Long-term COVID: promising program at the ÉPIC Center

Drawing on its extensive experience with patients suffering from heart problems, the ÉPIC Centre of the Montreal Heart Institute has developed a personalized cardiovascular rehabilitation program that has enabled some patients with long-term COVID to improve their quality of life.

After eight weeks, some participants in this program were able to improve their cardiorespiratory capacity (VO2 max, or the body’s ability to transport and use oxygen) and ventilatory efficiency (the amount of air needed to exert an effort).

Some have also noted a reduction in the impact of long-term COVID symptoms on their daily lives.

“We have decades of experience in cardiovascular rehabilitation, particularly with people who sometimes have severe heart disease, but who are [admissibles] “to rehabilitation,” said the study’s leader, postdoctoral researcher Florent Besnier.

“And in people who have this long COVID, there are symptoms that remind us of our patients that we are used to seeing, so muscle wasting, fatigue, problems making efforts in everyday life… We thought that maybe we could help them.”

Additionally, Besnier added, patients with heart problems and those with long-term COVID have in common that they become excessively sedentary and physically inactive, which contributes to their deconditioning.

Intrigued by these similarities between the two patient populations, Besnier and his colleagues recruited and randomly divided into two groups forty participants with an average age of 53.

The first group followed an individualized clinical rehabilitation program at the ÉPIC Center for eight weeks. This program included three weekly sessions of aerobic and resistance exercises as well as daily inspiratory muscle training. The second group maintained their daily habits, without additional intervention for the same period.

“In the intervention group, we were able to observe a statistically and clinically significant improvement in cardiorespiratory capacity of approximately 13%,” said Mr. Besnier. “We also saw a significant improvement in ventilatory efficiency. If I simplify a little, the patients are a little less out of breath for the same level of effort as before the study.”

The researchers also measured a significant improvement in “functional parameters” such as the ability to walk, stand up or sit down. “We’re talking about the impact of the symptoms, not their severity. The impact of the symptoms on family, personal or professional life had diminished,” Besnier said.

Small study

That said, for some reason, one-third of the intervention group experienced no improvement. All of these results, whether positive or negative, are comparable to those obtained during an intervention with cardiac patients.

The study leaders point out that this was a small study with only forty participants. It is therefore not possible to “generalize” the results obtained to all patients with long-term COVID, Mr. Besnier stressed, even if it represents a glimmer of hope for them by demonstrating that it is likely possible to improve their fate if they are offered the right rehabilitation program.

“We now need to assess the long-term impact of the rehabilitation program, but I remain optimistic,” said Besnier, who points out that a study recently published in the medical journal BMJ showed improvements were still present one year after the intervention.

Drawing on its extensive experience with patients suffering from heart problems, the ÉPIC Centre of the Montreal Heart Institute has developed a personalized cardiovascular rehabilitation program that has enabled some patients with long-term COVID to improve their quality of life.

The findings of this study were published by the American Journal of Physical Medicine & Rehabilitation.

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