Evaluation of the effectiveness of an outpatient rehabilitation course for patients previously hospitalised with COVID-19

Introduction: COVID-19 can result in persistent symptoms beyond resolution of acute illness. Rehabilitation courses known to be effective in respiratory or cardiac disease may aid recovery. Aim: To explore if a 6 week supervised rehabilitation course improves patient symptoms and function post COVID-19. Method: Patients were assessed pre & post a bi-weekly course using: Incremental Shuttle Walk Test (ISWT); 1 minute sit to stand test (1 min STS); quadriceps strength, MRC breathlessness, Functional Assessment of Chronic Illness Therapy – Fatigue scale (FACIT), EQ5D5L-UL and VAS, GAD-7 and PHQ-9. Progressive aerobic and resistance exercise was combined with education. Changes in outcomes are reported as mean(±SD). Paired t-tests assessed within subject change. Per protocol analysis was defined by completion of ≥75% planned sessions. Results: 13 patients enrolled, 10 completed (77%): age 57±13.6, 6 male, length of hospital stay 36.1 days (±38.1), days from discharge to enrolment 153.2 (±38.7). Improvements were seen in ISWT (139±152.6m; p=0.018), 1 min STS (6.0±4.4; p=0.001) and MRC (-0.6±0.5; p=0.005). Conclusion: These findings show a supervised rehabilitation course can improve exercise capacity, lower limb function and breathlessness in patients with persistent symptoms post COVID-19. Despite no overall change in fatigue, over half of patients demonstrated improvement in this domain. Further study is warranted to explore how best to deliver rehabilitation to impact the long term impairments seen with this novel disease.