RESUMEN
OBJECTIVES: To examine changes in functional capacity, health-related quality of life and psychological distress in patients with post-COVID-19 condition following a multidisciplinary rehabilitation programme. In addition, to explore whether additional respiratory muscle training for more impaired patients might support their recovery process. DESIGN: Retrospective observational cohort study. PATIENTS: A total of 779 patients with post-COVID-19 condition (47.9% female, mean age 56.6 years). METHODS: Measures assessed were: 6-minute walk test (6MWT), 5-level EQ-5D (EQ-5D-5L) including EQ Visual Analogue Scale (EQ-VAS) and Patient Health Questionnaire-4 (PHQ-4). Data were provided pre- and post-rehabilitation from 2 cohorts: (i) patients participating in a regular multidisciplinary rehabilitation programme; and (ii) patients receiving additional respiratory muscle training due to an initially greater level of impairment. Dependent t-tests and general linear mixed models were used for data analysis. RESULTS: A series of dependent t-tests revealed mean overall improvement for both groups in 6-minute walk test distance (6MWD), EQ-5D-5L index, EQ-VAS and PHQ-4 following the rehabilitation programme. General linear mixed models showed significant interaction effects between groups and time for the EQ-5D-5L index and 6MWD. CONCLUSION: A multidisciplinary rehabilitation programme appears to have a beneficial impact on the recovery process of patients with post-COVID-19 condition.
Asunto(s)
COVID-19 , Distrés Psicológico , Humanos , Femenino , Persona de Mediana Edad , Masculino , Pacientes Internos , Calidad de Vida , Estudios Retrospectivos , Encuestas y Cuestionarios , Estado de SaludRESUMEN
BACKGROUND: Chronic obstructive pulmonary disease (COPD) represents a major global health problem; however, there are no data regarding clinical phenotypes of these patients in Austria. METHODS: This was an analysis from the Austrian cohort of the cross-sectional Phenotypes of COPD in Central and Eastern Europe (POPE) study, which was offered to patients with stable COPD in a real-life setting. Patients were recruited at 5 different outpatient facilities in 3 different provinces in Austria. All consecutive patients aged ≥40 years with a diagnosis of COPD confirmed by a post-bronchodilator forced expired volume in 1 s/forced vital capacity (FEV1/FVC) ratio <0.7 during a stable state (≥4 weeks without exacerbation or worsening of any relevant comorbidities) were considered eligible. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analyses of differences in patient characteristics, symptom load, comorbidities, and pharmacological treatment. RESULTS: Among 283 patients fulfilling the inclusion criteria, 49.5% were considered non-exacerbators, 21.6% were classified as exacerbators with chronic bronchitis, 21.2% exacerbators without chronic bronchitis, and 7.8% were patients with an asthma-COPD overlap. Exacerbators had significantly higher prevalence of symptoms, lower lung function and exercise capacity, and a higher prevalence of comorbidities, such as heart failure and depression, compared with the other patient phenotypes. A large majority of patients with stable COPD in this cohort received inhaled triple therapy, irrespective of exacerbation history. CONCLUSIONS: There were significant differences in COPD outcome measures between predefined phenotypes of COPD in this study. The majority of patients with stable COPD in this Austrian population were not treated according to current COPD guidelines. While non-exacerbators appear to have been overtreated, patients with an asthma-COPD overlap appear to have been undertreated.