IntroductionThe potential additive benefits of rehabilitation beyond spontaneous recovery post-COVID-19 currently remain unknown.MethodsIn this prospective, interventional, non-randomised parallel assignment two-arm study, we investigated the effects of an 8-week rehabilitation programme (Rehab, n=25) added to usual care (UC) versus UC (n=27) on respiratory symptoms, fatigue, functional capacity, mental health and health-related quality of life in patients with COVID-19 pneumonia, 6–8 weeks post-hospital discharge. The rehabilitation programme included exercise, education, dietary and psychological support. Patients with chronic obstructive pulmonary disease, respiratory and heart failure were excluded from the study.ResultsAt baseline, groups were not different in mean age (56 years), gender (53% female), intensive care unit admission (61%), intubation (39%), days of hospitalisation (25), number of symptoms (9) and number of comorbidities (1.4). Baseline evaluation was conducted at median (IQR) 76 (27) days after symptoms onset. Groups were not different regarding baseline evaluation outcomes. At 8 weeks, Rehab showed significantly greater improvement in COPD Assessment Test by a mean±SEM (95% CI) 7.07±1.36 (4.29–9.84), p <0.001andall three fatigue questionnaires: Chalder-Likert: 5.65±1.27 (3.04–8.25), p <0.001; bimodal: 3.04±0.86 (1.28–4.79), p=0.001; Functional Assessment of Chronic Illness Therapy: 6.37±2.09 (2.08–10.65), p=0.005 and Fatigue Severity Scale: 1.36±0.433 (0.47–2.25), p=0.004. At 8 weeks rehab also showed significantly greater improvment in Short Physical Performance Battery: 1.13±0.33 (0.46–1.79), p=0.002; Hospital Anxiety and Depression Scale (HADS)Anxiety: 2.93±1.01 (0.67–5.18), p=0.013; Beck Depression Inventory: 7.81±3.07 (1.52–14.09), p=0.017; Montreal Cognitive Assessment: 2.83±0.63 (1.5–4.14), p <0.001; EuroQol (EQ-5D-5L) Utility Index: 0.21±0.05 (0.1–0.32), p=0.001 and Visual Analogue Scale: 6.57±3.21 (0.2–13.16), p=0.043. Both groups significantly improved 6-min walking distance by approximately 60 m and pulmonary function measures, whereas post-traumatic stress disorder measurement IES-R (Impact of Event Scale, Revised) and HADS-Depression score were not different between groups at 8 weeks. A 16% attrition rate was observed in the rehabilitation group exhibiting a threefold increase in training workload. There were no adverse effects reported during exercise training.DiscussionThese findings highlight the added value of rehabilitation post-COVID-19 to amplify the natural course of physical and mental recovery that otherwise would remain incomplete with UC.

We report a case study of a woman with Septic Shock who attended Psychological Intervention after medical treatment in the Intensive Care Unit of a Greek Teaching Hospital in Athens. Qualitative analysis of data was collected from Focused Interview, Genogram as a family history tool and Psychological Intervention based on Short/ Systemic Psychotherapy. The study focuses on the deep understanding of the patient’s changes in terms of thoughts, emotions and behaviors after the invasion of a serious disease, like Septic Shock

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We report a case study of an adult man with severe COVID-19 who attended Psychological Intervention after prolonged hospitalization in the Intensive Care Unit, intubation and finally, participation in Rehabilitation Programme of a Greek Teaching Hospital in Athens. To export results, a qualitative data analysis were collected from Focused Interview, Psychological Intervention based on Short/ Systemic Psychotherapy and a quantitative data analysis from the Beck Depression Inventory and further triangulation of qualitative and quantitative data took place. The study focuses on the psychology of COVID-19 survivor patient, in line with complex needs, psychological effects and specific stressors, following a life-threatening disease. In the light of a therapeutic ‘flexibility’ and finally of a combination of multi-factorial nature of the disease that requires integration and simultaneous exploring of not only the physical, but also of the psychological needs of the patient