Effects of pulmonary rehabilitation on major symptoms of long COVID (post-COVID-19 syndrome)

ABSTRACT

Several months after COVID-19 infection, a high proportion of patients complains of persistent symptoms (long COVID). Regardless of acute disease severity, dyspnea and fatigue are part of major symptoms. Spontaneous recovery is unlikely without any intervention. Thus, our aim was to assess the feasibility and efficacy of a pulmonary rehabilitation (PR) program to relieve these symptoms. 39 patients with a documented COVID-19 infection and suffering from persistent symptoms were included. They took part in PR program between Feb.-Dec. 2021. The program comprised, at the very least, 18 endurance and 10 resistance training sessions and 6 educational sessions (dyspnea management, psychological support and counselling). Exercise tolerance (ET), dyspnea (D-12), fatigue (MFI-20) and quality of life (QoL) were assessed by questionnaires before (T1) and after (T2) PR. Main delay between first symptoms and PR enrolment was 297+/-131 days. Main symptoms were dyspnea (n=34), fatigue (n=29), concentration disorders (n=16) and musculoskeletal pain (n=15). After PR, D-12 and MFI-20 decreased significantly (T115.5+/-8;T2 8.3+/-5.6;p<.05 and T1 65.6+/-14.3;T253.2+/-12.8;p<.05, respectively). In addition, QoL, through physical (PCS) and mental (MCS) dimensions, and ET significantly improved (PCS (T1) 34.8+/-9.7;PCS (T2) 42.7+/-8.3;p<.01;MCS (T1) 40.3+/-9.3;MCS (T2) 48.8+/-8.5;p<.01 and T1 516.6+/-131.6 m;T2 602.6+/-118.8 m;p<.05, respectively). PR appears to be a safe, feasible and efficient therapy to relieve dyspnea and fatigue in patients with residual symptoms of COVID-19 several months after initial infection. In addition, PR allows a significant improvement in ET and QoL for these patients.