Background: Severe and critically ill COVID-19 patients frequently need pulmonary rehabilitation (PR) after hospitalization. However, little is known about the effectiveness of PR in COVID-19 patients. Methods: We compared the performances in the six-min walk test (6MWT), chronic respiratory questionnaire (CRQ), and functional independence measure (FIM) from inpatient PR between 51 COVID-19 patients and 51 other patients with common pneumonia. We used multivariate linear regression controlled for baseline values at entrance, age, sex, and cumulative illness rating scale. The odds ratios (ORs) of non-improvement/improvement in 6MWT (>30-m) and CRQ (>10-point) at discharge were compared between the two groups (Fisher’s exact test). Results: The two groups had similar improvements in 6MWT and CRQ, but the COVID-19 group achieved a 4-point higher FIM (p-value = 0.004). The OR of non-improvement/improvement in 6MWT was 0.30 (p-value = 0.13) between COVID-19 and controls; however, the odds of non-improvement in CRQ tended to be 3.02 times higher (p-value = 0.075) in COVID-19 patients. Severe and critical COVID-19 patients had similar rehabilitation outcomes. Conclusions: Inpatient PR can effectively improve physical functions and life quality in COVID-19 patients, irrespective of disease severity. Whether the relatively low gains in CRQ is an indicator of chronic disease development in COVID-19 patients needs further studies.

Clostridium botulinum type G has not been identified until now from humans or animals; it has been isolated only twice, from soil samples in Argentina. Type G organisms were isolated from necropsy specimens in four adults and an 18-week-old infant. Type G botulinal toxin was demonstrated in the serum of three of these individuals. The toxic dose in mice ranged from 2 to 7 50% lethal doses/ml. These persons died suddenly and unexpectedly at home, without any pathologic evidence to account for the cause of death in four cases. Symptoms in two individuals were similar to those observed in food-borne botulism. Thus, a prompt postmortem search for toxin and organisms of C. Botulinum in blood and feces may be worthwhile in determining the etiology of unexplained deaths. More microbiologic, physiologic, and toxicologic data are needed to clarify the role of C. botulinum in the pathogenesis of sudden unexpected death in infants and adults.

isrctn.org Identifier: ISRCTN40854211.

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