IMPORTANCE: Long COVID presents an unmet therapeutic need. OBJECTIVE: To determine the effects of a resistance exercise intervention on exercise capacity, health status, and safety among adults after COVID-19 infection. DESIGN, SETTING, AND PARTICIPANTS: A 2-arm, multicenter, randomized clinical trial including 233 adults with a hospital or community diagnosis of COVID-19 infection in the preceding 12 months was undertaken from June 1, 2021, to April 26, 2024. The intervention group comprised 117 individuals, and the control group comprised 116 individuals. A total of 224 individuals at baseline and 193 individuals at 3 months completed Incremental Shuttle Walk Tests. EXPOSURES: The intervention group received the personalized resistance exercise intervention for 3 months, and the control group received treatment as usual. MAIN OUTCOMES AND MEASURES: The primary outcome was the distance achieved (in meters) in the Incremental Shuttle Walk Test undertaken 3 months after randomization. Secondary outcome measures included health-related quality of life (measured by the European Quality of Life 5-Dimension 5-Level Instrument (EQ-5D-5L)), anxiety and depression (measured by the Patient Health Questionnaire), and grip strength. RESULTS: A total of 233 adults (median age 53.6 years (IQR 43.8 to 60.8 years); 146 women (62.7%); 91 (39.1%) hospitalized with COVID-19 infection) were randomized (117 (50.2%) to the intervention group and 116 (49.8%) to the control group). The median percentage adherence with the exercise intervention was 71.0% (IQR 47.8% to 96.8%), equivalent to performing the exercises 5 days per week. The mean (SD) distance achieved in the Incremental Shuttle Walk Test was 328 (225) m for 224 individuals at baseline and 389 (249) m for 193 individuals at follow-up. The mean (SD) change in Incremental Shuttle Walk Test distance at 3 months compared with baseline was 83 (118) m in the intervention group (n = 94) and 47 (95) m in the control group (n = 98) (adjusted mean difference 36.5 m (95% CI 6.6 to 66.3 m); p = 0.02). By 3 months, compared with the control group, greater improvements in the intervention group were also observed for the health-related quality of life utility score (EQ-5D-5L) (0.06 (95% CI 0.01 to 0.11); p = 0.02), Patient Health Questionnaire category (0.5 (95% CI 0.2 to 0.8); p = 0.01), and handgrip strength (2.6 kg (95% CI 0.9 to 4.2 kg); p = 0.002). CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, a 3-month program of resistance exercise among adults after COVID-19 infection appeared to improve walking distance, health-related quality of life, anxiety, depression, and grip strength. This pragmatic intervention may be a generalizable therapy for individuals with persisting physical symptoms after COVID-19 infection. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04900961.

Full text (sometimes free) may be available at these link(s):      help

• PubMed Central
• DOI
• PubMed
• publisher