Pulmonary Rehabilitation for Patients With Long COVID

Individuals with long COVID who underwent 6 weeks of personalized interdisciplinary pulmonary rehabilitation experienced improvements in exercise capacity, functional status, dyspnea, fatigue, and quality of life, according to findings published recently in Respiration.

Those who survive COVID-19 may experience long-term sequelae that include respiratory, neuropsychiatric, cardiovascular, hematologic, gastrointestinal, renal, and endocrine manifestations. With the rapid increase in disease burden for long COVID, strategies to improve long-term outcomes are urgently needed.

In the current study, researchers aimed to assess the effectiveness and safety of outpatient pulmonary rehabilitation among patients with persistent or progressive respiratory and/or functional limitations after COVID-19. To accomplish this, researchers in Vienna, Austria, conducted a prospective observational single-center cohort study of 58 consecutive adult patients (43% female; 46.8±12.6 years of age; BMI 26.2±5.3 kg/m²) admitted to an outpatient pulmonary rehabilitation center between May 2020 and April 2021 due to persistent or progressive symptoms following COVID-19. Of these, 22 patients (38%) had been hospitalized due to severe COVID-19, and, 36 (62%) were quarantined at home with mild to moderate symptoms.

The investigators assessed the following endpoints after patient participation in an interdisciplinary individualized pulmonary rehabilitation program: 1) change in the 6-minute walk distance (6MWD); and 2) changes values for the post-COVID-19 functional status (PCFS) scale, Borg dyspnea scale, Fatigue Assessment Scale, and quality of life measures.

The baseline (set at an average of 4.4 months after infection onset) mean value for 6MWD was 584.1 m (±95.0), and functional mean impairment on the PCFS scale was 2 (IQR, 2-3). Patients improved their 6MWD by 62.9 m (±48.2; P <.001) on average; patients improved on the PCFS scale 1 grade. Significant improvements were noticeable for the endpoints of dyspnea, fatigue, and quality of life (all P <.001). During rehabilitation, forced expiratory volume in 1 second, lung diffusion capacity, and inspiratory muscle pressure all showed significant increases.

Researchers concluded that their findings supported the use of personalized rehabilitation as part of an integrated model of care for treating patients with long COVID. The investigators noted that the 2 most common long-term consequences of COVID-19, functional limitations and fatigue, improved after outpatient pulmonary rehabilitation of 6 weeks. Researchers also noted a need for further trials to assess long-term effects of rehabilitation and pulmonary function improvement over time.

In detailing study limitations, the investigators noted its high proportion of highly educated individuals, making study results not generalizable to the total population.

Reference

Nopp S, Moik F, Klok FA, et al. Outpatient pulmonary rehabilitation in patients with long COVID improves exercise capacity, functional status, dyspnea, fatigue, and quality of life. Respiration. Published online February 24, 2022. doi:10.1159/000522118