Pulmonary Rehabilitation Outcomes of Post-Acute COVID-19 Patients during Different Waves of the Pandemic.

(1) Background: Between the beginning of the coronavirus pandemic and summer 2022, we distinguished four pandemic waves, with different characteristics of the affected patients. This study investigated the impact of patient characteristics on the outcome of inpatient pulmonary rehabilitation (PR). (2) Methods: Using a prospective approach, the characteristics of post-acute COVID-19 patients of the different waves who participated in inpatient PR were compared based on their assessments and results collected as part of PR (Cumulative Illness Rating Scale (CIRS), six-minute walk test (6-MWT), Pulmonary Function Testing (PFT), and Functional Independent Measurement (FIM). (3) Results: A total of 483 patients were included in the analysis (Wave 1 n = 51, Wave 2 n = 202, Wave 3 n = 84, Wave 4 n = 146). Compared to Wave 3 + 4, patients of Wave 1 + 2 were older (69 vs. 63 years; p < 0.001), had a significantly lower CIRS (13.0 vs. 14.7 points; p = 0.004), had significant better PFT (FVC: 73 vs. 68%pred; p = 0.009; DLCOSB: 58 ± 18 vs. 50 ± 17%pred; p = 0.001), and showed significantly more comorbidities (2.0 vs. 1.6 n/pers.; p = 0.009). Wave 3 + 4 showed significantly greater improvements according to the 6-MWT (147 vs. 188 m; p < 0.001) and the FIM (5.6 vs. 21.1 points; p < 0.001). (4) Conclusions: Patients of the COVID-19 infection waves differed significantly according to their anthropometric data, incidence of comorbidities, and impact of the infection. All cohorts achieved clinically relevant and significant functional improvements during PR, with significant higher improvements in Wave 3 + 4.

Terra Firme-Forme Dermatosis Diagnostic Sign and Treatment: A Case Report.

Terra firma-forme dermatosis (TFFD) is a little-known disease of unknown etiology that clinically presents with asymptomatic brown to black plaques and resembles dirty skin. Here, we report the case of a 38-year-old woman with skin changes on her areolae that were mistakenly diagnosed as "dermatitis neglecta" by several physicians. Cleansing with water and soap had no impact on the skin appearance. But a swab of 70% isopropyl alcohol removed the plaques immediately, which confirmed the diagnosis of TFFD. Only a few cases of TFFD have been published, and this skin condition is not mentioned in many textbooks. Given the unfamiliarity of this disease, TFFD is speculated to be immensely underdiagnosed, even though a simple diagnostic sign exists.