Pulmonary rehabilitation focusing on the regulation of respiratory movement can improve prognosis of severe patients with COVID-19.

Background: Since the coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, it has become a global public health emergency. Besides conventional care, pulmonary rehabilitation (PR) is an equally important treatment for patients with COVID-19 suffering from respiratory, physical and psychological disease. The aim of this study is to investigate the role of PR on the inpatients with severe COVID-19.

Methods: This study was a self-pre- and post-control prospective clinical trial, which totally recruited 31 inpatients confirmed COVID-19 by RT-PCR. They were performed 3-week PR. The demographic data, medical records, symptoms, laboratory findings and chest computed tomographic (CT) scans of patients were collected at baseline. The effect of PR was assessed by questionnaires before PR as well as after 2- and 3-week PR.

Results: After 3-week PR and treatment, neutrophil percentage decreased, while lymphocyte percentage and lymphocyte count increased (before vs. 2 weeks after PR respectively: P=0.001; P=0.001; P<0.0001). Besides, CRP and procalcitonin reduced significantly (before vs. after respectively: P<0.0001; P=0.023). Patients' oxygen intake decreased and oxygen saturation increased significantly. Meanwhile, PR relieved the patients' symptoms of cough and dyspnea, improved the patients' self-care ability, physical fitness and mental state significantly. Activities of daily living (ADL) score increased and Modified Medical Research Council Dyspnea Scale (mMRC) decreased after PR.

Conclusions: PR can relieve symptoms, enhance health-related quality of life, improve respiratory muscle function and alleviate disease-related anxiety and depression of severe patients with COVID-19. PR should be provided throughout the diseases management process, regardless of whether the patient is hospitalized or at home.