Pulmonary rehabilitation improves functional outcomes and quality of life in post-SARS-CoV-2 mild-to-moderate infection patients: a pilot study

Submitted: January 12, 2023
Accepted: April 3, 2023
Published: April 4, 2023
Abstract Views: 858
PDF: 255
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SARS-CoV-2 infection impairs functional outcomes and quality of life, even in its mild-to-moderate form. Therefore, it is appropriate to draw attention to the role played by respiratory rehabilitation and physiotherapists in the pulmonary rehabilitation process that post-SARS-CoV-2 patients must undergo. We enrolled 80 patients in a prospective case-control study; 40 cases (mild-to-moderate post-SARS-CoV-2 infection patients) and 38 control subjects (i.e., patients affected by other respiratory diseases) completed the same full pulmonary rehabilitation cycle. 6-minute walking distance, Borg category-ratio 10 scale, modified Medical Research Council (mMRC) dyspnea scale, European quality of life 5-dimensions-3-level (EuroQoL EQ-5D-3L) questionnaire, Barthel scale, arterial blood gas test, and peripheral oxygen saturation were compared for all patients before and after rehabilitation. All patients experienced significant improvements in all parameters analyzed, except for the arterial blood gas test. Results were similar for both groups; in particular, both groups experienced improvements in the mMRC scale, EuroQoL EQ-5D-3L questionnaire, Barthel scale, and 6-minute walking distance. Pulmonary rehabilitation appears to improve exercise tolerance, dyspnea, and quality of life in patients recovering from a mild-to-moderate SARS-CoV-2 infection. Further studies are needed on a larger sample size population to validate these results.



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Grigoletto I, Cavalheri V, F de Lima F, Cipulo Ramos EM. Recovery after COVID-19: the potential role of pulmonary rehabilitation. Braz J Phys Ther 2020;24:463-4.
Polastri M, Nava S, Clini E, et al. COVID-19 and pulmonary rehabilitation: preparing for phase three. Eur Respir J 2020;55:2001822.
Curci C, Pisano F, Bonacci E, et al. Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 rehabilitation unit and proposal of a treatment protocol. Eur J Phys Rehabil Med 2020;56:633-41.
Glöckl R, Buhr-Schinner H, Koczulla AR, et al. DGP-Empfehlungen zur pneumologischen Rehabilitation bei COVID-19. Pneumologie 2020;74:496-504. [Article in German].
Zampogna E, Paneroni M, Belli S, et al. Pulmonary rehabilitation in patients recovering from COVID-19. Respiration 2021;100:416-22.
Wang TJ, Chau B, Lui M et al. Physical medicine and rehabilitation and pulmonary rehabilitation for COVID-19. Am J Phys Med Rehabil 2020;99:769-74.
Orzes N, Pini L, Levi G, et al. A prospective evaluation of lung function at three and six months in patients with previous SARS-COV-2 pneumonia. Respir Med 2021;186:106541.
Santana AV, Fontana AD, Pitta F. Pulmonary rehabilitation after COVID-19. J Bras Pneumol 2021;47:e20210034.
Ismail AMA. Cancelled elderly exercise sessions during the COVID-19 crisis: can physical therapists help from their homes? Eur J Physiother 2020;22:235.
Ismail AMA. Online exercise rehabilitation to stable COPD patients during the second COVID wave: are physiotherapists able to help? Adv Rehabil 2020;34:48-9.‏
Ismail AMA. Robot-assisted rehabilitation: it is the time for utilisation in in-patient health care facilities to maintain the activity of the elderly during the COVID-19 pandemic. Int Marit Health 2021;72:80-1.
Pini L, Montori R, Giordani J et al. Assessment of respiratory function and exercise tolerance at 4-6 months after COVID-19 infection in patients with pneumonia of different severity. Intern Med J 2023;202-8.
Mahoney FI, Barthel D. Functional evaluation: the Barthel index. Md State Med J 1965;14:61-5.
National Institutes of Health. Coronavirus disease 2019 (COVID-19) treatment guidelines. Available from: https://www.covid19treatmentguidelines.nih.gov/. Accessed on: 12/03/2023.
Antonelli M, Donelli D. Respiratory rehabilitation for post-COVID19 patients in spa centers: first steps from theory to practice. Int J Biometeorol 2020;64:1811-3.
Wade DT. Rehabilitation after COVID-19: an evidence-based approach. Clin Med (Lond) 2020;20:359-65.
Sun T, Guo L, Tian F, et al. Rehabilitation of patients with COVID-19. Expert Rev Respir Med 2020;14:1249-56.
Barker-Davies RM, O'Sullivan O, Senaratne KPP, et al. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Br J Sports Med 2020;54:949-59.
Yang YC, Chou CL, Kao CL. Exercise, nutrition, and medication considerations in the light of the COVID pandemic, with specific focus on geriatric population: a literature review. J Chin Med Assoc 2020;83:977-80.

Ethics Approval

All patients underwent a standard pulmonary rehabilitation cycle, were followed by professional physiotherapists and signed an informed consent form (available upon request) for data protection and collection for scientific purposes.

How to Cite

Levi, Guido, Marco Umberto Scaramozzino, Stefania Cavallo, Giuliano Castignini, Michela Bezzi, Laura Pini, Frank Nania, and Sheenam Sheenam. 2023. “Pulmonary Rehabilitation Improves Functional Outcomes and Quality of Life in Post-SARS-CoV-2 Mild-to-Moderate Infection Patients: A Pilot Study”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2524.