People hospitalised with COVID-19 can have a poor recovery, resulting in ongoing symptoms, poor quality of life and reduced independence in activities (including work). Reduced recovery is often called long COVID and affects over 1 million people in the UK alone.
Exercise interventions are known to improve symptoms of fatigue and breathlessness and improve engagement in daily activities and quality of life. We aimed to determine if an exercise rehabilitation programme can improve recovery in people with long COVID. The programme aligns strongly with the NHS’s shift towards community-based, preventative care by embedding rehabilitation for long COVID within existing services and enabling flexible digital delivery.
Following an eight-week intervention of exercise and education, people with long COVID demonstrated clinically significant improvements in exercise capacity compared to usual care. These improvements were significant regardless of the mode of delivery (face-to-face or digital). There were also improvements in fatigue symptoms, and importantly against a background of increased activity.
This work has impacted patients through contribution to guidelines and policy on rehabilitation. Established Pulmonary Rehabilitation services are delivering rehabilitation to their long COVID population, and they have recently been included as a population in the National Respiratory Audit Programme, allowing for real-world data assessment in the future, and by region.
The work has also influenced the Royal College of Physicians’ Pulmonary Rehabilitation Services Accreditation Scheme who also support the inclusion of Long COVID patients, developing established services for people who often feel neglected by healthcare. The website has been absorbed into www.i-impact.co.uk for further roll out. Future impact will commercialise this product for wider use, which is of particular importance as long COVID services become decommissioned.
We have also observed changes in immune function following the exercise programme which has upstream impact by providing a potential mechanism of action for other exercise-based interventions and post viral disease management. This could result in targeted treatment.
The UKRI/NIHR PHOSP consortium award
The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a consortium of leading researchers and clinicians from across the UK working together to understand and improve long-term health outcomes for patients who have been in hospital with confirmed or suspected COVID-19.
19 institutions and 51 trusts have collaborated on this work, including in Leicester, the BRC, the CRF and ARC East Midlands. For fill details see: www.phosp.org/institution-trust/