Post-COVID pulmonary rehabilitation at primary hospital in Nepal: Preliminary experience from LMIC

ABSTRACT

Introduction: Nepal is low and middle income country (LMIC) in South Asia with over 11 million SARS-CoV-2 infections reported till February 2022. Decline in lung function with poor functional status have been observed in substantial proportion among post-COVID patients in Nepal. Aims and objectives: The aim of this study was to assess benefits of pulmonary rehabilitation in post-COVID patients at Methinkot hospital, a primary level hospital in Nepal where specialized health services and rehabilitation facilities are not available. Method(s) A cross-sectional study was conducted in December 2021 at Methinkot hospital. Post-COVID patients with persistent symptoms were included. A structured pulmonary rehabilitation program comprising of breathing exercise, airway clearance technique, flexibility and endurance exercise was designed and was delivered by a visiting pulmonary rehabilitation specialist from tertiary hospital. Patients were instructed for thrice weekly home based rehabilitation for four weeks and were assessed at the end of four weeks. Result(s) Forty-two patients were included. Mean age of patients was 38.33+/-10.7 years. There were 17 (40.5 %) male. Shortness of breath on exertion (71.4%), fatigue (52.4%) and chest discomfort (35.7%) were the most common reported symptoms. Upon completion of four-week pulmonary rehabilitation, 34(81%) patients reported symptomatic improvement while 30(71.4%) reported rehabilitation measure to be beneficial. Conclusion(s) Early pulmonary rehabilitation service could be highly beneficial in reducing post-COVID morbidities. Establishment and continuation of sustainable and affordable rehabilitation service is challenging in resource limited setting.