Exercise capacity in patients surviving of the COVID-19: one year of follow-up

Background: After recovery from COVID-19, potential physical and functional sequelae lead to limitations in exercise tolerance. Evaluate exercise capacity in COVID-19 survivors at baseline, post-pulmonary rehabilitation, and one-year follow-up. Methods: Prospective longitudinal follow-up study of 15 patients post-COVID-19. Each participant underwent a comprehensive assessment during two visits: 1st visit = Clinical evaluation [Maximum Inspiratory Pressure; Maximum Expiratory Pressure; Duke Activity Status Index Questionnaire (estimated VO2)]; 2nd visit = Physical evaluation [Handgrip Strength and 6-minute step test]. The post-pulmonary rehabilitation consisted of breathing exercises, neuromuscular and aerobic exercises, 2 or 3 times/week, for 3 months. For the analysis, we used the following variation deltas: ∆1 (post-PRP to baseline); ∆2 (one-year follow-up to post-PRP); ∆3 (variation one-year follow-up to baseline). Results: The post-pulmonary rehabilitation we found significant improvements: [Maximum Inspiratory Pressure (∆1 33.7, p=0.016); estimated VO2 (∆1 10.1, p<0.001); the number of steps (∆1 50.6, p=0.002)].One-year follow-up:[Maximum Expiratory Pressure (∆3 37.1, p=0.024); estimated VO2 (∆3 13.5, p<0.001); the number of steps (∆3 58.6, p<0.001)]; chronotropic responses showed progress over time, with a reduction in resting HR (∆1 -14.1, p=0.006; ∆3 -13.8, p=0.008), greater heart rate recovery (∆3 13.7, p=0.008); lower perception of dyspnea at the 1st minute of recovery (∆1 -1.8, p=0.002; ∆3 -1.8, p<0.001). Conclusion: 3 months post-pulmonary rehabilitation and one-year follow-up after infection, patients showed increases in peripheral and respiratory muscle strength, which were reflected in exercise tolerance as estimated by the 6-minute step test.