{
  "abstract": "Rationale Post-COVID condition (PCC) is characterised by persistent symptoms that impair health-related quality of life (HRQoL); rehabilitation (REHAB) strategies remain scarce.Objective To investigate the effect of a symptom-based REHAB programme versus usual care on HRQoL in people with PCC.Methods In this single-blind randomised controlled trial, a total of 132 people with PCC were randomised to either a REHAB group or a control group, with 104 completing the trial. The REHAB group received a multimodal 3-week REHAB programme tailored to the participant’s primary symptom-based group (fatigue, cognitive problems or somatic symptoms); the control group received usual care. The primary endpoint was the between-group difference in change in HRQoL, measured by the 12-item Short Form Health Survey (SF-12) physical component summary (PCS) score at 3 weeks post baseline (intervention period). Changes from baseline to a 3-month follow-up after the intervention period were also analysed as a secondary measure. Additional outcomes included mental HRQoL (SF-12 mental component summary (MCS)), depression symptoms (Patient Health Questionnaire 9 (PHQ-9)) and anxiety symptoms (Generalized Anxiety Disorder 7 (GAD-7)).Results Participants (mean age 47±12.3 years, 90.4% not hospitalised during acute SARS-CoV-2 infection, 69.2% female) in the REHAB group (n=47) showed a significantly greater improvement in PCS compared with the control group (n=57) (mean difference (Δ) 2.9 points, 95% CI 0.2 to 5.7, p=0.038) at 3 weeks post baseline. This difference remained significant at the 3-month follow-up (Δ 4.2 points, 95% CI 1.5 to 6.9, p=0.003). The REHAB group also showed significant improvements in mental HRQoL (MCS: Δ 5.7 points, 95% CI 2.0 to 9.4, p=0.003), as well as in depression symptoms (PHQ-9: Δ −2.7 points, 95% CI −4.2 to −1.2, p<0.001) and anxiety symptoms (GAD-7: Δ −2.4 points, 95% CI −3.7 to −1.1, p<0.001) at 3 weeks post baseline compared with the control group. At the 3-month follow-up, the reduction in depression symptoms remained significant, while no significant differences were observed for mental HRQoL or anxiety symptoms.Conclusion A symptom-based rehabilitation programme significantly improved HRQoL in individuals with PCC after 3 weeks, with some benefits persisting at 3 months.Trial registration number NCT05172206.",
  "authors": [
    {
      "affiliations": [
        "Department of Pulmonary Rehabilitation, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany",
        "Institute for Pulmonary Rehabilitation Research, Teaching Hospital of the Paracelsus Medical University (Salzburg, AT), Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany"
      ],
      "name": "Tessa Schneeberger"
    },
    {
      "affiliations": [
        "Department of Pulmonary Rehabilitation, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany",
        "Institute for Pulmonary Rehabilitation Research, Teaching Hospital of the Paracelsus Medical University (Salzburg, AT), Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany"
      ],
      "name": "Inga Jarosch"
    },
    {
      "affiliations": [
        "Department of Pulmonary Rehabilitation, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany",
        "Institute for Pulmonary Rehabilitation Research, Teaching Hospital of the Paracelsus Medical University (Salzburg, AT), Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany"
      ],
      "name": "Daniela Kroll"
    },
    {
      "affiliations": [
        "Department of Pulmonary Rehabilitation, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany",
        "Institute for Pulmonary Rehabilitation Research, Teaching Hospital of the Paracelsus Medical University (Salzburg, AT), Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany"
      ],
      "name": "Rainer Gloeckl"
    },
    {
      "affiliations": [
        "Department of Pulmonary Rehabilitation, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany",
        "Institute for Pulmonary Rehabilitation Research, Teaching Hospital of the Paracelsus Medical University (Salzburg, AT), Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany"
      ],
      "name": "Carla Schneider"
    },
    {
      "affiliations": [
        "Unabhaengige Statistische Beratungen Bernhard Ulm, Munich, Germany"
      ],
      "name": "Bernhard Ulm"
    },
    {
      "affiliations": [
        "Department of Pneumology, I Medizinische Klinik, University of Augsburg, Augsburg, Germany"
      ],
      "name": "Martin Schwaiblmair"
    },
    {
      "affiliations": [
        "Praxis für Innere Medizin und Pneumologie, Lunge im Zentrum, Erlangen, Germany"
      ],
      "name": "Sabine Lampert"
    },
    {
      "affiliations": [
        "PneumoPraxis Marburg, Marburg, Germany",
        "Pulmonary and Critical Care Medicine, Department of Medicine, University Medical Center Giessen and Marburg, Member of the German Center for Lung Research (DZL), University of Marburg, Marburg, Germany"
      ],
      "name": "Timm Greulich"
    },
    {
      "affiliations": [
        "PneumoPraxis Marburg, Marburg, Germany",
        "Pulmonary and Critical Care Medicine, Department of Medicine, University Medical Center Giessen and Marburg, Member of the German Center for Lung Research (DZL), University of Marburg, Marburg, Germany"
      ],
      "name": "Ida Schoenherr"
    },
    {
      "affiliations": [
        "MECS Research GmbH, Berlin, Germany"
      ],
      "name": "Thomas Schultz"
    },
    {
      "affiliations": [
        "Praxis Dr Schrag, Bad Reichenhall, Germany"
      ],
      "name": "Till Schrag"
    },
    {
      "affiliations": [
        "Technology and Digital Solutions, Stanford Health Care, Palo Alto, California, USA"
      ],
      "name": "Clancy John Dennis"
    },
    {
      "affiliations": [
        "Department of Pulmonary Rehabilitation, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany",
        "Institute for Pulmonary Rehabilitation Research, Teaching Hospital of the Paracelsus Medical University (Salzburg, AT), Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany"
      ],
      "name": "Andreas Rembert Koczulla"
    }
  ],
  "title": "Symptom-based rehabilitation in people with post-COVID-19 condition (RELOAD study): a randomised controlled trial",
  "uid": "7e628216-3b4f-57a2-92df-b3dd689ae157"
}