Pulmonary rehabilitation in follow-up and inpatient rehabilitation for Long COVID: twelve months of follow-up.
Mercedes Rutsch, Heike Buhr-Schinner, Thomas Gross and 2 others
PMID 38903009WHAT IT FOUND
Long COVID patients improved during 21-day pulmonary rehabilitation, but fatigue and mental health problems worsened again by follow-up.
Among those employed at baseline, 86.9% of inpatient rehabilitation and 88.6% of follow-up rehabilitation patients had returned to work at 12 months.
Key findings
01Participants improved during rehabilitation, mostly with medium to large effects, but at follow-up fatigue and mental health outcomes increased while participation restrictions and physical quality of life continued to improve.
02Among patients employed at baseline, 86.9% of inpatient rehabilitation patients and 88.6% of follow-up rehabilitation patients reported returning to work 12 months after rehabilitation.
03Twelve months after rehabilitation, 33.1% of inpatient rehabilitation and 26.2% of follow-up rehabilitation respondents still had an increased risk of leaving the labor market prematurely.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
There was no control group without rehabilitation, so improvements during rehabilitation cannot be separated from natural recovery over time. Patients received multidisciplinary pulmonary rehabilitation with many therapies at the same time, so the contribution of endurance exercise, respiratory physiotherapy, psychological counselling, occupational therapy or any other single component cannot be separated. The study was conducted in the German rehabilitation system, so results may not apply where inpatient or follow-up rehabilitation is organised differently. Most outcomes were self-reported questionnaires, and participants did not complete all measurement points; missing values were excluded. Dropout analysis showed no major differences for most outcomes, but follow-up rehabilitation dropouts had a less severe initial COVID-19 course, and follow-up rehabilitation respondents included more people with severe or critical disease. The therapy section states pulmonary rehabilitation lasted 27 days, while the setting section describes a 21-day stay, so the exact duration is not fully clear. The study did not compare multidisciplinary rehabilitation with usual care, and the authors state there are currently no randomised controlled trials with sufficient numbers of cases for that comparison.
Declared interests
The authors declared no conflict of interest with any financial organization. The research was funded by the German Pension Insurance Association, grant number 0421/40-64-50-74. The authors report no involvement in the research by the sponsor.
The easy way to misread this
Do not read the improvements as proof that pulmonary rehabilitation caused them. The study had no control group and participants received many therapies at the same time, so natural recovery and the effect of any single component cannot be separated.