Advancing Pulmonary Rehabilitation Approach in Improving Well-being in a Long COVID-19 Syndrome Case

Abstract

Being a highly contagious disease, Coronavirus Disease-2019 (COVID-19) has shown its impact throughout the world. Clinical manifestations are seen primarily involving the respiratory system. Fever, cough, fatigue, and breathlessness are the commonly seen symptoms. Several cases of COVID-19 manifest as viral pneumonia-induced Acute Respiratory Distress Syndrome (ARDS). COVID19 symptoms appear not only during the course of the illness but also as its after effects. Long COVID-19 is said to be multisystem syndrome, categorised as postacute or chronic depending upon the time frame. It is characterized by the presence of symptoms beyond four weeks of the actual disease. Change in structural components in the lung leads to having a functional consequence on the body, affecting the cognitive, psychosocial, mental and physical well-being of the patients. Studies have shown alveolar damage same as ARDS. The most common pulmonary sequences seen are dyspnoea, cough (dry/with expectoration) and decreased diffusion capacity leading to reduced endurance. The present case report was of a 45-year-old nurse, who presented with the symptoms of postacute long COVID-19. Her previous scan of thorax showed a severity score of 11/25 after being tested COVID-19 positive. In view of the presenting complaints, a tailor-made pulmonary rehabilitation program was administered which showed great improvement in overall health condition. This case had been reported to document the effects of post COVID rehabilitation program on aspects such as functional capacity, quality of life, anxiety and depression using novel measures such as Incremental Shuttle Walk Test (ISWT), World Health Organisation Quality of Life-Brief Version (WHOQOL-BREF), and Depression, Anxiety and Stress Scale - 21 Items (DASS-21). Rehabilitation has been proven to be effective and safe in improving the exercise performance, quality of life affected due to COVID-19 and psychological function of the patients.