Exercise helps support patients with lasting COVID-19 symptoms, study says

Patients with lasting novel coronavirus (COVID-19) symptoms who completed a six-week, supervised rehabilitation program demonstrated significant improvements in exercise capacity, respiratory symptoms, fatigue, and cognition, according to a new study published in the journal Chronic Respiratory Disease.

The study followed thirty patients who took part in face-to-face exercise rehabilitation classes twice a week over a period of six weeks. The program included aerobic exercise, such as walking or using a treadmill, strength training of the arms and legs, and educational discussions to support symptom management based upon the information on the Your COVID Recovery platform, developed by the National Institute for Health Research in the United Kingdom.

Researchers found a statistically significant improvement in exercise capacity, as measured by scores of distance travelled and ability to keep going without a rest using incremental and endurance shuttle-walking tests. They also found that fatigue improved by five points on the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale over the six-week period. In addition, participants demonstrated improvement in their overall wellbeing and cognition, as measured by standardized clinical assessment tools.

Participants were referred through a hospital discharge follow-up telephone assessment, at a face-to-face COVID-19 clinic assessment, or via their GP. Individuals were offered the opportunity to take part if they displayed physical and/or psychological symptoms that were affecting their daily activities. Patients were excluded if they demonstrated acute symptoms or were not medically stable (such as uncontrolled diabetes) or had only symptoms that were deemed unlikely to benefit from a pulmonary rehabilitation program, such as loss of taste or smell.

Of the participants, there was an even split between men and women, with an average of 58 years. Eighty-seven percent of participants were admitted to hospital with COVID-19, staying on average 10 days in hospital. Fourteen per cent required mechanical ventilation and were treated in an intensive care unit. Four individuals had a pre-existing respiratory condition, such as asthma or chronic obstructive pulmonary disease (COPD).

"We know that COVID-19 survivors present with a wide variety of symptoms and that a one-size-fits-all approach to managing these would not be appropriate,” said Enya Daynes, PhD, lead author of the study and a specialist pulmonary rehabilitation and research physiotherapist, in a statement. “However, there are some overlap between the needs of COVID-19 survivors and patients who have accessed pulmonary rehabilitation [PR] for other conditions, such as COPD. So, we modified our well-established PR course for COVID-19 survivors and measured their symptoms to assess whether the program could be of potential benefit.”

The research team acknowledges that as a cohort study there is no control group of people with similar symptoms who did not embark on the modified pulmonary rehabilitation course to offer a comparison and that further studies with a larger patient population are needed to confirm their preliminary findings.

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