Breathing and Relaxation Exercises Help Improving Fear of COVID-19, Anxiety, and Sleep Quality: A Randomized Controlled Trial.

Objective: To investigate the effects of breathing and relaxation exercises performed via telerehabilitation on fear, anxiety, sleep quality, and quality of life of individuals without coronavirus disease 2019 (COVID-19) during the ongoing pandemic. Design: A prospective, randomized, controlled single-blind study. Methods: Fifty participants who had not been exposed to the COVID-19 virus earlier were randomly divided into experimental (n = 25) and control groups (n = 25). Both groups received an information session about COVID-19 once at the start of the study via a mobile phone video application. The experimental group also performed a breathing and relaxation exercise program twice daily (morning and evening), 7 days per week, for 4 weeks; one session of the program was conducted under the remote supervision of a physiotherapist as telerehabilitation, and the remaining sessions were performed as a home program. The Fear of COVID-19 Scale (FCV-19S), which was the primary outcome measure, The Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and EQ-5D-3L were administered to both groups. Results: The FCV-19S, HAMA, and PSQI were statistically significantly improved to compare the controls, with a large effect size (ηp2 = 0.135, 0.313, and 0.200, respectively). The EQ-5D-3L index and EQ-5D-3L visual analog scale were not statistically significantly different compared with the controls; however, a small effect size was detected for the differences between the two groups (ηp2 = 0.056 and 0.013, respectively). Conclusion: Breathing and relaxation exercises appear to be an effective and feasible approach to support mental health and sleep quality during the COVID-19 pandemic. Especially in highly contagious diseases such as COVID-19, telerehabilitation approaches may be useful for safely reaching individuals by eliminating human-to-human contact. Clinical Trial Registration number: NCT04910932.

Long-Term Characteristics of Severe COVID-19: Respiratory Function, Functional Capacity, and Quality of Life.

Recovery from pneumonia takes around 3-6 months in individuals with severe COVID-19. In order to detect the isolated damage caused by COVID-19, the 6-month period must pass after the recoveries. However, to our knowledge, no published study analyzes a comprehensive evaluation of individuals with severe COVID-19 after 6 months. We aimed to evaluate long-term consequences of severe COVID patients by comparing respiratory function, functional capacity, quality of life, fatigue, and balance 6 months after the intensive care unit (ICU) discharge with healthy individuals. METHOD: 26 post-COVID adult patients and 26 healthy individuals (control group) were included in this study. Physical characteristics of both groups and patients' ICU data, including APACHE II scores, were recorded. Lung function, respiratory, and peripheral muscle strength were measured. The lower limit of normal (LLN) cutoff points for forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were calculated. A 6-minute walk test (6MWT) was used to assess functional capacity. Time Up and Go test (TUG) with a stadiometer was performed for balance evaluation. Quality of life was evaluated using Nottingham Health Profile (NHP) and St George Respiratory Questionnaire (SGRQ). RESULTS: Percent predicted FVC and FEV1, 6MWT distance, change in oxygen saturation (SpO2) during 6MWT, were lower and NHP, SGRQ, FSS scores and TUG findings were higher in the COVID group than the control group (p < 0.05). The FVC of nine individuals and the FEV1 value of seven individuals in the COVID-19 group were below the LLN values. A moderate correlation was found between ICU length of stay and APACHE II scores with FVC, FEV1, 6MWT distance, and change in SpO2 values in the COVID-19 patients (p < 0.05). CONCLUSION: Respiratory function, functional capacity, quality of life, and fatigue levels of the individuals with severe COVID-19 infection are impaired at 6 months after ICU discharge. Impaired lung function might be associated with severe inflammation, which starts during the acute infection process and the fibrous tissue during the healing process, impairing lung compliance and diffusion capacity. Infiltration of coronavirus and inflammatory cytokines into the cerebrum and muscle might have increased fatigue and decreased functional capacity. Overall, our study suggests that severe COVID patients need post-discharge care even after 6 months of recovery.

Long-Term Characteristics of Severe COVID-19: Respiratory Function, Functional Capacity, and Quality of Life

Recovery from pneumonia takes around 3–6 months in individuals with severe COVID-19. In order to detect the isolated damage caused by COVID-19, the 6-month period must pass after the recoveries. However, to our knowledge, no published study analyzes a comprehensive evaluation of individuals with severe COVID-19 after 6 months. We aimed to evaluate long-term consequences of severe COVID patients by comparing respiratory function, functional capacity, quality of life, fatigue, and balance 6 months after the intensive care unit (ICU) discharge with healthy individuals. Method: 26 post-COVID adult patients and 26 healthy individuals (control group) were included in this study. Physical characteristics of both groups and patients' ICU data, including APACHE II scores, were recorded. Lung function, respiratory, and peripheral muscle strength were measured. The lower limit of normal (LLN) cutoff points for forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were calculated. A 6-minute walk test (6MWT) was used to assess functional capacity. Time Up and Go test (TUG) with a stadiometer was performed for balance evaluation. Quality of life was evaluated using Nottingham Health Profile (NHP) and St George Respiratory Questionnaire (SGRQ). Results: Percent predicted FVC and FEV1, 6MWT distance, change in oxygen saturation (SpO2) during 6MWT, were lower and NHP, SGRQ, FSS scores and TUG findings were higher in the COVID group than the control group (p < 0.05). The FVC of nine individuals and the FEV1 value of seven individuals in the COVID-19 group were below the LLN values. A moderate correlation was found between ICU length of stay and APACHE II scores with FVC, FEV1, 6MWT distance, and change in SpO2 values in the COVID-19 patients (p < 0.05). Conclusion: Respiratory function, functional capacity, quality of life, and fatigue levels of the individuals with severe COVID-19 infection are impaired at 6 months after ICU discharge. Impaired lung function might be associated with severe inflammation, which starts during the acute infection process and the fibrous tissue during the healing process, impairing lung compliance and diffusion capacity. Infiltration of coronavirus and inflammatory cytokines into the cerebrum and muscle might have increased fatigue and decreased functional capacity. Overall, our study suggests that severe COVID patients need post-discharge care even after 6 months of recovery.