Garbsch R; University of Witten/Herdecke, Witten, Germany.
Schafer H; Kotewitsch M; Mooren JM; Waranski M; Teschler M;
Vereckei K; Boll G; Mooren FC; Schmitz B

BMC Medicine. 22(1):446, 2024 Oct 08.

Post-COVID-19 Syndrome (PCS) entails a spectrum of symptoms,
including fatigue, reduced physical performance, dyspnea, cognitive
impairment, and psychological distress. Given the effectiveness of
exercise-based rehabilitation for PCS, this study examined the efficacy of
rehabilitation for PCS patients, focusing on sex-specific differences.
METHODS: Prospective cohort study during inpatient rehabilitation.
Cardiopulmonary exercise testing and spirometry were performed at
admission and discharge. Questionnaires were used to assess fatigue,
health-related quality of life, wellbeing, and workability for up to 6
months.
RESULTS: 145 patients (36% female, 47.1 +/- 12.7 years; 64% male, 52.0
+/- 9.1 years; p = 0.018) were referred to rehabilitation 262.0 +/- 128.8
days after infection (female, 285.5 +/- 140.6 days; male, 248.8 +/- 112.0
days; p = 0.110). Lead symptoms included fatigue/exercise intolerance
(81.4%), shortness of breath (74.5%), and cognitive dysfunction (52.4%).
Women presented with higher relative baseline exercise capacity (82.0 +/-
14.3%) than males (68.8 +/- 13.3%, p < 0.001), but showed greater
improvement in submaximal workload (p = 0.026). Men exhibited higher
values for FEV1, FEV1/VC, PEF, and MEF and lower VC at baseline (p <=
0.038), while FEV1/VC improvement more in women (p = 0.027). Higher
baseline fatigue and lower wellbeing was detected in women and correlated
with impaired pulmonary function (p < 0.05). Disease perception including
fatigue, health-related quality of life, wellbeing and workability
improved with rehabilitation for up to six-month.
CONCLUSIONS: Rehabilitation improves cardiopulmonary fitness, pulmonary
function and disease burden in women and men with long-term PCS. Women
with PCS may benefit from intensified respiratory muscle training.
Clinical assessment should include cardiopulmonary exercise testing and
pulmonary function tests and fatigue assessments for all PCS patients to
document limitations and tailor therapeutical strategies.