EXERCISE CAPACITY AND HEALTH-RELATED QUALITY OF LIFE IN SURVIVORS OF COVID-19 PNEUMONIA

ABSTRACT

TOPIC Chest Infections TYPE Original Investigations PURPOSE: To determine the effect of COVID-19 pneumonia on exercise capacity and quality of life among healthcare workers of the Philippine Heart Center who survived the disease. METHODS: This was a prospective cohort study conducted at the Philippine Heart Center (PHC) from September 2020 to January 2021. PHC Healthcare workers aged =/> 19 years old, discharged from PHC as a case of recovered COVID-19 Pneumonia were included. Those with signs and symptoms of possible COVID-19 reinfection, history of pulmonary resection, neurological or psychiatric disease, COPD, lung malignancies, or fulfilled any of the contraindications for a 6-Minute walk test (6MWT) were excluded. Participants were evaluated at the research site at 3 and 6 months from onset of illness (+/-2 weeks). During each visit, they were assessed for signs and symptoms of possible COVID-19 reinfection, vital signs were taken, 6MWT and the RAND free version of the Medical Outcomes Study 36-item Short Form General Health Survey (SF-36) questionnaires were completed. One-way ANOVA, Kruskal-Wallis test and Fisher's exact test were used to determine the difference of mean, rank and frequency within the three different COVID-19 severities. Paired Sample T-test or Wilcoxon Sign rank test was used to determine the difference of mean or rank from 3rd month to 6th month. Shapiro-Wilk was used to test the normality of the continuous variables. Null hypotheses was rejected at 0.05α-level of significance. RESULTS: Our study revealed that 3 months from illness-onset, COVID-19 survivors had lower average 6MWD (374 meters;326-404) compared to the general Filipino population. The 6MWD was also proportional to the severity of the disease, mild 393;369-426 vs moderate 318;304-326, vs severe147;129-167, p=0.001.Those who had mild (p=0.000) and moderate disease (p= 0.0076) had significant improvements in the 6MWD six months from the onset of illness, in contrast to those who had severe COVID-19 disease (p=0.431). Although there was appreciable improvement in the 6MWD for mild and moderate disease, the actual 6MWD achieved was still subpar with the reference values for the general Filipino population. Majority of the domains of the SF-36 where all lower compared with the general Filipino population. Among these, physical functioning, social functioning, role limitations due to physical problems and general health scored the lowest in our study. CONCLUSIONS: We have demonstrated that statistically significant, but not clinically relevant improvements on exercise capacity may be observed on healthcare workers who survived COVID-19 pneumonia. Furthermore, impairment on exercise capacity and health-related quality of life still persists in patients with COVID-19 pneumonia even after 6 months. CLINICAL IMPLICATIONS This finding underscores the need for large-scale follow up and early intervention to improve residual impairments in patients who had COVID-19. DISCLOSURES No relevant relationships by Jamaica Ross David, source=Web Response No relevant relationships by Maria Encarnita Limpin, source=Web Response no disclosure on file for Bernice Ong-Dela Cruz;