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11 pages, 238 KiB

Open AccessArticle

How Long Is Long COVID? Evaluation of Long-Term Health Status in Individuals Discharged from a Specialist Community Long COVID Service

by Rochelle Bodey, Jennifer Grimaldi, Hannah Tait, Belinda Godfrey, Sharon Witton, Jenna Shardha, Rachel Tarrant and Manoj Sivan

J. Clin. Med. 2024, 13(19), 5817; https://doi.org/10.3390/jcm13195817 - 29 Sep 2024

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Abstract

Background: Post COVID-19 syndrome or long COVID (LC) is a novel fluctuating condition with a protracted course in some patients. Specialist LC services have been operational in the UK since 2020 and deal with a high caseload of patients. Aims: To evaluate long-term [...] Read more.

Background: Post COVID-19 syndrome or long COVID (LC) is a novel fluctuating condition with a protracted course in some patients. Specialist LC services have been operational in the UK since 2020 and deal with a high caseload of patients. Aims: To evaluate long-term outcomes in patients discharged from a community-based LC specialist service. Methods: A service evaluation study that included patients who were well engaged in the services [completed the standard Patient Reported Outcome Measures (PROMs) and received intervention from clinician(s)] and had been discharged for at least 3 months from the service. They consented to the study and completed standard PROMs: COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), EQ-5D-5L and National Institute for Health and Care Excellence (NICE) criteria for myalgia encephalomyelitis/chronic fatigue syndrome (ME/CFS). Results: Out of 460 patients contacted, 112 (average of 37.6 months since infection and 9.8 months post-discharge) completed the PROMs. Of these, 90.2% patients continued to experience LC symptoms and disability and had not returned to their pre-COVID-19 health status. The average EQ-5D-5L index score was 0.53 (SD 0.29), highlighting a significant disability and that LC had become a long-term condition (LTC) in the majority of patients who responded to the survey. Of these patients, 43% met the criteria for suspected ME/CFS. Conclusions: A proportion of LC patients develop persistent long COVID (PLC) consistent with a LTC and had a significant overlap with ME/CFS. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

11 pages, 414 KiB

Open AccessArticle

The Impact of COVID-19 on Functional Capacity and Pulmonary Outcomes in the Hail Region: A Cross-Sectional Study

by Omar W. Althomali, Daria Hussain Shaik, Raheela Kanwal, Junaid Amin, Tolgahan Acar, Ahmed Abdelmoniem Ibrahim, Hisham M. Hussein, Aisha Ansari, Ayman A. Alhammad, Mohammad Shahid Ali, Ahmed Alqunun and Wael Alghamdi

J. Clin. Med. 2024, 13(18), 5571; https://doi.org/10.3390/jcm13185571 - 20 Sep 2024

Viewed by 938

Abstract

Background/Objectives: COVID-19, caused by the novel coronavirus SARS-CoV-2, has had a significant impact on life worldwide since its emergence in late 2019. The virus has caused a global pandemic, leading to widespread health, social, economic, and psychological effects. COVID-19 mainly affects the respiratory [...] Read more.

Background/Objectives: COVID-19, caused by the novel coronavirus SARS-CoV-2, has had a significant impact on life worldwide since its emergence in late 2019. The virus has caused a global pandemic, leading to widespread health, social, economic, and psychological effects. COVID-19 mainly affects the respiratory system. This study aimed to compare the functional capacity and pulmonary function outcomes between COVID-19 patients and individuals who have not been infected in the Hail region. Methods: Individuals of both genders above 18 years old who had been infected with COVID-19 in the previous 6 months or had never been infected were eligible to participate. Local hospitals and social media apps were used to recruit willing participants. Heart rate, pulse oxygen saturation, blood pressure, pulmonary function test, hand grip strength, and functional tests (6 min walk test, 30 s sit-to-stand test, and timed up and go test) were measured and compared between the groups. Statistical analysis was performed using SPSS Version 25. Results: Forty individuals affected with COVID-19 and forty-one healthy individuals were recruited. Our results showed that in individuals affected with COVID-19, scores on the minute ventilation, 30 s sit-to-stand, and 6 min walk tests were significantly lower than among healthy individuals. Other outcomes did not show any statistical differences between the groups. Conclusion: This study contributes to a greater understanding of the functional capacity status of individuals with COVID-19. Patients affected by COVID-19 may develop an impaired lung capacity and a decreased function capacity. These factors may negatively affect physical and cognitive health status. Future studies should evaluate the benefits of interventions with rehabilitation exercises following COVID-19. In light of the functional capacity and pulmonary function decline in individuals affected by COVID-19, interventions encompassing pulmonary and functional rehabilitation exercises are recommended to improve physical fitness and pulmonary function post-COVID-19. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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16 pages, 1638 KiB

