P70 The impact of post COVID-19 rehabilitation on hospital and non-hospitalised participant- is there a difference?

• Published in: Thorax Vol. 76; no. Suppl 2; pp. A104 - A105
• Main Authors: Singh, SJ, Watt, AC, Houchen-Wolloff, L, Ward, S, Chaplin, EJ, Gardiner, NY, Daynes, E
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 08.11.2021; BMJ Publishing Group LTD
• Subjects: Breaking barriers in pulmonary rehabilitation and physiotherapy; Coronaviruses; COVID-19; Rehabilitation
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax-2021-BTSabstracts.180

BackgroundThere is evidence that those hospitalised with COVID-19 have a significant and persistent symptom burden. Early data suggests that symptoms and functional deficit may be favourably influenced by a structured rehabilitation programme. There is little data describing the impact of a rehabilitation programme on those who had COVID-19 but were not hospitalised and managed in the community who also have persistent burdensome symptoms. We therefore wanted to explore early outcome data from rehabilitation post infection and specifically explore data from those referred from the community to our rehabilitation programme.MethodsParticipants were recruited to a 6 week out-patient supervised rehabilitation programme, with sessions twice a week. The programme was developed specifically for the post COVID-19 population using educational materials from the YourCovidRecovery website. The outcomes were: the incremental shuttle walking test (ISWT) (including a familiarisation test at baseline), the endurance shuttle walking test (ESWT), COPD Assessment Test (CAT), Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT), Hospital Anxiety and Depression Scale (HADS), EuroQual 5 domains (EQ5D) thermometer, the Montreal Cognitive Assessment (MoCA) and quadriceps maximum voluntary contraction (QMVC) (chair based strain gauge). Data was analysed using SPSS v25. A paired/independent t-test was used to compare changes before and after rehabilitation between and within groups.ResultsN= 82 individuals completed the COVID-19 rehabilitation programme (45 male, mean [SD] age 58.1(16.2) years), 49 white British. 62 individuals were admitted to hospital (11.8(14.8) days) and 20 non-hospitalised. Overall the data identified significant improvements in the whole group for the ISWT, ESWT HADS (D), CAT,FACIT, QMVC and EQ-5D thermometer (p<0.05). With the exception of the EQ-5D there was no significant difference in improvements between groups (P>0.05) (table 1). The within group changes demonstrated similar improvements in exercise capacity and the FACIT (p<0.01) but the non-hospital group did not reach statistical significance for other outcomes.Abstract P70 Table 1 All Hospitalised Mean difference (SD) Non-Hospitalised Mean difference (SD) Between group Difference Mean difference (95% CI ) ISWT(m) 100.1(95.6)** 95.5(90.0)** 114.4(112.8)** 18.9(70.7,-32.9) ESWT(secs) 332.0(636.9)** 308.0 (686.4)** 417.2(422.2)** 109.1 (470.0, -251.7) QMVC (kg) 5.2(4.8)** 5.6(4.7)** 3.7(5.5) 1.9 (2.2,-6.0) FACIT 3.8(7.8)** 3.4 (7.4)* 5.1(9.2)* 1.8 (-2.6,6.2) CAT 2.6(6.0)** 2.8(5.6)** 0.7(7.2) 2.1 (5.4,-1.1) EQ-5D (thermometer) 7.7(20.1)** 11.0(19.4)** 3.9(19.0) 14.9 (3.2, 26.6)* MoCA 0.8(3.8) 0.8(4.2) 0.7(1.9) 0.08(2.2,-2.4) HAD-A 0.6(3.1) 0.6(3.0) 0.4(3.3) 0.2 (1.5,-2.0) HAD-D 1.1(3.5)* 1.3(3.4)* 0.5(3.8) 0.8(1.2,-2.7) *<0.05 **<0.01ConclusionEarly data suggests that those who have prolonged and significant symptoms post COVID-19 improve after a supervised rehabilitation programme. The response to the intervention is similar in both hospitalised and non-hospitalised groups. This is early cohort data and therefore must be treated with caution, nevertheless is encouraging.