Effectiveness of pulmonary rehabilitation in COVID-19 respiratory failure patients post-ICU

Abstract

Introduction Some COVID-19 patients develop respiratory failure requiring admission to intensive care unit (ICU). We aim to evaluate the effects of pulmonary rehabilitation (PR) post-ICU in COVID-19 patients. Methods Twenty-one COVID-19 patients were evaluated pre- and post-PR and compared retrospectively to a non-COVID-19 group of 21 patients rehabilitated after ICU admission due to respiratory failure. Results PR induced greater 6-min walking distance improvement in COVID-19 patients (+205 ± 121 m) than in other respiratory failure patients post-ICU (+93 ± 66 m). The sooner PR was performed post-ICU, the better patients recovered. Conclusions PR induced large functional improvements in COVID-19 patients post-ICU although significant physical and psychosocial impairments remained post-PR.

Short-term Effects of a Three-week Inpatient Post-COVID-19 Pulmonary Rehabilitation Program - a Prospective Observational Study

“…In conclusion, these results indicate that patients with severe forms of COVID-19 show greater improvements over the course of PR, especially if the beginning of treatment occurs soon after the acute phase. These results are in line with the ndings obtained by Al Chikhanie et al [52]. However, it is important to emphasize that signi cant improvements were also found in group C, with some strong (6MWD, EQ-5D-5L-VAS) and moderate effect sizes (PHQ-9).…”

“…The lung function pattern, which was more restrictive at baseline, improved in the overall group with a moderate effect size, with signi cant improvements in groups A and B. Similar lung function improvements were also seen in some other post-COVID-19 PR studies [43,46,52]. Maximal inspiratory pressure also improved in the total group, with a small effect size, with the most severe limitation and the smallest nonsigni cant improvement seen in group C at T 1 .…”

S1-Leitlinie Post-COVID/Long-COVID

“…B. die pulmonalen, neurologischen oder kardiologischen Schädigungen ("Impairment") für die Rehabilitationsbedürftigkeit führend, soll entsprechend eine indikationsspezifische pneumologische, neurologische oder kardiologische Rehabilitation erfolgen [175]. Je nach individueller Symptomatik sind dabei begleitend oder grundständig psychosomatische, psychiatrische und/oder psychologisch-psychotherapeutische Behandlungsangebote indiziert, wobei auch die physische Stabilisierung im Rahmen der medizinischen Rehabilitation wesentlich zur Reduktion der emotionalen Belastung beitragen kann [176]. Eine individuelle Betrachtung mit Fokus auf die Belastbarkeit ist auch für das multidimensionale Chronische Fatigue-Syndrom (G93.3) entsprechend Abschnitt 5 erforderlich.…”

Rehabilitation nach COVID-19-Erkrankung

“…Einige retrospektive Analysen haben bereits 2020 gezeigt, dass eine (cardio-) pulmonale Rehabilitation im Anschluss an eine COVID-19-Erkrankung machbar, sicher und effektiv ist [21] , [22] . Neuere prospektive Studien, insbesondere aus Deutschland und der Schweiz bestätigen diese ersten Studiendaten [23] .…”