Background Growing consideration is emerging regarding the burden of persisting sequelae after SARS-CoV-2 infection. Out-patients exhibiting long Covid may benefit from ambulatory rehabilitation which is, to date, poorly documented. Methods A longitudinal follow-up over a one-year period was conducted in two ambulatory rehabilitation structures in order to describe the characteristics of real-life patients referred with Covid-19 sequelae and their evolution over the course of rehabilitation. Results 39 consecutive patients were included from April 1 st 2020 to April 1 st 2021. Patients were middle-aged (48±15yr), without comorbidities, and mostly mild to moderate SARS-CoV-2 infection (25(64%) not requiring hospitalisation). Rehabilitation referral was considered with a median delay of 73[34-178] days after disease onset. Most prevalent symptoms were dyspnoea (n=35(90%)) and fatigue (n=30(77%)). Hyperventilation syndrome was highly frequent (n=12(34%)). 29(74%) patients presented with prolonged functional sequelae, which was associated with younger age (43±14 vs . 50±10yr; p=0.002), greater prevalence of hyperventilation syndrome (n=12(41%) vs . 0(0%); p=0.255) and poorer quality of life (VQ-11; 31±10 vs . 23±9; p=0.030). Over the course of rehabilitation, exertional dyspnoea, 6-minutes walking distance, 3-minutes sit-to-stand test, hyperventilation syndrome prevalence and quality of life significantly improved. Conclusion Hyperventilation is frequent in long Covid and may explain persistent dyspnoea as well as altered quality of life. Our data support screening of hyperventilation syndrome and functional impairment in mild Covid-19 out-patients as both of these components may improve with ambulatory rehabilitation.

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BackgroundNoninvasive ventilation (NIV) improves survival and quality of life in amyotrophic lateral sclerosis (ALS) patients. NIV initiation is mostly conducted at hospital, but a recurrent lack of hospital beds led to the necessity to explore an at-home initiation process. We report here data from our NIV initiation cohort in ALS patients.Research QuestionCould, our at-home NIV initiation process with telemonitoring in ALS patients, be an efficient solution for adherence and nocturnal hypoxemia correction?MethodsWe performed a retrospective analysis of data collected from the 265 ALS patients followed in the Bordeaux ALS Centre for whom NIV initiation has been carried out between September 2017 and June 2021 with two modalities: at-home initiation or in-hospital initiation. The primary outcome was adherence to NIV at 30 days. The secondary outcome was at-home NIV initiation process efficiency on nocturnal hypoxemia correction.ResultsAt 30 days, NIV adherence (mean >4 h·day−1) was 66% in total population, 70% in the subgroup at-home NIV initiation and 52% in the subgroup in-hospital NIV initiation. Nocturnal hypoxemia correction was observed in 79% of adherent patients in the subgroup at-home NIV initiation. Mean delay of NIV prescription and at-home NIV initiation was 8.7 days (+/- 6.5)versus29,5% at hospital.ConclusionOur study shows that our at-home NIV initiation process in ALS patients is a good option to provide rapid access to NIV with good adherence and efficiency. Further literature on at-home NIV initiation benefit is welcomed especially to evaluate long-term efficiency and global cost analysis.

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