Beneficios de un programa de rehabilitación pulmonar para pacientes con COVID persistente: impacto de la gravedad inicial, tiempo de evolución y forma de presentación en los resultados clínicos

Abstract

Introduction

Two-thirds of patients infected with SARS-CoV-2 experience persistent symptoms after infection.

Objectives

To study the benefits of a respiratory rehabilitation program (RRP) in patients with long COVID and compare the results based on the time of evolution and clinical presentation.

Methods

Post-hoc analysis of a prospective cohort of patients with long COVID. Changes were evaluated using the modified Medical Research Council (mMRC) dyspnea scale, the 6-minute walk test (6MWT), maximal inspiratory and expiratory pressures (maxIP and maxEP), and peripheral muscle strength. Statistical tests used: Chi-square, paired and independent t-Student tests, one-way ANOVA, and a general linear model.

Results

Out of 158 patients referred to rehabilitation, 110 (mean age 58.1 years; 57.3% women) started the RRP. After the intervention, significant improvements were observed: a reduction of 0.8 points (95% CI: −1.1 to −0.6) on the mMRC dyspnea scale, an increase of 19.6 m (95% CI: −0.8 to 39.9) in the 6MWT, 16.8 cmH₂O (95% CI: 10.3 to 23.2) in maxIP, 22.5 cmH₂O (95% CI: 15.3 to 29.7) in maxEP, and 5.0 kg (95% CI: 3.3 to 6.7) in quadriceps strength. Although these improvements were independent of infection onset and disease duration, patients from the first wave showed more modest improvements.

Conclusions

The RRP provides clinical and functional benefits for patients with long COVID, regardless of disease duration and initial severity of infection.