Patient-reported outcome measures 3 and 6 months after pulmonary rehabilitation following COVID-19

Abstract

Recent studies have suggested that pulmonary rehabilitation (PR) improves patient-reported outcome measures (PROMs) in patients recovering from COVID-19. Yet, there are hardly any studies that report the further course of recovery after PR. Therefore, we assessed PROMs regarding exertional dyspnea, fatigue, depression, anxiety, and quality of life (QoL) of 224 patients (Øage: 54.3±10.4; 42% female) who were admitted to a three-week inpatient PR between 4/2020 and 4/2021 due to COVID-19. Data were assessed at the beginning (T1) and at the end (T2) of PR as well as 3 months (T3) and 6 months (T4) afterwards. Repeated measures ANOVAs were calculated to reveal significant changes. In line with previous results, we found significant reductions in symptom severity regarding all PROMs over the course of PR (<i>d</i>_T1-T2=0.910 to <i>d</i>_T1-T2=1.538) and a significant increase in QoL (<i>d</i>_T1-T2=-1.238). While the improvements in exertional dyspnea and QoL persisted after PR (<i>p</i>_T2-T3=0.321 and <i>p</i>­_T2-T3=0.358), each other variable significantly deteriorated again at T3 (<i>d</i>_T2-T3=-0.386 to <i>d</i>_T2-T3=-0.933). However, significant improvements between T1 and T4 could be detected in each variable (<i>d</i>_T1-T4=0.567 to <i>d</i>_T1-T4=0.696) except for anxiety (<i>p</i>_­T1-T4=0.708). The improvements were associated with an increase in QoL (<i>d</i>_T1-T4=-1.010). Our results suggest that PR leads to significant improvements in clinically relevant PROMs. In most variables, the improvements may also persist after PR. Since we found no improvements in the further course, we conclude that the improvements were predominantly due to PR rather than to the natural course of recovery after COVID-19.