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Effects of aerobic training on cardiopulmonary fitness in patients with long COVID-19: a randomized controlled trial
Bai B, Xu M, Zhou H, Liao Y, Liu F, Liu Y, Yuan Y, Geng Q, Ma H
Trials 2024 Oct 3;25(649):Epub
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Long COVID-19 is characterized by systemic deterioration of the entire body, leading to significant physical and mental disorders. Exercise training has the potential to improve persistent symptoms and cardiopulmonary functions. METHOD: This was a single-center, randomized, controlled trial. Twenty-four patients aged 18 to 75 years who had a history of SARS-CoV-2 infection and long COVID symptoms. Patients were randomly allocated in a 1:1 ratio to receive either a 4-week exercise training program or an attention control group. The training group participated in 12 supervised aerobic sessions on a cycling ergometer over 4 weeks. The outcomes were to assess the impact of a 4-week aerobic exercise on the persistent symptoms and cardiopulmonary fitness, the surrogate endpoints of COVID-19 recovery and cardiopulmonary health. RESULTS: After the 4-week intervention, significant reductions were observed in the total number of symptoms in the training group. Specifically, 67.8% of patients in the training group exhibited reduced or completely resolved symptoms, in comparison to 16.7% in the control group (p = 0.013). After adjusting for gender, significant improvements in the training group were observed for exercise time (pgroup*time = 0.028), maximum load (pgroup*time = 0.01), and peak VO2 (pgroup*time = 0.001), as well as O2 pulse (pgroup*time = 0.042) and maximum heart rate (pgroup*time = 0.007). The score of Short Form-12, depression, anxiety, perceived stress, and insomnia did not show significant changes between groups (pgroup*time > 0.05). CONCLUSION: A supervised aerobic training program has the potential to alleviate persistent symptoms and improve exercise tolerance in patients with long COVID-19. Further research is necessary to confirm these effects in a large population. This intervention could be easily implemented in non-hospital settings, potentially benefiting a broader range of individuals. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT05961462. Registered on July 25, 2023.

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