Post-Hospital COVID-19 Rehabilitation (PHOSP-R): A randomised controlled trial

<bold>Introduction:</bold> Patients following hospitalisation with COVID-19 experience on-going symptoms that reduce exercise capacity. We hypothesised that rehabilitation (supervised or digital) would support recovery and improve exercise capacity compared to usual care in adults with Long COVID. <bold>Methods:</bold> Adults with Long COVID following hospitalisation were recruited from two UK NHS hospitals. Participants were randomised to receive either eight weeks of supervised (twice weekly) or digital rehabilitation, or usual care. Rehabilitation comprised of individually prescribed aerobic and strength exercise, and education sessions. The primary outcome was exercise capacity measured using the Incremental Shuttle Walk Test (ISWT) distance (metres). Intention to treat analysis compared supervised rehabilitation to usual care, and digital rehabilitation to usual care. 44 participants were required per group to show a between group change of 50m. <bold>Results:</bold> Of the 181 participants were recruited (mean[SD] age 59[12]years, length of stay 11[19]days, n=99(55%) male), 149 participants completed the trial. The ISWT improved in the supervised and digital rehabilitation groups from mean[SD] 285[248]m to 312[252]m, and 353[227]m to 388[214]m, respectively, but no improvements were seen in usual care 328[201]m to 330[198]m. Improvements for supervised and digital interventions compared with usual care were mean[SD] change 52.3[16.7]m p<0.01 and 33.6[16.8]m p=0.04, respectively. These improvements are comparable to established minimal clinical important differences (35m). <bold>Conclusion:</bold> Supervised and digital rehabilitation improved exercise capacity compared to usual care in previously hospitalised adults with Long COVID.