MEDICAL AND SOCIAL REHABILITATION OF ELDERLY PATIENTS WITH POST-COVID SYNDROME AND COPD: THE EXPERIENCE OF KYRGYZSTAN

The coexistence of chronic obstructive pulmonary disease (COPD) and post-COVID syndrome presents significant clinical and social challenges, particularly among elderly populations in geographically diverse countries such as Kyrgyzstan. This study evaluates medical and social rehabilitation strategies for elderly patients with these conditions, with special emphasis on differences between urban and high-altitude regions.

A mixed-methods approach was employed, combining clinical assessments, spirometry, biomarker analysis (IL-6, TNF-α, CRP), patient-reported outcomes, and semi-structured interviews. The study included a total of 150 participants aged 60 years and older, recruited from urban (Bishkek) and high-altitude (Naryn) regions. Participants were distributed into four groups: COPD (n=35), post-COVID syndrome (n=40), COPD with post-COVID syndrome (n=45), and a control group (n=30). Results demonstrated that patients with both COPD and post-COVID syndrome exhibited the highest inflammatory marker levels, severe lung function decline (average FEV1 48.5% predicted), and greater functional limitations, including mobility impairment and severe dyspnea.

High-altitude patients experienced lower oxygen saturation, elevated inflammation, and higher fatigue scores, reflecting the additional burden of chronic hypoxia. Rehabilitation outcomes were more favorable in urban settings, where specialized services and oxygen therapy were more accessible.

The findings emphasize the urgent need for tailored rehabilitation strategies, including altitude-adapted pulmonary rehabilitation, anti-inflammatory therapies, telemedicine, and expanded home-based oxygen care. Strengthening healthcare infra-structure and addressing regional disparities are critical for improving outcomes and quality of life in this vulnerable population.