# Case Report: Rehabilitation assessment and exercise using cardiopulmonary exercise test after coronavirus-disease pneumonia

## TL;DR

This case report shows how cardiopulmonary exercise testing and rehabilitation helped two patients recover from long-term effects of COVID-19.

## Contribution

Demonstrates the safety and effectiveness of CPET-guided rehabilitation in post-COVID-19 patients.

## Key findings

- Both patients showed reduced exercise tolerance and oxygenation after acute COVID-19.
- Rehabilitation based on CPET results improved aerobic capacity and allowed patients to stop oxygen use.
- Patients were successfully discharged home after three months of training.

## Abstract

Coronavirus disease (COVID-19) affects not only respiratory function, but also physical function and decreases activities of daily living. Cardiopulmonary evaluation using cardiopulmonary exercise test (CPET) was performed in two patients with persistent respiratory distress one month after acute treatment for COVID-19. The results showed decrease in exercise tolerance, ventilation ability, oxygenation ability, heart rate reserve, stroke volume, and muscle metabolism in both cases. By performing rehabilitation exercise according to the results of CPET, both patients were able to withdraw from oxygen inhalation, improve their functions (17.4 vs. 22.1 in case 1 and 9.0 vs. 16.1 in case 2 on peak exercise aerobic capacity), and were discharged to their homes three months after training. Rehabilitation assessment and exercise using CPET in COVID-19 patients could be safe and useful.