Rehabilitation Programs Effectiveness Model: a Retrospective Comparative Study of Patients with Post-Acute COVID-19 Syndrome

AIM. To evaluate the expected effectiveness of post-COVID rehabilitation strategies. MATERIAL AND METHODS. The study was conducted August, 2021 – March, 2022 in the republican and federal rehabilitation centers: Krasnodar Territory (n=25), the Republic of Buryatia (n=25), and Moscow (n= 25). The data were obtained by a retrospective analysis of medical records and by interviewing the study participants who had an indication or had been treated in a rehabilitation centre for post-acute COVID-19 syndrome (U 09.9). The average length of time after the onset of the acute period of the disease was 6.5 ± 2.5 months. A prognostic model was constructed to estimate the expected effectiveness of the rehabilitation programme, as measured by a reduction in the severity of dyspnea. Nonlinear maximum likelihood logit regression was used to build the model. RESULTS AND DISCUSSION. According to the presented model, the best expected rehabilitation effectiveness was found in the National Medical Research Center (Moscow) (β=-1.788685, p=0.009964604), a slightly lower expected rehabilitation effectiveness was observed in the resort with a curative climate (Krasnodar Territory) (β=0.9913501, p=0.182944), the lowest expected effectiveness was registered in the regional rehabilitation center (the Republic of Buryatia) (β=1.054594 p=0.2642723). The need for an integrated approach in the treatment of patients with post-acute COVID-19 syndrome was pointed out by many domestic and foreign researchers, however, the choice and content of treatment strategies is debatable. Our study provides a preliminary answer to this question. CONCLUSION. The developed model of the expected effectiveness of the rehabilitation of patients suffering from shortness of breath after undergoing COVID-19 has a specificity of 54.54%, sensitivity of 91.3% and an overall accuracy of 84.21%. The best expected rehabilitation effectiveness was found in the National Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of the Russian Federation (Moscow) (β=-1.788685, p=0.009964604), somewhat lower in the resort with a curative climate (Krasnodar territory) (β=0.9913501, p=0.182944), the lowest expected efficiency was registered in the regional rehabilitation center (the Republic of Buryatia) (β=1.054594 p=0.2642723).