP], Andreas R Koczulla[SUP] 5 6 [/SUP], Cihan Ay[SUP] 1 [/SUP], Ralf Harun Zwick[SUP] 3 7 [/SUP]
Affiliations
- PMID: 35203084
- DOI: 10.1159/000522118
Abstract
Background: COVID-19 survivors face the risk of long-term sequelae including fatigue, breathlessness, and functional limitations. Pulmonary rehabilitation has been recommended, although formal studies quantifying the effect of rehabilitation in COVID-19 patients are lacking.
Methods: We conducted a prospective observational cohort study including consecutive patients admitted to an outpatient pulmonary rehabilitation center due to persistent symptoms after COVID-19. The primary endpoint was change in 6-min walk distance (6MWD) after undergoing a 6-week interdisciplinary individualized pulmonary rehabilitation program. Secondary endpoints included change in the post-COVID-19 functional status (PCFS) scale, Borg dyspnea scale, Fatigue Assessment Scale, and quality of life. Further, changes in pulmonary function tests were explored.
Results: Of 64 patients undergoing rehabilitation, 58 patients (mean age 47 years, 43% women, 38% severe/critical COVID-19) were included in the per-protocol-analysis. At baseline (i.e., in mean 4.4 months after infection onset), mean 6MWD was 584.1 m (±95.0), and functional impairment was graded in median at 2 (IQR, 2-3) on the PCFS. On average, patients improved their 6MWD by 62.9 m (±48.2, p < 0.001) and reported an improvement of 1 grade on the PCFS scale. Accordingly, we observed significant improvements across secondary endpoints including presence of dyspnea (p < 0.001), fatigue (p < 0.001), and quality of life (p < 0.001). Also, pulmonary function parameters (forced expiratory volume in 1 s, lung diffusion capacity, inspiratory muscle pressure) significantly increased during rehabilitation.
Conclusion: In patients with long COVID, exercise capacity, functional status, dyspnea, fatigue, and quality of life improved after 6 weeks of personalized interdisciplinary pulmonary rehabilitation. Future studies are needed to establish the optimal protocol, duration, and long-term benefits as well as cost-effectiveness of rehabilitation.
Keywords: Coronavirus disease 2019; Dyspnea; Exercise training; Long coronavirus disease; Outpatient; Pulmonary rehabilitation; Quality of life; Sequelae; Severe acute respiratory syndrome coronavirus 2.