Early pulmonary rehabilitation post-extubation may improve outcomes in COVID-19 survivors

A small study presented at the virtual European Respiratory Society International Congress highlighted the importance of pulmonary rehabilitation after extubation in patients recovering from COVID-19.

“Pulmonary rehabilitation post-COVID-19, the sooner and the longer, is better,” Yara Al Chikhanie, PhD student in pulmonary physiopathology and rehabilitation at Grenoble Alpes University, France, said during a presentation.

Researchers evaluated the recovery of physical capacities after COVID-19 in 19 patients (mean age, 71 years; 11 men; mean BMI, 26 kg/m²). All patients were recovering from COVID-19 and admitted to a pulmonary rehabilitation center France.

On average, patients spent 24 days in the ICU and 13 days in the pulmonary ward after extubation before being admitted to the specialized center for pulmonary rehabilitation. Mean duration of pulmonary rehabilitation was 21 days.

After rehabilitation, mean 6-minute walk distance improved from 120 m to 337 m and patients reached, on average, 43% of the normal predicted distance. Patients with a longer delay from extubation to pulmonary rehabilitation had significantly lower improvement in 6-minute walk distance, according to the results.

After 21 days, all patients demonstrated recovery and had normal lung volume and lung capacities, leg and handgrip strengths, and reduced risk for anxiety and depression. When assessing the psychological effect on survivors who were intubated, researchers found that severe PTSD in concerned patients was not resolved and quality of life did not significantly improve.

In other results, the researchers reported most patients had severe oxygen desaturation with no significant perception of dyspnea.

Signs of fibrosis were observed in some patients; the researchers said these patients will require follow-up after 6 months.

The researchers observed that the longer a patient waited to begin pulmonary rehabilitation, the “less and the slower” the patient would recover from COVID-19 infection, Chikhanie said. Those admitted for pulmonary rehabilitation fewer than 7 days after extubation demonstrated faster and better progression than those admitted 7 days or later.

“These results show the importance of pulmonary rehabilitation post-COVID-19,” Chikhanie said.

Reference:

• Press Release.