1
|
Mujovic N, Nikolic D, Markovic F, Stjepanovic M, Zekovic M, Ali HSH, Zivanovic D, Savic M, Laban M. The Effects of Six Weeks Pulmonary Rehabilitation on Functional and Psychological Outcomes in Long-COVID Patients: Preliminary Results from Serbian Single Center Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:671. [PMID: 38674318 PMCID: PMC11052156 DOI: 10.3390/medicina60040671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: In this study, we aimed to evaluate the effects of six weeks of pulmonary rehabilitation on functional and psychological outcomes in long-COVID patients. Material and Methods: The prospective clinical study included 46 patients that were diagnosed with COVID-19. A respiratory rehabilitation program was implemented for six weeks. Further valuables were tested before the beginning of the rehabilitation program (admission) and six weeks after (discharge): SpO2, heart rate, respiratory rate, Visual Analogue Scale (VAS) score, Borg score, Sit-to-Stand (StS) test number of repetition, distance of 6-Minute Walking Test (6MWT), Patient Health Questionnaire (PHQ) 9 score and Generalized anxiety disorder (GAD) anxiety score. These parameters were tested before the rehabilitation program on admission and at discharge and after the rehabilitation program on admission and at discharge. The results were presented with standard descriptive and analytical methods. Differences between the continuous variables before and after physical rehabilitation intervention were tested using the Wilcoxon test. Graphical analysis is presented with a box plot. Results: On discharge, in comparison with admission, the values of SpO2 were significantly lower (p = 0.007) before the 6MWT, and VAS scores were significantly higher (p = 0.036), while after the 6MWT, VAS scores were significantly lower (p < 0.001) as were Borg scores (p = 0.016). On discharge, in comparison with admission, the respiratory rate was significantly higher (p = 0.005) before the StS test, and Borg scores were significantly lower (p = 0.001), while after the StS test, SpO2 levels were significantly higher (p = 0.036) and VAS scores were significantly lower (p < 0.001), as were Borg scores (p = 0.008). After discharge, the values of the StS test were significantly higher (p = 0.011), PHQ9 scores were significantly lower (p < 0.001) and GAD anxiety scores were significantly lower as well (p = 0.005), while the distances measured in meters on the 6MWT were significantly increased (p < 0.001). Conclusions: A structured rehabilitation program in our study was shown to have beneficial effects on physiological, psychological and functional improvements in patients with long-COVID, and therefore it is advisable for these patients.
Collapse
Affiliation(s)
- Natasa Mujovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.S.); (D.Z.); (M.S.)
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.S.); (D.Z.); (M.S.)
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
| | - Filip Markovic
- Clinic for Pulmonary Diseases, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (F.M.); (M.L.)
| | - Mihailo Stjepanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.S.); (D.Z.); (M.S.)
- Clinic for Pulmonary Diseases, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (F.M.); (M.L.)
| | - Milica Zekovic
- Laboratory for Sports Medicine and Exercise Therapy, Institute of Medical Physiology “Rihard Burijan”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | | | - Dubravka Zivanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.S.); (D.Z.); (M.S.)
- Clinic of Dermatology and Venerology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milan Savic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.N.); (M.S.); (D.Z.); (M.S.)
- Clinic for Lung Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Marija Laban
- Clinic for Pulmonary Diseases, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (F.M.); (M.L.)
| |
Collapse
|
2
|
Dierckx W, De Backer W, De Meyer Y, Lauwers E, Franck E, De Backer J, Ides K. Personalized pulmonary rehabilitation program for patients with post-acute sequelae of COVID-19: A proof-of-concept retrospective study. Physiol Rep 2024; 12:e15931. [PMID: 38296347 PMCID: PMC10830387 DOI: 10.14814/phy2.15931] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/05/2024] Open
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.
Collapse
Affiliation(s)
- Wendel Dierckx
- Centre for Research and Innovation in Care, Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
- Multidisciplinary Medical CentreMedImprove BVKontichBelgium
| | - Wilfried De Backer
- Multidisciplinary Medical CentreMedImprove BVKontichBelgium
- Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
- FLUIDDA NVKontichBelgium
| | - Yinka De Meyer
- Multidisciplinary Medical CentreMedImprove BVKontichBelgium
- Clinical OperationsFLUIDDA NVKontichBelgium
| | - Eline Lauwers
- Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
- Clinical OperationsFLUIDDA NVKontichBelgium
| | - Erik Franck
- Centre for Research and Innovation in Care, Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
| | | | - Kris Ides
- Multidisciplinary Medical CentreMedImprove BVKontichBelgium
- Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
- CoSys Research Lab, Faculty of Applied EngineeringUniversity of AntwerpAntwerpBelgium
- Flanders Make Strategic Research CentreLommelBelgium
- Department of PaediatricsAntwerp University HospitalEdegemBelgium
| |
Collapse
|