Open AccessArticle

Long COVID Cardiopulmonary Symptoms and Health Resort Treatment: A Retrospective Study

by Grzegorz Onik, Katarzyna Knapik and Karolina Sieroń

J. Clin. Med. 2024, 13(18), 5563; https://doi.org/10.3390/jcm13185563 - 19 Sep 2024

Viewed by 661

Abstract

Background/Objectives: Long COVID covers many cardio-pulmonary symptoms, worsening individuals’ health status. Health resort treatment applies balneological factors, physical medicine modalities, climate actions, and exercises that may be beneficial for COVID-19 survivors. This study aimed to assess the severity of the cardiopulmonary symptoms [...] Read more.

Background/Objectives: Long COVID covers many cardio-pulmonary symptoms, worsening individuals’ health status. Health resort treatment applies balneological factors, physical medicine modalities, climate actions, and exercises that may be beneficial for COVID-19 survivors. This study aimed to assess the severity of the cardiopulmonary symptoms in people qualified for health resort treatment and its efficacy in this group of patients. Methods: Medical records of 239 people attending health resort treatment were analysed. A total of 122 people (71 women and 51 men) with a mean age of 64.35 years ± 8.66 years were enrolled in the analysis. The cardiopulmonary symptoms of long COVID were assessed twice: before and after health resort treatment. Results: Persisting COVID-19 symptoms do not differentiate between women and men. Health resort treatment reduces symptoms severity in both sexes. Age does not mediate the efficacy of health resort treatment. Conclusions: The persistent symptoms of COVID-19 are of low intensity in people qualified for health resort treatment and are independent of gender. Health resort treatment effectively mitigates dyspnoea, tightness of chest, and sputum in long COVID patients, so it should be implemented into the standard treatment course for COVID-19 survivors as a continuation of therapy. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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14 pages, 1120 KiB

Open AccessArticle

Impact of Spa Therapy on Symptoms and Quality of Life in Post-COVID-19 Patients with Chronic Conditions

by Maria Costantino, Valentina Giudice, Mario Farroni, Francesco Marongiu, Francesco De Caro and Amelia Filippelli

J. Clin. Med. 2024, 13(17), 5091; https://doi.org/10.3390/jcm13175091 - 27 Aug 2024

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Abstract

Background: With limited pharmacological interventions, post-COVID-19 condition is a clinical challenge, and supplementary therapies are essential for symptom relief and enhancing quality of life (QoL). In our prospective observational study, we aimed to evaluate the impact of Salus per aquam (Spa) therapy on [...] Read more.

Background: With limited pharmacological interventions, post-COVID-19 condition is a clinical challenge, and supplementary therapies are essential for symptom relief and enhancing quality of life (QoL). In our prospective observational study, we aimed to evaluate the impact of Salus per aquam (Spa) therapy on post-COVID-19 symptoms and QoL in individuals who suffer from chronic joint, musculoskeletal, skin, and/or respiratory conditions. Methods: A total of 159 individuals undergoing Spa therapy were enrolled, and 78 of them had post-COVID-19 symptoms, assessed using Visual Analogue Scale (VAS) and modified British Medical Research Council Questionnaire (mMRC-DS scales), as well as the Short Form 36 Health Status Survey (SF-36) questionnaire for QoL. Results: Spa therapy significantly reduced most post-COVID-19 symptoms, especially chronic fatigue, pain, brain fog, and persistent cough (all p < 0.05), as well as physical (+72%) and emotional (+66%) limitations. When stratified by sex, males showed a greater improvement from baseline, while females consistently displayed a higher amelioration in all QoL dimensions. Moreover, full vaccination with 3–4 doses significantly protected against SARS-CoV-2 re-infections and post-COVID-19 development (p < 0.05). Conclusions: Spa therapy demonstrated effectiveness in mitigating post-COVID-19 symptoms and enhancing QoL in patients suffering from chronic diseases. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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13 pages, 651 KiB

Open AccessArticle

Compassion Fatigue in a Cohort of South Italian Nurses and Hospital-Based Clinical Social Workers Following COVID-19: A Cross-Sectional Survey

by Rosaria De Luca, Mirjam Bonanno, Maria Grazia Maggio, Antonino Todaro, Carmela Rifici, Carmela Mento, Maria Rosaria Anna Muscatello, Milva Veronica Castorina, Paolo Tonin, Angelo Quartarone, Maria Elena Pugliese and Rocco Salvatore Calabrò

J. Clin. Med. 2024, 13(14), 4200; https://doi.org/10.3390/jcm13144200 - 18 Jul 2024

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Abstract

Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk [...] Read more.

Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk of compassion fatigue (CF). In this multicentric study, as a primary objective, we evaluate the incidence and/or prevalence of CF in a cohort of Italian nurses and HCWs (hospital-based clinical social workers of neurological patients) who have contracted SARS-CoV-2 infection. Our secondary aim is to evaluate the difference in experiencing CF between subjects with and without long-term COVID. Methods: In this study, 101 HCWs attending three different neurorehabilitation settings (the Neurorehabilitation Unit of the “Bonino Pulejo” Neurolesi Center of Messina, the Neurorehabilitation Department of Crotone, and the Psychiatric Unit of the University Hospital of Messina) were enrolled from May 2021 to May 2023. Data were collected through self-administered semi-structured interviews. Results: We observed high percentages of CF difficulties in both nurses and HCWs, related to mood alteration in 57.7%, headaches in 44.4%, and fatigue in 62%. Higher percentages were found in individuals with long-term COVID-19, including mood alteration in 93.9%, headache in 88.6%, and memory-related problems in 98.5%. Conclusions: The complexity of a patient’s care pathway, especially in chronic disease situations, requires an enormous commitment that can lead to burnout and CF, which should be considered to initiate preventive interventions aimed at helping “those who help”, for the well-being of patients, healthcare teams, and healthcare organizations. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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19 pages, 751 KiB

Open AccessArticle

Physical Health in Patients with Post-COVID-19 6 and 12 Months after an Inpatient Rehabilitation: An Observational Study

by Katrin Müller, Marcel Ottiger, Iris Poppele, Alois Wastlhuber, Michael Stegbauer and Torsten Schlesinger

J. Clin. Med. 2024, 13(13), 3988; https://doi.org/10.3390/jcm13133988 - 8 Jul 2024

Cited by 1 | Viewed by 1977

Abstract

Background: Rehabilitation is an effective and feasible approach for post-COVID patients to improve physical health. However, knowledge regarding the long-term impact of rehabilitation on the physical health of these patients is lacking. Methods: Changes in physical health of 127 patients with COVID-19 as [...] Read more.

Background: Rehabilitation is an effective and feasible approach for post-COVID patients to improve physical health. However, knowledge regarding the long-term impact of rehabilitation on the physical health of these patients is lacking. Methods: Changes in physical health of 127 patients with COVID-19 as an occupational disease or work accident were assessed in a longitudinal observational study. Post-COVID symptoms, functional status, functional exercise capacity, endurance capacity, physical performance, quadricep strength, handgrip strength, motor balance ability, and self-reported physical performance were examined at the beginning as well as 6 and 12 months after the rehabilitation. Group differences concerning sex, age, acute COVID status, comorbidities prior to COVID-19, and aftercare interventions were also analysed. Results: Even 12 months after rehabilitation, the prevalence of post-COVID symptoms (28.6–94.7%) remained remarkably high in the study population. Significant improvements in various aspects of physical health were observed 6 (r = 0.288–0.755) and 12 months (r = 0.189–0.681) after the rehabilitation. Participants demonstrated enhanced endurance, strength, and balance function, as well as improvement in subjective physical ability. Significant group differences were observed between younger and older patients, those with mild–moderate and severe–critical COVID-19, and patients with and without pre-existing cardiovascular disease, metabolic disease, psychological disease, neuro-sensory disease, musculoskeletal disease, and exercising in an outpatient group. Conclusions: The study identifies persistent challenges in COVID-19 recovery, despite significant improvements in physical health 6 and 12 months after rehabilitation. Further research and the implementation of standardised approaches are required to enhance the outcomes of post-COVID rehabilitation, with a focus on developing personalised care strategies for long-term recovery. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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12 pages, 639 KiB

Open AccessArticle

The Impact of Resistance Training on Equilibrium Abilities and Quality of Life in Older Adults after SARS-CoV-2 Survival

by Patrycja Bobowik, Jan Gajewski, Ida Wiszomirska, Agnieszka Maciejewska-Skrendo, Katarzyna Leźnicka and Katarzyna Kaczmarczyk

J. Clin. Med. 2024, 13(10), 2747; https://doi.org/10.3390/jcm13102747 - 7 May 2024

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Abstract

Background: The scientific literature on COVID-19 and its long-term impacts on all-body systems and their treatments is still limited. The aim of the study was to create a safe protocol-based intervention to improve functional and equilibrium abilities in older adults impacted by COVID-19. [...] Read more.

