Exercise program improves quality of life in COVID-19 survivors

Key takeaways:

• The program improved physical functioning, vitality, muscle weakness and more among people recovering from severe COVID-19.
• Future research should assess what types of exercise offer the most benefits.

For survivors of serious COVID-19, a physical activity program was a safe, effective intervention for improving health-related quality of life, persistent symptoms and more, according to the results of a randomized controlled trial.

Exercise has been investigated as a possible therapy for a wide range of diseases and has been previously linked to different psychological and physiological systems, Igor Longobardi, a PhD candidate in the Graduate Program in Musculoskeletal Sciences at the University of São Paulo, and colleagues wrote in the British Journal of Sports Medicine.

Previous research has indicated that people who were more physically active prior to developing COVID-19 had a lower risk for severe outcomes than those who were less physically active. Data have also shown that regular exercise may enhance the COVID-19 vaccine’s effectiveness and that a healthy lifestyle was associated with a lower risk for long COVID.

The researchers conducted a randomized controlled trial to evaluate how a home-based exercise training (HBET) program might impact health-related quality of life (HRQoL) — determined by a variety of physical and mental factors influencing self-perceived health status — and health-related outcomes among survivors of severe cases of COVID-19.

“There is an emergency for novel therapies capable of recovering overall health in these patients,” Longobardi and colleagues wrote. “We hypothesized that a HBET program would improve HRQoL, and physical and mental parameters in survivors of severe/critical COVID-19.”

The researchers randomly assigned 50 people who survived critical COVID-19 in a 1:1 ratio to two groups: standard of care as the control or a 16-week semi-supervised, individualized HBET program that involved 60 to 80 minute sessions of aerobic training and muscle strengthening three times per week. They assessed HRQoL changes with the 36-Item Short-Form Health Survey.

Compared with the control group, participants in the intervention group had greater HRQoL scores in the physical component summary, with an estimated mean difference (EMD) of 16.8 points (95% CI, 5.8-27.9). They also saw greater benefits with general health (EMD = 17.4 points; 95% CI, 1.8-33.1), vitality (EMD = 15.1 points; 95% CI, 0.2-30.1), 30-second sit-to-stand (EMD = 2.38 reps; 95% CI, 0.01-4.76) and physical functioning (EMD = 22.5 points; 95% CI, 6.1-42.9). Myalgia and muscle weakness also improved in HBET compared with control, according to the researchers.

“This model of exercise emerges as an effective and safe therapeutic strategy in recovering patients recovering from severe/critical COVID-19,” Longobardi and colleagues concluded. “Future multicenter studies with larger sample sizes should address the effectiveness of different exercise interventions, as well as barriers and facilitators to their implementation, in cohorts of patients experiencing persistent symptoms of COVID-19.”