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Benefits of pulmonary rehabilitation in COVID-19 – a prospective observational cohort study

Rainer Gloeckl, Daniela Leitl, Inga Jarosch, Tessa Schneeberger, Christoph Nell, Nikola Stenzel, Claus F. Vogelmeier, Klaus Kenn, Andreas R. Koczulla
ERJ Open Research 2021; DOI: 10.1183/23120541.00108-2021
Rainer Gloeckl
1Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
2Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
7These authors contributed equally to the preparation of this manuscript
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  • For correspondence: RGloeckl@Schoen-Klinik.de
Daniela Leitl
1Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
2Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
7These authors contributed equally to the preparation of this manuscript
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Inga Jarosch
1Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
2Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
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Tessa Schneeberger
1Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
2Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
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Christoph Nell
3Department of Pulmonology, Philipps-University Marburg, Marburg, Germany
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Nikola Stenzel
4Psychologische Hochschule Berlin (PHB), Berlin, Germany
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Claus F. Vogelmeier
5Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-Universität Marburg, Marburg, Germany; Member of the German Center for Lung Research (DZL), Marburg, Germany
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Klaus Kenn
1Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
2Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
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Andreas R. Koczulla
1Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
2Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
6Teaching hospital, Paracelsus Medical University, Salzburg, Austria
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Abstract

Background The new Corona-Virus disease (COVID-19) can result in a large variety of chronic health issues like impaired lung function, reduced exercise performance, and diminished quality of life. Our study aimed to investigate the efficacy, feasibility, and safety of pulmonary rehabilitation (PR) in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease.

Methods Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive three-week inpatient PR were included in this prospective, observational cohort study. Several measures of exercise performance (6-minute walk distance, 6MWD), lung function (forced vital capacity, FVC), and quality of life (36 question short-form health survey, SF-36) were assessed before and after PR.

Results Fifty patients were included in the study (24 with mild/moderate and 26 with severe/critical COVID-19). On admission, patients had a reduced 6MWD (mild: 509 m [426–539]; severe: 344 m [244–392]), an impaired FVC (mild: 80% [59–91]; severe: 75% [60–91]) and a low SF-36 mental health score (mild: 49 pts [37–54]; severe: 39 pts [30–53]). Patients attended a median of 100% [94–100] of all provided PR sessions. At discharge, patients in both subgroups improved in 6MWD (mild/moderate: +48 m [35–113 m]; severe/critical: +124 m [75–145 m], both p<0.001), FVC (mild/moderate: +7.7% [1.0–17.8], p=0.002; severe/critical: +11.3% [1.0–16.9], p<0.001) and SF-36 mental component (mild/moderate +5.6 pts [1.4–9.2], p=0.071; severe/critical: +14.4 pts [−0.6–24.5], p<0.001). No adverse event was observed.

Conclusion Our study shows that PR is a feasible, safe, and effective therapeutic option in COVID-19 patients independent of disease severity.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Gloeckl has nothing to disclose.

Conflict of interest: Dr. Leitl has nothing to disclose.

Conflict of interest: Dr. Jarosch has nothing to disclose.

Conflict of interest: Dr. Schneeberger has nothing to disclose.

Conflict of interest: Dr. Nell has nothing to disclose.

Conflict of interest: Dr. Stenzel has nothing to disclose.

Conflict of interest: Dr. Vogelmeier has nothing to disclose.

Conflict of interest: Dr. Kenn has nothing to disclose.

Conflict of interest: Dr. Koczulla has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received February 12, 2021.
  • Accepted February 23, 2021.
  • Copyright ©The authors 2021
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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Benefits of pulmonary rehabilitation in COVID-19 – a prospective observational cohort study
Rainer Gloeckl, Daniela Leitl, Inga Jarosch, Tessa Schneeberger, Christoph Nell, Nikola Stenzel, Claus F. Vogelmeier, Klaus Kenn, Andreas R. Koczulla
ERJ Open Research Jan 2021, 00108-2021; DOI: 10.1183/23120541.00108-2021

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Benefits of pulmonary rehabilitation in COVID-19 – a prospective observational cohort study
Rainer Gloeckl, Daniela Leitl, Inga Jarosch, Tessa Schneeberger, Christoph Nell, Nikola Stenzel, Claus F. Vogelmeier, Klaus Kenn, Andreas R. Koczulla
ERJ Open Research Jan 2021, 00108-2021; DOI: 10.1183/23120541.00108-2021
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