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The weekly recovery of physical capacities in COVID - 19 patients during post - extubation pulmonary rehabilitation Yara Al Samuel Vergès Frédéric Veale UGA Laboratory Alps University , 2Pulmonary rehabilitation center Dieulefit Santé , France Université Grenoble Alpes Dieulefit Santé Introduction Methods Results Graph 2. Weekly change in 6MWD Graph 3. Evolution of during the 6MWT 650 100 Some COVID - 19 patients develop a severe form of the disease and therefore require admission to the intensive care unit ( ) for acute respiratory distress syndrome . 600 550 95 500 19 patients ( 11 male , 8 female ) with an average age of years were admitted to Dieulefit Santé ( PR clinic , France ) . All had at least one of the following comorbidities : cardiovascular disease , chronic obstructive pulmonary disease diabetes , obesity cancer . Mean body mass index was 26 Kg/ We evaluated walking capacities using weekly - minute walking tests ( 6MWT ): distance ( 6MWD ) , oxygen saturation response ( SpO2 ) , heart rate ( HR ), and dyspnea . Graph 1. Example of SpO2 and HR kinetics during the 6MWT 450 400 6MWD ( m ) ( 350 These patients may experience a long stay in ICU with severe complications related to curarization , prolonged anesthesia , prone position unusual specific ventilator settings , and prolonged stay in the pulmonary ward Patients therefore require pulmonary rehabilitation ( PR ) post - extubation , in a specialized center 300 250 80 200 100 150 93 91 80 81 75 100 79 79 79 79 ( % ) 50 7 70 14 35 42 49 56 63 1 2 150 21 28 Days post extubation Duration ( min ) In this study , we aim to evaluate on a weekly basis the recovery of physical capacities post COVID - 19 during 115 110 124 124 124 121 119 HR ( bpm ) 100 50 1 4 5 6 2 3 Duration ( min ) In addition , patients had a global physical and psychological evaluation on arrival and at the end of the gram . On average , they spent 24 days in ICU and 13 in the pulmonary ward at the same hospital post extubation before being admitted to Dieulefit Santé At the end of PR (21 +8 days ) , the 6MWD Most patients had severe desaturation increased from 120 to 337 . during the test in ambient air ( 85 % Patients reached 43 % of the normal without significant perception of predicted distance . A longer delay from dyspnea ( 4 extubation to PR correlated significantly with lower improvement in . Some patients showed signs of fibrosis in All patients had a significant recovery and lung scans , requiring follow - up after 6 returned to normal in the following months . parameters : lung volumes and capacities These findings show the importance of PR leg and handgrip strengths , respiratory in patients post COVID - 19 , the sooner and pressures , balance , anxiety and depression . the longer , the better . A long term follow Post - traumatic stress disorder was not up would be interesting to evaluate the resolved in concerned patients and quality long term impact of COVID - 19 . of life was not significantly improved . Conclusion : Post COVID - 19 pulmonary rehabilitation , the sooner and the longer , the better . ( No conflict of interest to declare )

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The weekly recovery of physical capacities in COVID -19 patients during post-extubation pulmonary rehabilitationYara Al Samuel Vergès Frédéric Veale UGA

Laboratory Alps University, 2Pulmonary rehabilitation center Dieulefit Santé , France UniversitéGrenoble Alpes Dieulefit Santé

Introduction Methods Results

Graph 2. Weekly change in 6MWD Graph 3. Evolution of during the 6MWT650 100

Some COVID -19 patients develop a severeform of the disease and therefore requireadmission to the intensive care unit ( )

for acute respiratory distress syndrome .

600

55095

500

19 patients (11 male , 8 female ) with an

average age of years were admitted to

Dieulefit Santé (PR clinic , France) . All had at

least one of the following comorbidities :cardiovascular disease , chronic obstructive

pulmonary disease diabetes , obesity

cancer. Mean body mass index was 26Kg/ We evaluated walking capacities usingweekly - minute walking tests (6MWT):distance (6MWD ) , oxygen saturation response(SpO2) , heart rate (HR), and dyspnea .

Graph 1. Example of SpO2 and HR kinetics during the 6MWT

450

400

6MWD(m)

(

350

These patients may experience a long stayin ICU with severe complications related tocurarization , prolonged anesthesia , proneposition unusual specific ventilatorsettings, and prolonged stay in thepulmonary ward

Patients therefore require pulmonaryrehabilitation (PR) post-extubation , in aspecialized center

300

250

80

200

100

15093

9180

8175

10079 7979 79

(

%)

50

7

70

14 35 42 49 56 63 1 2

150

21 28

Days post extubation Duration ( min)In this study, we aim to evaluate on aweekly basis the recovery of physical

capacities post COVID - 19 during115

110124 124124121119

HR(

bpm)

100

50

1 4 5 62 3

Duration (min)

In addition , patients had a global physical andpsychological evaluation on arrival and at theend of the gram . On average , they spent24 days in ICU and 13 in thepulmonary ward at the same hospital postextubation before being admitted to DieulefitSanté

At the end of PR (21 +8 days ) , the 6MWD Most patients had severe desaturation

increased from 120 to 337 . during the test in ambient air ( 85%Patients reached 43% of the normal without significant perception ofpredicted distance . A longer delay from dyspnea ( 4extubation to PR correlated significantlywith lower improvement in . Some patients showed signs of fibrosis in

All patients had a significant recovery and lung scans, requiringfollow -up after 6

returned to normal in the followingmonths .

parameters : lung volumes and capacities These findings show the importance of PRleg and handgrip strengths , respiratory

in patients post COVID - 19, the sooner andpressures , balance , anxiety and depression . the longer, the better. A long term followPost-traumatic stress disorder was not up would be interesting to evaluate theresolved in concerned patients and quality long term impact of COVID -19.of life was not significantly improved .

Conclusion : Post COVID -19 pulmonary rehabilitation , the sooner and the longer, the better.(No conflict of interest to declare )