Changes in fatigue symptoms following an exercise-based rehabilitation programme for patients with Long-COVID

Abstract

There is evidence to support COVID-19 rehabilitation programmes improving persistent COVID-19 symptoms; however, there is concern that therapies that include an exercise component may increase fatigue and post-exertional symptom exacerbation (PESE).To determine the effect of a 6 week COVID-19 rehabilitation programme on fatigue and PESE in individuals with on-going COVID-19 symptoms.After a routine medical assessment, individuals with persistent COVID-19 symptoms were enrolled on a 6-week COVID-19 specific rehabilitation programme. The programme included symptom-titrated exercise, education, and self-management advice. Fatigue was assessed pre- and post-programme using the Functional Assessment Chronic Illness Therapy-Fatigue questionnaire (FACIT). Exercise capacity (Incremental and Endurance Shuttle Walking Test; ISWT/ESWT) and PESE (DePaul Symptom Questionnaire; DSQ) were also assessed pre- and post-programme. Composite scores were calculated for the frequency and severity domains of the DSQ.148 patients (median [IQR] age 59[49–72] years, 82 (60%) female, 81(54%) hospitalised) completed the COVID-19 rehabilitation programme. FACIT score reduced pre- to post-programme by a mean[CI] change of −5[−7, −4];p<0.01. Exercise capacity increased by 82[65, 99] m for the ISWT and 398[333, 462]seconds for the ESWT (n=148). PESE was assessed in 44 patients. The DSQ frequency and severity composite score improved by 20[13, 28] and 19[13, 26] points, respectively (p<0.01, n=44).This data demonstrates the potential benefits of a COVID-19 rehabilitation programme on improving fatigue, exercise capacity, and symptom exacerbation, in those with persistent COVID-19 symptoms.