Late Breaking Abstract - The weekly recovery of physical capacities in COVID-19 patients during post-extubation pulmonary rehabilitation

Abstract

Some COVID-19 patients develop a severe form of the disease requiring intubation and admission to the intensive care unit (ICU). We aim to evaluate the recovery of the walking ability during pulmonary rehabilitation (PR) post-extubation. We evaluated patients with severe COVID-19 during PR using weekly six-minute walking tests. We measured the walking distance (6MWD), oxygen saturation (SpO2) and dyspnea. 17 COVID-19 patients (10 male, 7 female) with an average age of 70±11 years old were admitted to the Dieulefit Sante PR center. All had at least one of the following comorbidities: cardiovascular, COPD, diabetes or cancer, and mean BMI was 27±6 Kg/m2. On average, they spent 22±7 days in ICU and 12±8 days in the pulmonary ward before enrolling in PR. This graph shows the weekly 6MWD evolution. On average, PR lasted 21±8 days, 6MWD increased from 16±16% to 43±21% of theoretical values. A strong negative correlation existed between the number of days post-extubation before PR, and the gain in 6MWD. Patients showed severe desaturation (SpO2 nadir 85±5 %) despite oxygen supply (4±1 L/min) but modest dyspnea (4±2). Patients had a significant recovery early post-extubation but left PR with a significant impairment in 6MWD. Patients who spent less time bedridden between ICU and PR, recovered faster. These results show the importance of PR in patients post COVID-19, the sooner and the longer, the better.