Hybrid Pulmonary Rehabilitation Improves Cardiorespiratory Exercise Fitness in Formerly Hospitalised Long COVID Patients, 2025, Chynkiamis et al

[forestglip]

Hybrid Pulmonary Rehabilitation Improves Cardiorespiratory Exercise Fitness in Formerly Hospitalised Long COVID Patients
Nikolaos Chynkiamis, Angelos Vontetsianos, Christina Anagnostopoulou, Christiana Lekka, Maria Ioanna Gounaridi, Evangelos Oikonomou, Manolis Vavuranakis, Nikoleta Rovina, Petros Bakakos, Nikolaos Koulouris, Georgios Kaltsakas, Ioannis Vogiatzis

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Background/Objectives
Supervised pulmonary rehabilitation (PR) is effective in improving cardiorespiratory fitness in non-hospitalised individuals with long COVID. However, there is limited evidence regarding PR-induced improvements in cardiorespiratory parameters in previously hospitalised COVID-19 survivors.

This study aimed to investigate the effect of a hybrid PR programme (outpatient followed by a digital intervention) on exercise tolerance, cardiorespiratory adaptations, functional capacity and quality of life outcomes in previously hospitalised COVID-19 survivors.

Methods
Forty-two patients (age (mean ± SD): 57 ± 12 yrs) with excessive fatigue due to long COVID (FACIT score (26 ± 10) were allocated to PR (n = 27) or usual care (UC) (n = 15) 140 ± 75 days from hospital discharge.

PR consisted of 8 outpatient sessions (twice weekly for 4 weeks) followed by 24 home-based sessions (3 times/week for 8 weeks). Patients in the UC group were instructed to be physically active. Exercise tolerance was assessed by cardiopulmonary cycling testing to the limit of tolerance.

Results
Following the completion of the hybrid PR programme, peak work rate (WRpeak) and peak oxygen uptake (VO2peak) were, respectively, improved in the PR group by 19 ± 10 Watt (p = 0.001) and by 2.4 ± 3.0 mL/kg/min (p = 0.001).

Furthermore, in the PR group, the 6 min walk distance was increased by 72 ± 69 metres (p = 0.001). FACIT and mMRC scores were also improved in the PR group by 15 ± 10 (p = 0.001) and by 1.4 ± 1.0 (p = 0.001), respectively.

In the UC group, only the mMRC score was improved by 0.7 ± 1.0 (p = 0.008).

Conclusions
The application of a hybrid PR programme was beneficial in improving cardiorespiratory exercise fitness, functional capacity and quality of life in previously hospitalised COVID-19 survivors.

Link | PDF (Journal of Clinical Medicine) [Open Access]

 

[Utsikt]

Spoiler: Table 4

No between-group differences for any QoL or daily FC scores, except for FACIT.

This has to be one of the weakest excuses I’ve ever heard for not randomising:

4.1. Study Limitations​

A few limitations should be taken into consideration while interpreting the results. The present study consisted of a relatively small sample size, and randomization was not feasible due to ethical considerations. Specifically, it was considered unethical to deny participation by patients with long COVID, and thus, the UC group was composed of long COVID patients who were unable to attend for personal reasons. Overall, patient eligibility was limited due to social and work commitments.

 

[Utsikt]

According to their registration at clinicaltrials.gov, the purpose of their study was to see if there were gender differences in the recovery rates with a hybrid rehab approach:

The main question it aims to answer is the following:

• does gender limits the effects of a hybrid pulmonary rehabilitation programme on respiratory and peripheral muscle strength?

They also say that it’s a retrospective study, and I have no idea about how that would work.

The data that will be collected retrospectively for the present study as the patients have already completed the pulmonary rehabilitation programme.

They also state that the outcomes will be between-group differences between the genders.

 

[rvallee]

Furthermore, in the PR group, the 6 min walk distance was increased by 72 ± 69 metres

That would be great if the problem had anything to do with falling short by 72 or so meters, ± 69 of course, when walking for 6 minutes, but it has nothing whatsoever to do with that, so it's about as useful as a yo-yo teaching class that finds that people get better at yo-yoing after being taught a few tricks and practicing them.

In the "who gives a damn category?", this raises a solid 4, ± 10.