Department of Rehabilitation Sciences, Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany -
Ostseeklinik Schönberg-Holm, Schönberg-Holm, Germany.
Eur J Phys Rehabil Med. 2024 Aug;60(4):716-728. doi: 10.23736/S1973-9087.24.08207-8. Epub 2024 Jun 20.
Individuals with persistent impairments due to Coronavirus disease 2019 (COVID-19) can receive pulmonary rehabilitation in Germany. To date, there is no evidence of the medium- or long-term effects of pulmonary rehabilitation on Long COVID.
This study examined changes in health and occupational outcomes over time and described the therapeutic content of pulmonary rehabilitation and aftercare. This analysis also compared two rehabilitation groups after COVID-19 who had different levels of access to rehabilitation.
Longitudinal observational study with multicenter and prospective data collection.
Pulmonary rehabilitation in four different rehabilitation facilities in Germany.
Individuals with a mild course of disease and long-lasting impairments (inpatient rehabilitation, IR) and patients with a severe course after hospitalization (follow-up rehabilitation, FuR). Participants had to be between 18 and 65 years of age.
Written questionnaires were administered at the beginning and end of rehabilitation, as well as six and twelve months after rehabilitation. Health-related quality of life (HrQoL), fatigue, participation restrictions, COVID-19 symptoms, mental and physical health were assessed, as well as occupational outcomes and questions about rehabilitation and aftercare.
IR patients were predominantly female (68.0%) and 52 years of age on average, while 66.1% of Long COVID rehabilitees in FuR were male and three years older. Over the course of rehabilitation, most COVID-19 symptoms decreased with statistical significance. The subjective health scales showed improvements with medium to large effect sizes (ES) over time in IR (P<0.01; ES between 0.55 (cognitive fatigue) and 1.40 (physical fatigue)) and small to large effects in FuR (P<0.01; ES between 0.45 (anxiety) and 1.32 (physical fatigue)). One year after rehabilitation, most effects remained at a moderate level. After twelve months, an increase in neurocognitive symptoms was observed in FuR patients. More than 80% of employed people returned to work one year after rehabilitation, although FuR patients returned to work a median of four weeks later (P<0.01).
The comparative analysis showed that rehabilitees in different forms of rehabilitation attended rehabilitation with different impairments and rehabilitation goals, which are partly considered in treatment and aftercare.
To provide needs-based rehabilitation to different rehabilitation groups with Long COVID, knowledge of their health histories and preferences is necessary.
患有因 2019 年冠状病毒病（COVID-19）引起的持续性损害的个体可以在德国接受肺康复治疗。迄今为止，尚无关于肺康复对长 COVID 的中、长期影响的证据。
本研究旨在考察随着时间的推移健康和职业结果的变化，并描述肺康复和康复后的治疗内容。该分析还比较了 COVID-19 后两种康复水平不同的康复组。
具有多中心和前瞻性数据收集的纵向观察性研究。
德国四个不同康复机构的肺康复。
患有轻度疾病和长期损害的个体（住院康复，IR）和住院后患有严重疾病的患者（随访康复，FuR）。参与者必须在 18 至 65 岁之间。
在康复开始和结束时以及康复后 6 个月和 12 个月时进行书面问卷调查。评估健康相关生活质量（HrQoL）、疲劳、参与受限、COVID-19 症状、心理和身体健康，以及职业结果和关于康复和康复后护理的问题。
IR 患者主要为女性（68.0%），平均年龄为 52 岁，而 FuR 中有 66.1%的长 COVID 康复者为男性，年龄大 3 岁。在康复过程中，大多数 COVID-19 症状均有统计学意义的下降。主观健康量表显示，IR 中随时间的推移呈中到大效应量（ES）改善（P<0.01；ES 介于 0.55（认知疲劳）和 1.40（体力疲劳）之间），而 FuR 中呈小到中到大效应量改善（P<0.01；ES 介于 0.45（焦虑）和 1.32（体力疲劳）之间）。康复一年后，大多数影响仍处于中等水平。12 个月后，FuR 患者的神经认知症状增加。康复一年后，超过 80%的就业人员恢复工作，尽管 FuR 患者的工作恢复中位数晚了四周（P<0.01）。
对比分析表明，不同形式的康复中，康复者的康复损伤和康复目标不同，这在治疗和康复后护理中部分得到考虑。
为了为不同的长 COVID 康复群体提供基于需求的康复，了解他们的健康史和偏好是必要的。
