# LONG-TERM OUTCOMES FOLLOWING A PULMONARY TELEREHABILITATION TRIAL FOR PEOPLE WITH RESPIRATORY POST-ACUTE SEQUELAE OF COVID: A 12-MONTH FOLLOW-UP STUDY

## TL;DR

This study found that people with long-term respiratory symptoms after COVID-19 showed some improvement in physical and psychological health 12 months after a pulmonary telerehabilitation trial.

## Contribution

The study reveals that post-COVID symptoms can improve over time, even if no immediate benefit was seen from a 4-week telerehabilitation program.

## Key findings

- Participants showed significant improvements in the 5-repetition sit-to-stand test and COPD Assessment Test after 12 months.
- Some domains of the SF-36 and COVID-19 Yorkshire Rehabilitation Scale also improved significantly.
- Despite no initial improvement during the trial, participants experienced recovery in respiratory symptoms and fatigue over time.

## Abstract

To determine whether changes in physical and psychological outcomes occurred in the 12 months following completion of a randomized controlled trial comparing a 4-week pulmonary telerehabilitation programme with a control group of usual care in people with respiratory post-acute sequelae of COVID.

This was a prospective, observational, multi-site, assessor-blinded study. Primary outcome: 1-minute sit-to-stand test. Secondary outcomes: 5-repetition sit-to-stand test; Montreal Cognitive Assessment; COVID-19 Yorkshire Rehabilitation Scale; COPD Assessment Test; 36-Item Short-Form Health Survey; Hospital Anxiety and Depression Scale; Fatigue Severity Scale; and the Kessler Psychological Distress Scale. All outcomes were assessed at baseline and 12 months following randomized controlled trial participation. All participants were analysed as a single group at 12 months, given there were no significant differences in the randomized controlled trial.

Of 50 participants enrolled in the randomized controlled trial, 29 (58%) participated in the 12-month follow-up. Compared with baseline, at the 12-month follow-up there was no statistically significant improvement in the primary outcome of the 1-min sit-to-stand test (1.5 points, CI: –1.3 to 4.2), yet statistically significant differences in the 5-repetition sit-to-stand test (–1.4 seconds CI: –2.7 to –0.1), COPD Assessment Test (–4.1 points CI: –6.8 to –1.4), and some domains of SF-36 and COVID-19 Yorkshire Rehabilitation Scale.

This study demonstrated that people reporting respiratory post-acute sequelae of COVID experienced some recovery at 12 months, despite not improving initially during a 4-week pulmonary telerehabilitation programme or control period.

This study explored the recovery of people with persistent respiratory symptoms following COVID-19 infection who participated in a programme of pulmonary rehabilitation as part of a clinical trial. The clinical trial found no significant differences between those who participated vs did not participate in the pulmonary rehabilitation programme. Despite this, among the participants who were reassessed 12 months following participation in the trial, there were significant improvements in respiratory symptoms, lower-limb functional performance, and fatigue. This study demonstrates that individuals may experience improvement in post-COVID symptoms over time.