Pulmonary Rehabilitation in Patients Recovering from COVID-19

Abstract

<b><i>Background:</i></b> In hospitalized patients recovering from the SARS-coronavirus-2 disease 19 (COVID-19), high prevalence of muscle weakness and physical performance impairment has been observed. <b><i>Objectives:</i></b> The aim of this study was to evaluate the effectiveness of pulmonary rehabilitation in these subjects in a real-life setting. <b><i>Methods:</i></b> Retrospective data analysis of patients recovering from COVID-19, including those requiring assisted ventilation or oxygen therapy, consecutively admitted to an in-patient pulmonary rehabilitation program between April 1 and August 15, 2020. Short Physical Performance Battery (SPPB: primary outcome), Barthel Index (BI), and six-min walking distance were assessed as outcome measures. <b><i>Results:</i></b> Data of 140 patients were analyzed. After rehabilitation, patients showed improvements in SPPB {from: (median [IQR]) 0.5 (0–7) to 7 (4–10), <i>p</i> < 0.001} and BI (from 55 [30–90] to 95 [65–100], <i>p</i> < 0.001), as well as in other assessed outcome measures. The proportion of patients unable at admission to stand, rise from a chair and walk was significantly reduced (<i>p</i> < 0.00). <b><i>Conclusions:</i></b> Pulmonary rehabilitation is possible and effective in patients recovering from COVID-19. Our findings may be useful to guide clinicians taking care of patients surviving COVID-19 infection.

Short-term Effects of a Three-week Inpatient Post-COVID-19 Pulmonary Rehabilitation Program - a Prospective Observational Study

“…However, the values may vary with the time interval from the acute phase of the disease and decrease with disease severity, as was shown for post-COVID-19 rehabilitants by Glöckl et al[43]. This may explain the fact that the 6MWDs of group B and group C were higher than those reported for COVID-19 patients directly after an acute infection[46,47,59]. In all subgroups, the 6MWD improved, with large effect sizes, in groups A, B and C by 131 m (34.8%), 96 m (20.9%), and 74 m (15.4%), respectively.…”

Increasing Knowledge on Post-Acute Rehabilitation in COVID-19

“…Since the first wave of the pandemic occurred in early 2020, only a small number of studies discussing physiotherapy practice have been published when compared with thousands of articles in the medical field. From a certain point of view, the study by Zampogna et al [ 1 ] can be considered one of the firsts including a considerable number of patients via a retrospective observational design. Another previously published study by Jiandani et al [ 3 ] investigated the effects of rehabilitation in COVID-19 in a broader population using the same study design.…”

“…All these hypotheses should be considered when reading the study by Zampogna et al [ 1 ] who have produced research containing valuable insights. In fact, from their article, it can be gathered − among the various information available − that patients can afford a rehabilitation treatment (whose intensity varied according to their clinical conditions) when having a PaO 2 /FiO 2 ratio ≥310 mm Hg, after a long hospitalization ≥33.5 days, and being able to walk ≥250 m at the 6-min walking test after having attended a rehabilitation programme [ 1 ]. Let me say that these are not secondary aspects.…”

“…Another message that can be taken from the experience of Zampogna et al [ 1 ] concerns the obvious reflection on the impossibility to conduct studies with control populations because, in that case, patients could be exposed to the risk of not receiving rehabilitation.…”

“…The study by Zampogna et al [ 1 ] provides helpful insights to be transferred to the real world. It could contribute to inspiring authors, reviewers, and editors in producing, revising, and publishing more pieces of research considering that observational studies of rehabilitation in COVID-19 are probably the unique viable option if we want to expand our knowledge in this specific matter.…”