Gloeckl Rainer, Leitl Daniela, Jarosch Inga, Schneeberger Tessa, Nell Christoph, Stenzel Nikola, Vogelmeier Claus F, Kenn Klaus, Koczulla Andreas R
Dept of Pulmonary Rehabilitation, Philipps-University of Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
ERJ Open Res. 2021 May 31;7(2). doi: 10.1183/23120541.00108-2021. eCollection 2021 Apr.
Coronavirus disease 2019 (COVID-19) can result in a large variety of chronic health issues such as impaired lung function, reduced exercise performance and diminished quality of life. Our study aimed to investigate the efficacy, feasibility and safety of pulmonary rehabilitation in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease.
Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive 3-week inpatient pulmonary rehabilitation programme were included in this prospective, observational cohort study. Several measures of exercise performance (6-min 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 pulmonary rehabilitation.
50 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: median 509 m, interquartile range (IQR) 426-539 m; severe: 344 m, 244-392 m), an impaired FVC (mild: 80%, 59-91%; severe: 75%, 60-91%) and a low SF-36 mental health score (mild: 49 points, 37-54 points; severe: 39 points, 30-53 points). Patients attended a median (IQR) 100% (94-100%) of all provided pulmonary rehabilitation 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 points, 1.4-9.2 points, p=0.071; severe/critical: +14.4 points, -0.6-24.5, p<0.001). No adverse event was observed.
Our study shows that pulmonary rehabilitation is a feasible, safe and effective therapeutic option in COVID-19 patients independent of disease severity.
2019冠状病毒病（COVID-19）可导致多种慢性健康问题，如肺功能受损、运动能力下降和生活质量降低。我们的研究旨在调查肺康复对COVID-19患者的疗效、可行性和安全性，并比较疾病轻度/中度和重度/危重症病程患者的结局。
本前瞻性观察性队列研究纳入了因COVID-19轻度至危重症病程进入为期3周的综合住院肺康复计划急性期后的患者。在肺康复前后评估了运动能力（6分钟步行距离（6MWD））、肺功能（用力肺活量（FVC））和生活质量（36项简短健康调查（SF-36））的多项指标。
50例患者纳入研究（24例为轻度/中度COVID-19，26例为重度/危重症COVID-19）。入院时，患者的6MWD降低（轻度：中位数509米，四分位间距（IQR）426 - 539米；重度：344米，244 - 392米），FVC受损（轻度：80%，59 - 91%；重度：75%，60 - 91%），SF-36心理健康评分较低（轻度：49分，37 - 54分；重度：39分，30 - 53分）。患者参加了所有提供的肺康复课程的中位数（IQR）为100%（94 - 100%）。出院时，两个亚组的患者在6MWD（轻度/中度：增加48米，35 - 113米；重度/危重症：增加124米，75 - 145米；均p<0.001）、FVC（轻度/中度：增加7.7%，1.0 - 17.8%，p = 0.002；重度/危重症：增加11.3%，1.0 - 16.9%，p<0.001）和SF-36心理成分（轻度/中度：增加5.6分，1.4 - 9.2分，p = 0.071；重度/危重症：增加14.4分，-0.6 - 24.5，p<0.001）方面均有改善。未观察到不良事件。
我们的研究表明，肺康复是COVID-19患者可行、安全且有效的治疗选择，与疾病严重程度无关。
