ABSTRACT
Recent studies have suggested that pulmonary rehabilitation (PR) improves patient-reported outcome measures (PROMs) in patients recovering from COVID-19. Yet, there are hardly any studies that report the further course of recovery after PR. Therefore, we assessed PROMs regarding exertional dyspnea, fatigue, depression, anxiety, and quality of life (QoL) of 224 patients (Oage: 54.3+/-10.4;42% female) who were admitted to a three-week inpatient PR between 4/2020 and 4/2021 due to COVID-19. Data were assessed at the beginning (T1) and at the end (T2) of PR as well as 3 months (T3) and 6 months (T4) afterwards. Repeated measures ANOVAs were calculated to reveal significant changes. In line with previous results, we found significant reductions in symptom severity regarding all PROMs over the course of PR (dT1-T2 =0.910 to dT1-T2=1.538) and a significant increase in QoL (dT1-T2=-1.238). While the improvements in exertional dyspnea and QoL persisted after PR (PT2-T3 =0.321 and pT2-T3=0.358), each other variable significantly deteriorated again at T3 (dT2-T3=-0.386 to dT2-T3=-0.933). However, significant improvements between T1 and T4 could be detected in each variable (dT1-T4=0.567 to dT1-T4=0.696) except for anxiety (pT1-T4=0.708). The improvements were associated with an increase in QoL (dT1-T4=-1.010). Our results suggest that PR leads to significant improvements in clinically relevant PROMs. In most variables, the improvements may also persist after PR. Since we found no improvements in the further course, we conclude that the improvements were predominantly due to PR rather than to the natural course of recovery after COVID-19.
ABSTRACT
Both during and after the acute phase, COVID-19 is associated with a variety of clinical symptoms, many of which may persist even several months after the infection [1, 2]. One of the most common symptoms that is likely to persist is fatigue [1, 3]. Despite intensive research, little is known about the factors that contribute to the development and persistence of fatigue during and after COVID-19 [3]. Since sleep apnoea and particularly more severe forms are commonly associated with tiredness and exertion, an increased rate of sleep apnoea may explain at least in part the commonly mentioned fatigue symptoms.