Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w

Physical exercise as a treatment for persisting symptoms post COVID infection –review of ongoing studies and prospective training study

A. Kogel1, M. Machatschek1, R. Scharschmidt2, C. Wollny2, F. Lordick3, M. Ghanem2, U. Laufs1, S. Fikenzer1

1Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig; 2Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Universitätsklinikum Leipzig, Leipzig; 3Medizinische Klinik und Poliklinik 2 – Onkologie, Gastroenterologie, Hepatologie, Pneumologie, Infektiologie, Universitätsklinikum Leipzig, Leipzig;

To date, no evidence-basedtreatment is available for the increasing number of patients withpersisting symptoms postCOVID19 infection.We hypothesized thatphysical exercise mayrepresent a safe and effective treatmentoptionpostCOVID.We performed a systematic searchoftheliteraturethat revealed a lack of randomized trainingstudies in patients postCOVID. Based on these findings a prospective randomized controlledstudy with open-label andblinded endpoint evaluation was designed.272 patients withsymptoms of fatigue persisting over6weeks postCOVIDinfection were screened.Patientswith cardiovascular findings were excluded.44patientsconsented andwere randomizedtofour weeks of supervised personalized strength endurance training for 4 weeks or usualcare.The mean age was 42.7±13.4 years,and61% were females.There were no adverse events related to the training.Spirometric analysis showedasignificantly higher increaseinVO2peak(exercise: 10.0±12.7% vs. control: 0.1±8.9%, p<0.01)and oxygen-pulse(exercise: 9.8±10.8% vs. control: 0.0±13.9%, p<0.05) indicating the trainingeffects of the intervention.Parameters of the Multidimensional Fatigue inventory-20 (MFI-20),theMcGill Quality of Life Questionnaire (MQOL),and thePost-COVID-19 Functional Status(PCFS)were significantly improved after 4 weeks in both groups.The improvementsinfatigueand quality of lifewere notstatistically differentbetween the training and usual care groups.Conclusion: Exercise is safe and improves physical capacityin post-COVID patients. Fatigueand quality of life improve over time in individuals that are willing to participate in a trainingstudy irrespective of allocation to the training group.

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