Post-Hospitalisation COVID-19 Rehabilitation (PHOSP-R): a randomised controlled trial of exercise-based rehabilitation

Eur Respir J. 2025 May 22;65(5):2402152. doi: 10.1183/13993003.02152-2024. Print 2025 May.

Abstract

Objective: Post-COVID syndrome involves prolonged symptoms with multisystem and functional impairment lasting ≥12 weeks after acute coronavirus disease 2019 (COVID-19). We aimed to determine the efficacy of exercise-based rehabilitation interventions, either face-to-face or remote, compared to usual care in individuals experiencing post-COVID syndrome following a hospitalisation with acute COVID-19.

Design: This single-blind randomised controlled trial compared two exercise-based rehabilitation interventions (face-to-face or remote) to usual care in participants with post-COVID syndrome following a hospitalisation. The interventions were either a face-to-face or remote 8-week programme of individually prescribed exercise and education. The primary outcome was the change in Incremental Shuttle Walking Test (ISWT) following 8 weeks of intervention (either face-to-face or remote) compared to usual care. Other secondary outcomes were measured including health-related quality of life (HRQoL), and exploratory outcomes included lymphocyte immunotyping.

Results: 181 participants (55% male, mean±sd age 59±12 years, length of hospital stay 12±19 days) were randomised. There was an improvement in the ISWT distance following face-to-face rehabilitation (mean 52 m, 95% CI 19-85 m; p=0.002) and remote rehabilitation (mean 34 m, 95% CI 1-66 m; p=0.047) compared to usual care alone. There were no differences between groups for HRQoL self-reported symptoms. Analysis of immune markers revealed significant increases in naïve and memory CD8+ T-cells following face-to-face rehabilitation versus usual care alone (p<0.001, n=31).

Conclusion: Exercise-based rehabilitation improved short-term exercise capacity in post-COVID syndrome following an acute hospitalisation and showed potential for beneficial immunomodulatory effects.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • COVID-19* / rehabilitation
  • Exercise Therapy* / methods
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Post-Acute COVID-19 Syndrome
  • Quality of Life
  • SARS-CoV-2
  • Single-Blind Method
  • Treatment Outcome
  • Walk Test