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. 2024 Feb;12(3):e15931.
doi: 10.14814/phy2.15931.

Personalized pulmonary rehabilitation program for patients with post-acute sequelae of COVID-19: A proof-of-concept retrospective study

Wendel Dierckx  1   2 , Wilfried De Backer  2   3   4 , Yinka De Meyer  2   5 , Eline Lauwers  3   5 , Erik Franck  1 , Jan De Backer  6 , Kris Ides  2   3   7   8   9
Affiliations

Personalized pulmonary rehabilitation program for patients with post-acute sequelae of COVID-19: A proof-of-concept retrospective study

Wendel Dierckx et al. Physiol Rep. 2024 Feb.

Abstract

Long-COVID patients present with a decline in physical fitness. The aim of this study is to reveal the impact of pulmonary rehabilitation (PR) on physical fitness, quality of life (QoL), and parameters of quantified thorax CT. Long-COVID patients enrolled in a 3-month PR program were retrospectively studied. PR included endurance and resistance training three times a week. Assessments pre- and post-rehabilitation included quantified chest CT, pulmonary function tests (PFT), six-minute walk test (6MWT), cardiopulmonary exercise test, and questionnaires: Hospital Anxiety and Depression Scale, post-COVID-19 Functional Status scale, Borg score, and EuroQol. Seventeen subjects (5M/12F), mean age 42 ± 13 years, were included. PR improved all questionnaires' results significantly. Only significant difference in PFT parameters was correlation between baseline total lung capacity (TLC) and difference in TLC pre- and post-rehabilitation (p = 0.002). 6MWT increased from 329 to 365 m (p < 0.001), VO2max changed from 21 to 24 mL/kg/min (p = 0.007), peak load increased from 116 to 141 Watt (p < 0.001). Blood volume in small pulmonary vessels of 1.25 to 5 mm2 in cross-sectional area (BV5%) was higher than observed in patients with acute COVID-19 infection. After rehabilitation, BV5% decreased from 65% to 62% (p = 0.020). These changes correlated directly with changes in TLC (p = 0.039). Quantified CT airway volume increased after rehabilitation (p = 0.013). After rehabilitation, TLC tended to normalize due to (re)opening of small airways, with decline in air trapping and recruitment of alveoli. Furthermore, this study revealed that pulmonary rehabilitation can improve QoL and physical fitness in long-COVID patients.

Keywords: COVID-19; PASC; functional respiratory imaging; pulmonary rehabilitation.

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Figures

FIGURE 1
FIGURE 1
Differences in spectrum plot of BV5% at baseline. FRI revealed a declinded BV5% in subject a and b. Those subjects were excluded from the study. Subjects c and d showed an increased BV5% and were enrolled in de pulmonary rehabilitation program.
FIGURE 2
FIGURE 2
Flowchart of the enrolment.
FIGURE 3
FIGURE 3
Correlation between baseline TLC and changes in TLC.
FIGURE 4
FIGURE 4
Evolution of airway volumes. Evolution in spectrum of the small blood vessels.
See this image and copyright information in PMC

References

    1. Ahmed, I. , Mustafaoglu, R. , Yeldan, I. , Yasaci, Z. , & Erhan, B. (2022). Effect of pulmonary rehabilitation approaches on dyspnea, exercise capacity, fatigue, lung functions, and quality of life in patients with COVID‐19: A systematic review and meta‐analysis. Archives of Physical Medicine and Rehabilitation, 103, 2051–2062. - PMC - PubMed
    1. Aparisi, Á. , Ybarra‐Falcón, C. , García‐Gómez, M. , Tobar, J. , Iglesias‐Echeverría, C. , Jaurrieta‐Largo, S. , Ladrón, R. , Uribarri, A. , Catalá, P. , Hinojosa, W. , Marcos‐Mangas, M. , Fernández‐Prieto, L. , Sedano‐Gutiérrez, R. , Cusacovich, I. , Andaluz‐Ojeda, D. , De Vega‐Sánchez, B. , Recio‐Platero, A. , Sanz‐Patiño, E. , Calvo, D. , … San Román, J. A. (2021). Clinical medicine exercise ventilatory inefficiency in post‐COVID‐19 syndrome: Insights from a prospective evaluation. Journal of Clinical Medicine, 10, 2591. - PMC - PubMed
    1. Benkalfate, N. , Eschapasse, E. , Georges, T. , Leblanc, C. , Dirou, S. , Melscoet, L. , Chéné, A. L. , Horeau‐Langlard, D. , Bry, C. , Chambellan, A. , Nicolas, A. , Claire, D. , Liberge, R. , Karakachoff, M. , Hardouin, J. B. , Blanc, F. X. , & Lemarchand, P. (2022). Evaluation of the post‐COVID‐19 functional status (PCFS) scale in a cohort of patients recovering from hypoxemic SARS‐CoV‐2 pneumonia. BMJ Open Respiratory Research, 9(1), e001136. - PMC - PubMed
    1. Chen, C. , Haupert, S. R. , Zimmermann, L. , Shi, X. , Fritsche, L. G. , & Mukherjee, B. (2022). Global prevalence of post‐coronavirus disease 2019 (COVID‐19) condition or long COVID: A meta‐analysis and systematic review. The Journal of Infectious Diseases, 226(9), 1593–1607. - PMC - PubMed
    1. Cho, J. L. , Villacreses, R. , Nagpal, P. , Guo, J. , Pezzulo, A. A. , Thurman, A. L. , Hamzeh, N. Y. , Blount, R. J. , Fortis, S. , Hoffman, E. A. , Zabner, J. , & Comellas, A. P. (2022). Quantitative chest CT assessment of small airways disease in post‐acute SARS‐CoV‐2 infection. Radiology, 304(1), 185–192. - PMC - PubMed