Post-Hospitalisation COVID-19 Rehabilitation (PHOSP-R): A randomised controlled trial of exercise-based rehabilitation

TY - JOUR

T1 - Post-Hospitalisation COVID-19 Rehabilitation (PHOSP-R)

T2 - A randomised controlled trial of exercise-based rehabilitation

AU - Daynes, Enya

AU - Evans, Rachael A.

AU - Greening, Neil J.

AU - Bishop, Nicolette C

AU - Yates, Thomas

AU - Lozano-Rojas, Daniel

AU - Ntotsis, Kimon

AU - Richardson, Matthew

AU - Baldwin, Molly

AU - Hamrouni, Malik

AU - Hume, Emily

AU - McAuley, Hamish J. C.

AU - Mills, George E.

AU - Megaritis, Dimitrios

AU - Roberts, Matthew D

AU - Bolton, Charlotte E.

AU - Chalmers, James

AU - Chalder, Trudie

AU - Docherty, Annemarie B

AU - Elneima, Omer

AU - Harrison, Ewen M

AU - Harris, Victoria C.

AU - Ho, Ling-Pei

AU - Horsley, Alexander

AU - Houchen-Wolloff, Linzy

AU - Leavy, Olivia C.

AU - Marks, Michael

AU - Poinasamy, Krishna

AU - Quint, Jennifer K.

AU - Raman, Betty

AU - Saunders, Ruth M.

AU - Shikotra, Aarti

AU - Singapuri, Amisha

AU - Sereno, Marco

AU - Terry, Sarah

AU - Wain, Louise V.

AU - Man, William D-C

AU - Echevarria, Carlos

AU - Vogiatzis, Ioannis

AU - Brightling, Christopher E.

AU - Singh, Sally J.

AU - George, J

N1 - Copyright: ©The authors 2025

PY - 2025

Y1 - 2025

N2 - Objective Post-COVID syndrome involves prolonged symptoms with multisystem and functional impairment lasting ≽12 weeks after acute coronavirus disease 2019 (COVID-19). We aimed to determine the efficacy of exercise-based rehabilitation interventions, either face-to-face or remote, compared to usual care in individuals experiencing post-COVID syndrome following a hospitalisation with acute COVID-19. Design This single-blind randomised controlled trial compared two exercise-based rehabilitation interventions (face-to-face or remote) to usual care in participants with post-COVID syndrome following a hospitalisation. The interventions were either a face-to-face or remote 8-week programme of individually prescribed exercise and education. The primary outcome was the change in Incremental Shuttle Walking Test (ISWT) following 8 weeks of intervention (either face-to-face or remote) compared to usual care. Other secondary outcomes were measured including health-related quality of life (HRQoL), and exploratory outcomes included lymphocyte immunotyping. Results 181 participants (55% male, mean±SD age 59±12 years, length of hospital stay 12±19 days) were randomised. There was an improvement in the ISWT distance following face-to-face rehabilitation (mean 52 m, 95% CI 19–85 m; p=0.002) and remote rehabilitation (mean 34 m, 95% CI 1–66 m; p=0.047) compared to usual care alone. There were no differences between groups for HRQoL self-reported symptoms. Analysis of immune markers revealed significant increases in naïve and memory CD8 + T-cells following face-to-face rehabilitation versus usual care alone (p<0.001, n=31). Conclusion Exercise-based rehabilitation improved short-term exercise capacity in post-COVID syndrome following an acute hospitalisation and showed potential for beneficial immunomodulatory effects.

AB - Objective Post-COVID syndrome involves prolonged symptoms with multisystem and functional impairment lasting ≽12 weeks after acute coronavirus disease 2019 (COVID-19). We aimed to determine the efficacy of exercise-based rehabilitation interventions, either face-to-face or remote, compared to usual care in individuals experiencing post-COVID syndrome following a hospitalisation with acute COVID-19. Design This single-blind randomised controlled trial compared two exercise-based rehabilitation interventions (face-to-face or remote) to usual care in participants with post-COVID syndrome following a hospitalisation. The interventions were either a face-to-face or remote 8-week programme of individually prescribed exercise and education. The primary outcome was the change in Incremental Shuttle Walking Test (ISWT) following 8 weeks of intervention (either face-to-face or remote) compared to usual care. Other secondary outcomes were measured including health-related quality of life (HRQoL), and exploratory outcomes included lymphocyte immunotyping. Results 181 participants (55% male, mean±SD age 59±12 years, length of hospital stay 12±19 days) were randomised. There was an improvement in the ISWT distance following face-to-face rehabilitation (mean 52 m, 95% CI 19–85 m; p=0.002) and remote rehabilitation (mean 34 m, 95% CI 1–66 m; p=0.047) compared to usual care alone. There were no differences between groups for HRQoL self-reported symptoms. Analysis of immune markers revealed significant increases in naïve and memory CD8 + T-cells following face-to-face rehabilitation versus usual care alone (p<0.001, n=31). Conclusion Exercise-based rehabilitation improved short-term exercise capacity in post-COVID syndrome following an acute hospitalisation and showed potential for beneficial immunomodulatory effects.

UR - https://www.scopus.com/pages/publications/105007459163

U2 - 10.1183/13993003.02152-2024

DO - 10.1183/13993003.02152-2024

M3 - Article

C2 - 39978856

SN - 0903-1936

VL - 65

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 5

M1 - 2402152

ER -