Late Breaking Abstract - Symptom-based rehabilitation (REHAB) vs. usual care in people with post COVID-19 condition – the Reload trial: a randomized controlled trial (RCT)

<bold>Background:</bold> Post-COVID-19 condition (PCC) is characterized by heterogeneous symptoms, impacting daily and quality life (QoL). Despite numerous isolated intervention studies, evidence from RCTs and comprehensive REHAB programs to support guidelines is missing. <bold>Objective:</bold> To investigate the effect of a symptom-based REHAB program compared with usual care on QoL in people with PCC. <bold>Methods:</bold> Participants were randomized to either usual care (control group, CG) or a comprehensive, multimodal 3-week inpatient REHAB program (intervention group, IG), with interventions tailored to improve fatigue, cognitive function or somatic symptoms, depending on the individual´s most significant symptom (<ext-link>NCT05172206</ext-link>). Primary outcome was change in QoL, measured by the SF-12 physical (PSS) & mental summary scale (MSS) from pre [T1] to post REHAB/usual care period [T2]. Change in QoL was also analyzed at a 3-month follow-up [T3] as a secondary measure. <bold>Results:</bold> Of 132 participants,102 completed the study (IG: n=47, 47±13y; CG: n=55, 48±11y; mild COVID-19 infection: IG 89%, CG 91%; unable to work due to PCC: IG 40.4%, CG 38%). Significant between-group differences existed in QoL change from T1 to T2 (PSS Δ2.9pts. 95%CI [0.26 to 5.51], p=0.031; MSS Δ6.53pts. 95%CI [2.62 to 10.51], p=0.001) in favor of the IG. At T3, between-group differences remained significant for PSS (Δ4.3pts. 95%CI [1.66 to 6.96], p=0.002) but not for MSS (Δ3.80pts. 95%CI [−0.15 to 7.76], p=0.059). <bold>Conclusion:</bold> This RCT demonstrates for the first time that a comprehensive and multimodal symptom-based REHAB program specific for PCC significantly improves QoL and is superior to natural recovery.