Benefits of pulmonary rehabilitation in COVID-19: a prospective observational cohort study.


Journal

ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 12 02 2021
accepted: 23 02 2021
entrez: 7 6 2021
pubmed: 8 6 2021
medline: 8 6 2021
Statut: epublish

Résumé

Coronavirus disease 2019 (COVID-19) can result in a large variety of chronic health issues such as impaired lung function, reduced exercise performance and diminished quality of life. Our study aimed to investigate the efficacy, feasibility and safety of pulmonary rehabilitation in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease. Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive 3-week inpatient pulmonary rehabilitation programme were included in this prospective, observational cohort study. Several measures of exercise performance (6-min walk distance (6MWD)), lung function (forced vital capacity (FVC)) and quality of life (36-question short-form health survey (SF-36)) were assessed before and after pulmonary rehabilitation. 50 patients were included in the study (24 with mild/moderate and 26 with severe/critical COVID-19). On admission, patients had a reduced 6MWD (mild: median 509 m, interquartile range (IQR) 426-539 m; severe: 344 m, 244-392 m), an impaired FVC (mild: 80%, 59-91%; severe: 75%, 60-91%) and a low SF-36 mental health score (mild: 49 points, 37-54 points; severe: 39 points, 30-53 points). Patients attended a median (IQR) 100% (94-100%) of all provided pulmonary rehabilitation sessions. At discharge, patients in both subgroups improved in 6MWD (mild/moderate: +48 m, 35-113 m; severe/critical: +124 m, 75-145 m; both p<0.001), FVC (mild/moderate: +7.7%, 1.0-17.8%, p=0.002; severe/critical: +11.3%, 1.0-16.9%, p<0.001) and SF-36 mental component (mild/moderate: +5.6 points, 1.4-9.2 points, p=0.071; severe/critical: +14.4 points, -0.6-24.5, p<0.001). No adverse event was observed. Our study shows that pulmonary rehabilitation is a feasible, safe and effective therapeutic option in COVID-19 patients independent of disease severity.

Sections du résumé

BACKGROUND BACKGROUND
Coronavirus disease 2019 (COVID-19) can result in a large variety of chronic health issues such as impaired lung function, reduced exercise performance and diminished quality of life. Our study aimed to investigate the efficacy, feasibility and safety of pulmonary rehabilitation in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease.
METHODS METHODS
Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive 3-week inpatient pulmonary rehabilitation programme were included in this prospective, observational cohort study. Several measures of exercise performance (6-min walk distance (6MWD)), lung function (forced vital capacity (FVC)) and quality of life (36-question short-form health survey (SF-36)) were assessed before and after pulmonary rehabilitation.
RESULTS RESULTS
50 patients were included in the study (24 with mild/moderate and 26 with severe/critical COVID-19). On admission, patients had a reduced 6MWD (mild: median 509 m, interquartile range (IQR) 426-539 m; severe: 344 m, 244-392 m), an impaired FVC (mild: 80%, 59-91%; severe: 75%, 60-91%) and a low SF-36 mental health score (mild: 49 points, 37-54 points; severe: 39 points, 30-53 points). Patients attended a median (IQR) 100% (94-100%) of all provided pulmonary rehabilitation sessions. At discharge, patients in both subgroups improved in 6MWD (mild/moderate: +48 m, 35-113 m; severe/critical: +124 m, 75-145 m; both p<0.001), FVC (mild/moderate: +7.7%, 1.0-17.8%, p=0.002; severe/critical: +11.3%, 1.0-16.9%, p<0.001) and SF-36 mental component (mild/moderate: +5.6 points, 1.4-9.2 points, p=0.071; severe/critical: +14.4 points, -0.6-24.5, p<0.001). No adverse event was observed.
CONCLUSION CONCLUSIONS
Our study shows that pulmonary rehabilitation is a feasible, safe and effective therapeutic option in COVID-19 patients independent of disease severity.

Identifiants

pubmed: 34095290
doi: 10.1183/23120541.00108-2021
pii: 00108-2021
pmc: PMC7957293
pii:
doi:

Types de publication

Journal Article Comment

Langues

eng

Commentaires et corrections

Type : CommentOn

Informations de copyright

Copyright ©The authors 2021.

Déclaration de conflit d'intérêts

Conflict of interest: R. Gloeckl has nothing to disclose. Conflict of interest: D. Leitl has nothing to disclose. Conflict of interest: I. Jarosch has nothing to disclose. Conflict of interest: T. Schneeberger has nothing to disclose. Conflict of interest: C. Nell has nothing to disclose. Conflict of interest: N. Stenzel has nothing to disclose. Conflict of interest: C.F. Vogelmeier has nothing to disclose. Conflict of interest: K. Kenn has nothing to disclose. Conflict of interest: A.R. Koczulla has nothing to disclose.

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Auteurs

Rainer Gloeckl (R)

Dept of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
These authors contributed equally.

Daniela Leitl (D)

Dept of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
These authors contributed equally.

Inga Jarosch (I)

Dept of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.

Tessa Schneeberger (T)

Dept of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.

Christoph Nell (C)

Dept of Pulmonology, Philipps-University Marburg, Marburg, Germany.

Nikola Stenzel (N)

Psychologische Hochschule Berlin (PHB), Berlin, Germany.

Claus F Vogelmeier (CF)

Dept of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University of Marburg, Member of the DZL, Marburg, Germany.

Klaus Kenn (K)

Dept of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.

Andreas R Koczulla (AR)

Dept of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
Teaching Hospital, Paracelsus Medical University, Salzburg, Austria.

Classifications MeSH