The added value of patient education in pulmonary rehabilitation of acute COVID-19 cases: a randomized controlled study

Pulmonary rehabilitation plays a key role in the recovery of patients hospitalized with COVID-19. However, the potential additive effect of structured patient education on clinical outcomes remains underexplored. This study aims to evaluate the impact of a standard versus education-enhanced pulmonary rehabilitation program on cardiopulmonary function, functional capacity, and emotional well-being in patients hospitalized with acute COVID-19. This randomized controlled trial randomized 80 patients with confirmed SARS-CoV-2 infection, of whom 70 completed the study and were included in the final analysis. Participants were assigned to either a control group receiving standard pulmonary rehabilitation or an intervention group receiving the same rehabilitation protocol supplemented by daily health education. Outcomes were measured at baseline and post-intervention using oxygen saturation, arterial blood gases, incentive spirometry, the Barthel Index, HADS depression scale, mMRC dyspnea scale, Borg fatigue scale, and the sit-to-stand test. Both groups showed significant improvements across all measured outcomes (p < 0.001). However, the intervention group demonstrated superior gains in SpO₂ (Δ + 15,0vs. + 8,0), pO₂ (Δ + 17,1vs. + 2,7 mmHg), and lung capacity (Δ + 1500,0vs. + 750,0 mL). Functional and psychological improvements were also greater in the intervention group, including Barthel Index (Δ + 60,0vs. + 45,0), HADS (Δ -16,0vs. -7,0), mMRC (Δ -2,0vs. -1,0), Borg fatigue score (Δ -6,0vs. -4,0), and sit-to-stand repetitions (Δ + 5,0vs. + 2,0) (all p < 0.001). Adding structured patient education to a pulmonary rehabilitation program may contribute to recovery in hospitalized patients with acute COVID-19. This integrative approach leads to improved cardiopulmonary function, greater physical independence, and reduced psychological burden. Trial registration: ClinicalTrials.gov ( https://clinicaltrials.gov/ct2/show/NCT06522724 ), Registry Identifier: NCT06522724, Registration Date:19/07/2024.