(VP017) CARDIOPULMONARY REHABILITATION IMPROVES CARDIORESPIRATORY FITNESS IN LONG-COVID-19 PATIENTS: A RANDOMIZED CONTROLLED TRIAL

Background: Long COVID-19 syndrome is when symptoms persist for more than 3 months after the infection (around 15% of adults infected by COVID-19). Long COVID-19 is a multi-system disease with over 100 listed symptoms; the most common are fatigue, trouble sleeping, breathlessness, pain and cognitive problems. Some studies have evaluated the effect of rehabilitation programs on respiratory and physical functions, but randomized controlled trials are needed.

Objective: To investigate the effectiveness of an eight-week cardiopulmonary rehabilitation program on cardiorespiratory fitness (VO2peak), respiratory capacity (spirometry test), quality of life (SF-36), post COVID-19 functional status (PCFS) and Medical Research Council (MRC) dyspnoea scale in individuals with long-COVID-19.

METHODS AND RESULTS: Forty individuals with long COVID-19 (26 women and 14 men, mean age 53±11 years, mean days with long-COVID 427±224 days, 15% were hospitalized, 6% were hospitalized in an intensive care unit, 79% were not hospitalized during acute infection) were randomized into 2 groups: 1/ rehabilitation: centre-based individualized exercise-training program (eight weeks, three times per week with light to moderate aerobic exercise, muscle strengthening and daily respiratory exercises) and 2/ control: individuals maintain their daily habits during an eight-week period.

No significant differences between groups were detected at baseline (age, sex, BMI, VO2peak, duration of long-COVID). VO2peak improved significantly in the rehab group compared to the control group (from 20.2±5.1 to 22.8±5.6 and from 18.2±4.5 to 18.6±3.8 mL.kg.min respectively, p=0.005). First ventilatory threshold also improved significantly in the rehab group (from 14.2±2.7 to 15.4±3.4 and from 13.1±1.8 to 13.0±2.9 mL.kg.min respectively, p=0.045). In the rehab group, 66% of individuals improved their functional status on the PCFS scale versus 33% in the control group (p=0.063). Fourty-one % of individuals in the rehab group improved their perceived breathlessness on the MRC dyspnoea scale versus 5.5% in the control group (p=0.043). Forced expiratory volume in 1 second was normal at baseline and did not change after the study for any group. Bodily Pain significantly improved and to a greater extent in the rehab group compared to the control group (p=0.019). The Mental Health scale (SF-36) improved in a similar way (p=0.003).

Conclusion:

Conclusion: An individualized and supervised cardiopulmonary rehabilitation training is safe and effective to improve cardiorespiratory fitness, symptoms, general pain and mental health in individuals with long COVID-19. A clinical assessment of people affected by long-COVID is necessary before starting a rehabilitation program and the thresholds for triggering post-exertional malaise must be considered.