Digital pulmonary rehabilitation intervention in post COVID-19 recovery at primary care hospital in rural Nepal: Experience from resource-limited setting of LMIC

<bold>Introduction:</bold> Nepal reported over 1 million COVID-19 cases resulting in impaired lung function and diminished quality of life. <bold>Aims and objectives:</bold> To evaluate effectiveness of digital pulmonary rehabilitation intervention in post COVID-19 recovery. <bold>Methods:</bold> An intervention study with pre-post study design was conducted at Methinkot hospital, a primary hospital in rural Nepal from January to June 2022. Digital pulmonary rehabilitation model through collaborative effort was developed at resource constrained research site due to unavailabilty of rehabilitative services. 40 patients with post COVID lung damage were recruited in each intervention and control groups. Intervention group received 3 week pulmonary rehabilitation while control group received conventional care. Pre and post-intervention physical and respiratory health outcome and health related quality of life using European quality of life 5 dimension 3 level (EQ-5D-3L) index was compared. <bold>Results:</bold> Mean age of patients was 36.04±11.89 years with 45% male. Significant difference in mean respiratory rate, peripheral oxygen saturation, 1-minute sit-to-stand test and 6-minute walk test was observed in intervention group with p-value <0.05 while no significant difference observed in control group. Significant difference in mobility, pain/discomfort and anxiety/depression dimension of EQ-5D-3L was observed in intervention group with p-value<0.05 while no significant difference observed in control group. <bold>Conclusions:</bold> Digital pulmonary rehabilitation is effective in improving lung health in resource-limited settings of LMIC where rehabilitative services are not available.