Improved peak exercise performance after 12 weeks of pulmonary rehabilitation in patients post COVID-19

ABSTRACT

Background: Pulmonary Rehabilitation (PR) is recommended for patients that suffered from severe COVID19. The exercise and training response as well as predictors of response are not yet well studied. Aim(s) To study the response to an incremental exercise test performed before and after 12 weeks of outpatient PR. Method(s) An exercise test was conducted in 37 of 70 patients that completed PR after COVID19, (age 52+/-9, BMI 29+/-6, 20 male, FEV1 89+/-21%pre, 31 hospitalized). Result(s) Before starting PR, exercise tolerance was reduced. A cardiac, ventilatory, gas exchange and muscular limitation was observed in 24%, 22%, 37% and 45% of patients respectively. Physiologic limitations were inconclusive in 19% of patients. After completing PR, significant desaturation was still seen in 30% of patients. Rehabilitation increased Wmax by 58+/-55% and VO2max by 40+/-38% of baseline values with significant improvements in O2pulse (see table1). Multiple regression revealed that improvement in VO2peak was associated with gender (+386ml/min in male p=0.01 Partial R2=0.14), and Hospital anxiety and depression scale -21ml/min per baseline point in total score (partial R2 0.18 p=0.03). Quadriceps force did not significantly enter the model (p=0.1). Conclusion(s) Peak exercise tolerance increased rapidly upon initiation of PR in patients after COVID19. In patients with psychologic morbidity at baseline, this response seems somewhat blunted.