Effects of a 16-week home-based exercise training programme on health-related quality of life, functional capacity, and persistent symptoms in survivors of severe/critical COVID-19: a randomised controlled trial

Abstract

BackgroundLong-lasting effects of COVID-19 may include cardiovascular, respiratory, skeletal muscle, metabolic, psychological disorders and persistent symptoms that can impair health-related quality of life (HRQoL). We investigated the effects of a home-based exercise training (HBET) programme on HRQoL and health-related outcomes in survivors of severe/critical COVID-19.MethodsThis was a single-centre, single-blinded, parallel-group, randomised controlled trial. Fifty survivors of severe/critical COVID-19 (5±1 months after intensive care unit discharge) were randomly allocated (1:1) to either a 3 times a week (~60–80 min/session), semi-supervised, individualised, HBET programme or standard of care (CONTROL). Changes in HRQoL were evaluated through the 36-Item Short-Form Health Survey, and physical component summary was predetermined as the primary outcome. Secondary outcomes included cardiorespiratory fitness, pulmonary function, functional capacity, body composition and persistent symptoms. Assessments were performed at baseline and after 16 weeks of intervention. Statistical analysis followed intention-to-treat principles.ResultsAfter the intervention, HBET showed greater HRQoL score than CONTROL in the physical component summary (estimated mean difference, EMD: 16.8 points; 95% CI 5.8 to 27.9; effect size, ES: 0.74), physical functioning (EMD: 22.5 points, 95% CI 6.1 to 42.9, ES: 0.83), general health (EMD: 17.4 points, 95% CI 1.8 to 33.1, ES: 0.73) and vitality (EMD: 15.1 points, 95% CI 0.2 to 30.1, ES: 0.49) domains. 30-second sit-to-stand (EMD: 2.38 reps, 95% CI 0.01 to 4.76, ES: 0.86), and muscle weakness and myalgia were also improved in HBET compared with CONTROL (p<0.05). No significant differences were seen in the remaining variables. There were no adverse events.ConclusionHBET is an effective and safe intervention to improve physical domains of HRQoL, functional capacity and persistent symptoms in survivors of severe/critical COVID-19.Trial registration numberNCT04615052.

Navigating the Spectrum of Two Pediatric COVID-19 Complications: Multi-System Inflammatory Syndrome in Children and Post-Acute Sequelae of SARS-CoV-2 Infection

“…Immunological perturbations may also play a role [42,43]. Finally, very recent data have been published linking a reduction in serotonin levels to one or more of the above mechanisms [44].…”

Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial

“…Although intuitively physical and mental health rehabilitation in a condition characterised by breathlessness, fatigue, reduced physical capacity, and poor emotional wellbeing might be beneficial, no previous empirical data have supported this, particularly in relation to people admitted to hospital with covid-19 or to remotely supervised online interventions. In survivors (n=50) of severe and critical covid-19 (five months post-hospital discharge), 16 weeks of semi-supervised home based rehabilitation was more effective than control for improving physical function and health related quality of life 33. A multicentre cohort study (n=582) comparing recovery trajectory after hospital discharge for covid-19 across different care pathways reported improved physical function in two supervised rehabilitation cohorts compared with two cohorts receiving limited or no rehabilitation 34.…”

“…In survivors (n=50) of severe and critical covid-19 (five months post-hospital discharge), 16 weeks of semi-supervised home based rehabilitation was more effective than control for improving physical function and health related quality of life. 33 A multicentre cohort study (n=582) comparing recovery trajectory after hospital discharge for covid-19 across different care pathways reported improved physical function in two supervised rehabilitation cohorts compared with two cohorts receiving limited or no rehabilitation. 34 Although informative, data from these studies are not definitive and the many differences with our methodology and participants’ characteristics prevent comparison.…”

Effects of Exercise Rehabilitation on Cardiorespiratory Fitness in Long-COVID-19 Survivors: A Meta-Analysis

“…The characteristics of the included studies are detailed in Table 1 . The eligible studies consisted of five RCTs [ 21 , 29 , 39 , 40 , 41 ] and seven non-RCTs [ 20 , 22 , 23 , 42 , 43 , 44 , 45 ]. All non-RCTs had a single-group study design which contained pre- and post-intervention data.…”