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

Gloeckl, Rainer; Leitl, Daniela; Jarosch, Inga; Schneeberger, Tessa; Nell, Christoph; Stenzel, Nikola; Vogelmeier, Claus F.; Kenn, Klaus; Koczulla, Andreas R.

BACKGROUND: The new Corona-Virus disease (COVID-19) can result in a large variety of chronic health issues like impaired lung function, reduced exercise performance, and diminished quality of life. Our study aimed to investigate the efficacy, feasibility, and safety of pulmonary rehabilitation (PR) in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease. METHODS: Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive three-week inpatient PR were included in this prospective, observational cohort study. Several measures of exercise performance (6-minute 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 PR. RESULTS: Fifty 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: 509 m [426–539]; severe: 344 m [244–392]), an impaired FVC (mild: 80% [59–91]; severe: 75% [60–91]) and a low SF-36 mental health score (mild: 49 pts [37–54]; severe: 39 pts [30–53]). Patients attended a median of 100% [94–100] of all provided PR 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 pts [1.4–9.2], p=0.071; severe/critical: +14.4 pts [−0.6–24.5], p<0.001). No adverse event was observed. CONCLUSION: Our study shows that PR is a feasible, safe, and effective therapeutic option in COVID-19 patients independent of disease severity.