Long COVID-19: Impact of a personalized rehabilitation program.

INTRODUCTION

Several guidelines have proposed specific rehabilitation programs to treat symptoms/sequelae in patients with post-acute COVID syndrome (PACS). Only a few studies show that rehabilitation reduce disability after COVID-19.

OBJECTIVE

To describe the response to a personalized rehabilitation program in terms of exercise tolerance, muscle function, dyspnea, quality of life, and frailty state in a cohort of patients with PACS.

METHODS

Observational prospective cohort study of community-dwelling patients. The rehabilitation program included three modalities (outpatient, home-based, and self-administered), optionally supplemented with respiratory muscle training.

STUDY VARIABLES: 6-minute walking distance (6MWD), inspiratory muscle strength (PImax), dyspnea, muscle strength (estimated with the Medical Research Council scale and handgrip), health-related quality of life (HRQoL), and frailty estimated with the Short Physical Performance Battery (SPPB) and at 3- and 6-months following baseline.

RESULTS

Of 178 patients with PACS, 101 (56.7%) were enrolled in a rehabilitation program: 41.6% home-based, 27.7% outpatient, and 24.8% self-administered. Inspiratory muscle training (IMT) was provided to 56 patients, with 50 included in the rehabilitation program and 6 (5.9%) receiving IMT alone. Significant improvements were observed at 3 months in mMRC strength (p=0.001), SPPB (p<0.0001), handgrip strength (p=0.017), mMRC dyspnea, PImax (p<0.0001), and 6-MWD (p=0.008). Improvements persisted at 6 months for mMRC strength (p=0.048), SPPB (p=0.002), PImax (p<0.0001), and 6MWD (p=0.048). HRQoL mental and physical component scores improved only at 3 months.

CONCLUSIONS

Personalized rehabilitation for patients with PACS improved muscle parameters, dyspnoea, and exercise capacity, but not HRQoL, up to 6 months. Improvements in respiratory muscle strength were associated with reductions in dyspnoea and increased exercise capacity.