Exercise capacity in COVID-19 surviving patients: impact of physical rehabilitation

Background: At least 65 million individuals worldwide have Long COVID and despite efforts to explain the effects of exercise prescription on the recovery of these individuals, there is a need to explore its effects on exercise tolerance and cardiorespiratory fitness. Therefore, our main objective was to evaluate the effect of the Physical Rehabilitation Program (PRP) on muscle strength and physical exercise capacity of COVID-19 survivors. Methods: The cohort included 28 patients post COVID-19, each participant performed a comprehensive and multisystem evaluation in two visits, in the pre- and post-PRP: 1st visit = clinical evaluation periods (maximal inspiratory pressure (MIP); maximal expiratory pressure (MEP) and Duke Activity Status Index (VO2peak). 2nd visit= physical evaluation 6-minute Step Test (6MST) and Handgrip Strength (HGS). The PRP consisted of breathing exercises, muscle strength exercises for upper and lower limbs and aerobic exercise, 2 or 3 times/week for 03 months. Results: The post-PRP we found: improvement in peripheral 95%CI 2.7 (2.0-3.4), p=0.001, Huge and respiratory MIP 95%CI 1.6 (0.9-2.3), p<0.001, Very large) and MEP 95%CI 2.7 (2.0-3.4), p=0.001, Huge) muscle strength; increase in cardiorespiratory fitness according to estimated-VO2peak 95%CI 2.3 (1.5-3.1), p<0.001, Huge and the number of steps climbed in the 6MST 95%CI 1.6 (0.9-2.3), p<0.001, Very large; adaptations resulting lower resting heart rate (HR), higher peak HR, good modulation of HR resulting from stress caused by 6MST; linear and positive association between peripheral and respiratory muscle strength and the number of steps climbed 6MST and greater HR recovery especially post-PRP; recovery-first minute HR remained unchanged post-PRP. Conclusion: In patients post COVID19, we emphasize the great effect of individualized and supervised PRP on the increase in peripheral and respiratory muscle strength/ quality and cardiorespiratory fitness. Despite the gains obtained in PRP, the risk of death based on HR recovery did not change.