{"title":"Respiratory post COVID sequelae: the role of pulmonary function impairment, fatigue and obesity in dyspnea and the impact of SPA rehabilitation.","authors":"Emanuela Resta, Chiara Noviello, Preethymol Peter, Giusi Graziano, Valeria Dalena, Alessia Caputi, Giorgio Castellana, Giacomo Riformato, Silvio Tafuri, Pierucci Pierucci","doi":"10.1080/17476348.2025.2516801","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Respiratory COVID-19 post-acute sequelae (PASC) may persist for extended periods following recovery.</p><p><strong>Methods: </strong>Patients with PASC who were referred for Salus Per Aquam (SPA) therapy were enrolled in the study.</p><p><strong>Aim: </strong>To categorize patients based on the presence of dyspnea and fatigue, with a specific focus on obesity, chronic respiratory conditions, and predictors of rehabilitation outcomes.</p><p><strong>Results: </strong>From July-November 2021, 327 consecutive patients were enrolled at the spa center. Among these, 31% had been previously hospitalized, 5% had required noninvasive or invasive mechanical ventilation. Approximately one-third of the cohort underwent DLCO testing, which was abnormal in 56.3% of cases. Patients with impaired DLCO had significantly higher dyspnea rates compared to those with normal DLCO (88.9% vs. 64.3%, <i>p</i> < 0.0001). Dyspneic patients were more likely to have one or more comorbidities (<i>p</i> < 0.001), be obese (<i>p</i> = 0.005), and have a history of chronic respiratory disease (<i>p</i> = 0.0009). Patients reporting fatigue also had higher rates of dyspnea (91.2% vs. 61.5%, <i>p</i> < 0.0001), were more frequently obese (<i>p</i> = 0.03), had more comorbidities (<i>p</i> = 0.02), and had a greater history of hospitalization (<i>p</i> = 0.02). No improvement in dyspnea/fatigue was observed post-SPA treatment among patients with DLCO impairment and obese. However, patients with chronic respiratory conditions reported benefit.</p><p><strong>Conclusions: </strong>Dyspnea in PASC is complex and multifactorial. The findings suggest that SPA rehabilitation may be particularly beneficial for alleviating fatigue and enhancing overall well-being in selected subgroups of patients with PASC.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1017-1026"},"PeriodicalIF":2.7000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert review of respiratory medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/17476348.2025.2516801","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/10 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Respiratory COVID-19 post-acute sequelae (PASC) may persist for extended periods following recovery.
Methods: Patients with PASC who were referred for Salus Per Aquam (SPA) therapy were enrolled in the study.
Aim: To categorize patients based on the presence of dyspnea and fatigue, with a specific focus on obesity, chronic respiratory conditions, and predictors of rehabilitation outcomes.
Results: From July-November 2021, 327 consecutive patients were enrolled at the spa center. Among these, 31% had been previously hospitalized, 5% had required noninvasive or invasive mechanical ventilation. Approximately one-third of the cohort underwent DLCO testing, which was abnormal in 56.3% of cases. Patients with impaired DLCO had significantly higher dyspnea rates compared to those with normal DLCO (88.9% vs. 64.3%, p < 0.0001). Dyspneic patients were more likely to have one or more comorbidities (p < 0.001), be obese (p = 0.005), and have a history of chronic respiratory disease (p = 0.0009). Patients reporting fatigue also had higher rates of dyspnea (91.2% vs. 61.5%, p < 0.0001), were more frequently obese (p = 0.03), had more comorbidities (p = 0.02), and had a greater history of hospitalization (p = 0.02). No improvement in dyspnea/fatigue was observed post-SPA treatment among patients with DLCO impairment and obese. However, patients with chronic respiratory conditions reported benefit.
Conclusions: Dyspnea in PASC is complex and multifactorial. The findings suggest that SPA rehabilitation may be particularly beneficial for alleviating fatigue and enhancing overall well-being in selected subgroups of patients with PASC.
背景:呼吸道COVID-19急性后后遗症(PASC)可能在康复后持续较长时间。方法:PASC患者转介进行水疗治疗(SPA)纳入研究。目的:根据呼吸困难和疲劳的存在对患者进行分类,特别关注肥胖、慢性呼吸疾病和康复结果的预测因素。结果:从2021年7月至11月,327例连续患者入组水疗中心。其中,31%曾住院,5%曾需要无创或有创机械通气。大约三分之一的队列进行了DLCO检测,56.3%的病例检测异常。DLCO受损患者的呼吸困难发生率明显高于DLCO正常患者(88.9% vs. 64.3%,p p p = 0.005),且有慢性呼吸系统疾病史(p = 0.0009)。报告疲劳的患者也有更高的呼吸困难率(91.2%比61.5%,p p = 0.03),有更多的合并症(p = 0.02),有更多的住院史(p = 0.02)。在DLCO损伤和肥胖患者中,spa治疗后呼吸困难/疲劳未见改善。然而,慢性呼吸系统疾病患者报告获益。结论:PASC患者呼吸困难是复杂的、多因素的。研究结果表明,SPA康复可能特别有利于减轻PASC患者亚组的疲劳和提高整体幸福感。