Post-COVID Rehabilitation Outcomes: A Comparative Cohort Study

To evaluate and compare rehabilitation outcomes in patients with post-COVID syndrome (post-COVID) vs those with pulmonary, cardiovascular, metabolic, and orthopedic conditions.

Monocentric comparative cohort pre-post study.

Outpatient rehabilitation center.

Consecutive sample of 597 outpatient rehabilitation patients (N=597) (post-COVID, 227; orthopedic disorder, 147; cardiovascular disorder, 84; metabolic disorder, 83; chronic obstructive pulmonary disease [COPD], 35; asthma, 24) aged 50.3±12.7 years, 54.6% women.

Individualized, multidisciplinary outpatient rehabilitation (6-10wk, total 3.000min, minimum 3sessions/wk, and 2-3h/session) including strength/endurance training, physiotherapy, psychological support, and nutritional counseling.

Physical function was assessed with the 6-minute walking test (6MWT), and quality of life (QOL) with the 5-level EuroQol 5-dimensional questionnaire were measured at admission and discharge of outpatient rehabilitation. Differences within and between groups were analyzed using the analysis of variance, and the effect of baseline values on the outcome's performance was modeled.

The Post-COVID group was younger (44.7±12.6y), and the percentage of women (75.4%) was higher than in other outpatient rehabilitation groups. All groups improved significantly during rehabilitation. Patients with post-COVID showed the lowest baseline and discharge QOL scores. Baseline-adjusted scores demonstrated that, despite overall improvements, the post-COVID group reported significantly lower QOL than other outpatient rehabilitation groups, except the COPD group. In contrast, the post-COVID group achieved the highest physical function gains in 6MWT (+60.4m, P<.001). Baseline-adjusted scores indicated the highest physical function in patients with post-COVID (6MWT, PC = 632.4 m vs ALL = 603.4 m), outperforming all other outpatient rehabilitation groups. Baseline and change scores were negatively correlated, highlighting the need for baseline adjustment.

Although outpatient rehabilitation was associated with improvements in physical function in patients with post-COVID, QOL deficits persist, discordant with other common outpatient rehabilitation indications. Targeted rehabilitation strategies addressing mental health and fatigue are needed to optimize post-COVID recovery.