Does Pulmonary Rehabilitation Improve Outcomes of Post-COVID Sequelae?

Comprehensive pulmonary rehabilitation after COVID-19 infection produces improvement in outcomes such as walking distance and peripheral muscle strength, even in hospitalized patients with respiratory failure requiring oxygen therapy and mechanical ventilation, according to a recent study conducted in Ireland. Results of the study were presented at the American Thoracic Society (ATS) 2022 Annual Meeting, held in San Francisco, CA, May 13 to 18.

Many patients develop persistent, debilitating, and sometimes long-lasting symptoms, including dyspnea, fatigue and cognitive problems, after infection with the SARS-CoV-2 virus. The authors sought to find out whether pulmonary rehabilitation, which has been proposed as a resolution of these issues, could improve outcomes of affected patients.

The researchers gathered demographic data prospectively from 71 patients who completed an 8-week, outpatient pulmonary rehabilitation program (PRP). They assessed outcome measures including results of a 6-minute walk test (6MWT) and an arm grip strength test, as well as scores from the Chronic Obstructive Pulmonary Disease (COPD) Assessment Tool (CAT), St. George’s Respiratory Questionnaire (SGRQ), the Hospital Anxiety and Depression Scale (HADS), and the Post-COVID-19 Functional Scale (PCFS). The rehabilitation plan included exercise classes conducted twice per week and weekly occupational therapy sessions, as well as sessions focusing on attendant symptoms such as fatigue, sleep disturbances, and neurocognitive deficits.

The average age of patients finishing the PRP was 52.3 years, and 55% were women. Of the total, 35% of patients had been hospitalized, and most of those experienced respiratory failure that required oxygen therapy. Some hospitalized patients also needed noninvasive or invasive mechanical ventilation.

Results of the 6MWT improved from 413.1 to 512.8 minutes (P <.0001). Better results also were observed in right (64.3 to 70.9 pounds) and left (62.3 to 68.0 pounds) arm grip strength (P <.0001).

Data showed statistically significant improvement in the following symptom scores: CAT, 18.9 to 13.1; SGRQ, 43.0 to 32.7; HADS, 14.3 to 12.0; and PCFS 2 to 1 point (P  <.0001).

“A comprehensive PRP for individuals with ongoing symptoms following COVID-19 infection is associated with significant and clinically meaningful improvement in 6MWT distance, peripheral muscle strength, CAT, SGRQ and HADS scores and the PCFS,” the authors noted. “These data support the role of PRPs in individuals suffering from post-acute COVID syndrome,” they concluded.

Reference

O’Beirne SL, A. M. O’Mahony , P. Tonge , N. Jackson , D. Kidney , G. Nolan. Outcomes following comprehensive pulmonary rehabilitation after COVID-19 infection. Presented at: the American Thoracic Society (ATS) 2022 International Conference; May 13-18, 2022; San Francisco, CA. Session C16.