Evaluation of the effectiveness of the third stage rehabilitation in patients after COVID-19 in a day hospital

Abstract

Introduction. For patients with the consequences of COVID-19 it seems relevant to undergo a rehabilitation program to restore the respiratory function, oxygen uptake by tissues, increase exercise tolerance, etc. Rehabilitation includes aerobic-based exercises adequate to the patient’s state and physical capabilities, breathing exercises and physiotherapy modalities. Aim. To evaluate the effectiveness of the third stage rehabilitation in patients aged 18–45 years with the consequences of COVID-19 (U07.1) in a day hospital of multispecialty hospital. Materials and methods. One hundred and thirty-nine patients aged 18–45 years with a verified diagnosis of pneumonia associated with COVID-19 (U07.1) were examined in a day hospital of multispecialty hospital. The patients were divided into 2 groups: 107 patients of the 1st group underwent the third stage rehabilitation; 32 people from who made up the 2nd group refused rehabilitation. The severity of dyspnea was assessed using the Medical Research Council (MRC) Dyspnea Scale; functional impairment in the performance of activities of daily living – according to the Baseline Dyspnea Index and Transitional Dyspnea Index scales; exercise tolerance – according to the 6-minute walk test and the modified Borg Scale; the severity of anxiety and depression – according to the Hospital Anxiety and Depression Scale (HADS); pain intensity – according to the Visual Analogue Scale (VAS); quality of life – according to the EuroQoL Five-Dimension Questionnaire (EQ-5D). Statistical processing of the obtained results was carried out. Results. In the group of patients who completed rehabilitation, upon follow-up examination, there was a significant decrease in complaints, normalization of a number of hemodynamic parameters, an improvement in the 6-minute walk test scores, a decrease in the severity of dyspnea according to the MRC Dyspnea Scale by 1.8 times, a decrease in anxiety according to the HADS by 2.1 times, a decrease in pain according to the VAS by 3.2 times, an improvement in exercise tolerance according to the modified Borg Scale by 1.8 times and quality of life – according to the EQ-5D by 1.4 times. In the group of patients who refused rehabilitation, the change in these indicators was not significant. Conclusion. For patients who have had pneumonia associated with SARS-CoV-2, it is advisable to go through the third stage rehabilitation in a day hospital in order to restore the respiratory functions, increase exercise tolerance, reduce anxiety and improve quality of life.