Effectiveness of cardiopulmonary rehabilitation after COVID-19 in Poland.

Introduction: Patients with a history of COVID‑19 are characterized by a deteriorated level of cardiorespiratory fitness (CRF). The COVID‑19 rehabilitation program of the National Health Fund (NHF) was developed and financed by the public insurer in Poland to help convalescents return to full health.

Objectives: We aimed to evaluate the effectiveness of cardiopulmonary rehabilitation (CR) after COVID‑19, carried out under the NHF program.

Patients And Methods: The study included 553 convalescents at a mean age of 63.5 years (SD, 10.26; 316 women [57.1%]), hospitalized at the Cardiac Rehabilitation Department of the Ustroń Health Resort, Poland, after a median of 23.10 weeks (interquartile range [IQR], 16.25-29.00) following COVID‑19. The mean duration of CR was 21 days (IQR, 21-28). The effectiveness of CR was assessed based on the improvement in spirometry and clinical parameters, as well as indicators of CRF and exercise tolerance.

Results: The mean baseline CRF level, as assessed by the 6‑minute walk test (6MWT), was reduced to 76.32% of the predicted value (SD, 15.87) in men and 85.83% of the predicted value (SD, 15.60) in women, while the mean values of the spirometry parameters were normal. During CR, there was an improvement in the median 6MWT distance by 42.5 m (95% CI, 37.50-45.00; P <0.001), and in the median exercise tolerance assessed on the Borg scale (fatigue, by -1 point; 95% CI, -1.0 to -1.0; P <0.001; dyspnea, by -1.5 points; 95% CI, -1.5 to -1.0; P <0.001). We observed a decrease in the mean resting blood pressure by 8.57 mm Hg (95% CI, -11.30 to -5.84; P <0.001) for systolic and by 3.38 mm Hg (95% CI, -4.53 to -2.23; P <0.001) for diastolic values. The most pronounced improvement was seen in the patients with low CRF level at baseline, who were eligible for lower‑intensity rehabilitation models. The CR effectiveness was not dependent on the severity of COVID‑19 or the time from the disease onset to the commencement of rehabilitation.

Conclusions: CR is a safe and effective intervention that can accelerate recovery from COVID‑19, including an increase in exercise capacity and exercise tolerance.