Randomized controlled trial of home-based vs. hospital-based pulmonary rehabilitation in post COVID-19 patients

BACKGROUND: Between 30% and 60% of people who have been infected with COVID-19 still had symptoms 3 months after the start of the disease. Prescribing a pulmonary rehabilitation program in rehabilitation facilities for post COVID-19 patients could help alleviate the symptoms. However, rehabilitation facilities known to provide good quality care to COVID-19 patients and all other patients, could become saturated by the rise in cases. Home-based rehabilitation is a potential solution that could be sustainable in the long term to avoid this saturation and/or a very long waiting list for patients. AIM: The aim of this study was to investigate whether home-based rehabilitation would have similar effects compared to inpatient rehabilitation on physical and respiratory variables in post COVID-19 patients. DESIGN: This is a randomized controlled trial. SETTING: Pulmonary rehabilitation facility. POPULATION: Seventeen post COVID-19 patients were randomized into two groups: inpatient pulmonary rehabilitation (IPR) or home-based pulmonary rehabilitation (HPR). METHODS: The comparison of the two rehabilitation methods relied on questionnaires, physical tests and the evaluation of several respiratory parameters. A 2-way Analysis of Variance (ANOVA) with repeated measures was performed to assess the effects of time (pre- vs. post-rehabilitation), group (IPR vs. HPR) and their interaction for all parameters. RESULTS: The main result of this study is that distance covered in the 6MWT (6MWD) shows significant improvements, between pre- and postrehabilitation program in both groups (+95 m in IPR group vs.+72 m in HPR group, P<0.001) with no significant interaction between time and group (P=0.420). CONCLUSIONS: These results suggest that home-based pulmonary rehabilitation would be as efficient as IPR to decrease physical sequelae in post COVID-19 patients. CLINICAL REHABILITATION IMPACT: It is possible to suggest both methods (home-based rehabilitation or inpatient pulmonary rehabilitation) according to the specificities of each patient and depending on hospital saturation. The choice of one or the other method should not be made to the detriment of the patient.