Background: The scientific literature on COVID-19 and its long-term impacts on all-body systems and their treatments is still limited. The aim of the study was to create a safe protocol-based intervention to improve functional and equilibrium abilities in older adults impacted by COVID-19. Methods: This study used a sample of 46 people (intervention group: n = 26; control group: n = 20). Resistance training (RT) was held twice a week, with 60 min per session for 8 weeks. The postural stability and quality of life questionnaire (WHQOOL) was completed during pre- and post-testing. Results: The results indicated significant differences in overall stability index (OSI) with eyes open (EO), anterior–posterior stability index (APSI) EO, fall-risk index 6-2 (FRI6-2) values in males (p < 0.05), and APSI EO (p < 0.05) values in females compared to control groups, respectively. In the training, a significant improvement was reported in OSI EO and APSI EO (p < 0.05) female groups compared to baseline results and in FRI6-2 values in both gender groups (p < 0.01—men, p < 0.05—women). The effect of the intervention was recorded in the intervention group in the OSI EO (Z = −3.12, p < 0.01, R = 0.533) and FRI6-2 (Z = −2.06, p < 0.05, R = 0.354). Additionally, significantly different reactions between the groups were observed in the psychological domain (DOM2) (Z = 2.194, p < 0.028, R = 0.389), social relationship domain (DOM3) (Z = 2.051, p < 0.0403, R = 0.361), and in question 2 concerning general health (Z = 3.309, p < 0.0009, R = 0.535). Conclusions: The findings indicate that RT had a positive effect on older adults affected by COVID-19, led to a significant improvement in their postural stability, and had a significant impact on elements of psychological well-being and quality of life. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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14 pages, 1797 KiB

Open AccessArticle

A Comparison of Sensorimotor Integration and Motor Fitness Components between Collegiate Athletes with and without Long COVID: A Cross-Sectional Study with Pair-Matched Controls

by Ibrahim M. Moustafa, Amal Ahbouch, Raheesa P. Kader, Tamer Mohamed Shousha and Abdulla Alrahoomi

J. Clin. Med. 2024, 13(9), 2469; https://doi.org/10.3390/jcm13092469 - 24 Apr 2024

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Abstract

Background: Long COVID presents a concern for collegiate athletes, potentially impacting sensorimotor processing and motor fitness. This study aimed to assess these effects. Methods: This cross-sectional study involved 60 athletes diagnosed with Long COVID and 60 controls. Sensorimotor processing and integration were evaluated [...] Read more.

Background: Long COVID presents a concern for collegiate athletes, potentially impacting sensorimotor processing and motor fitness. This study aimed to assess these effects. Methods: This cross-sectional study involved 60 athletes diagnosed with Long COVID and 60 controls. Sensorimotor processing and integration were evaluated using neurophysiological variables (N13, P14, N20, P27, and N30), while motor fitness was assessed through balance, agility, and vertical jump testing. T-tests compared groups, and Pearson’s correlations explored relationships. Results: Significant differences (p < 0.001) were observed in neurophysiological variables and motor fitness between Long COVID and control groups. Fatigue correlated positively (p < 0.001) with neurophysiological variables in Long COVID cases but not with motor fitness (p = 0.08, p = 0.07, p = 0.09). Conclusions: Collegiate athletes with Long COVID exhibit abnormal sensorimotor processing, integration, and diminished motor fitness compared to uninfected peers. The fatigue severity of Long COVID correlates with neurophysiological changes, suggesting a link between sensorimotor deficits and fatigue. Targeted interventions for sensorimotor deficits and fatigue management are crucial for athletes recovering from Long COVID. This study underscores the importance of addressing these issues to optimize the recovery and performance of collegiate athletes affected by Long COVID. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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15 pages, 2075 KiB

Open AccessArticle

Resistance Exercise Program Is Feasible and Effective in Improving Functional Strength in Post-COVID Survivors

by Katarzyna Kaczmarczyk, Yogi Matharu, Patrycja Bobowik, Jan Gajewski, Agnieszka Maciejewska-Skrendo and Kornelia Kulig

J. Clin. Med. 2024, 13(6), 1712; https://doi.org/10.3390/jcm13061712 - 16 Mar 2024

Cited by 3 | Viewed by 1242

Abstract

Background: Evidence suggests that COVID-19 infection can cause lasting health consequences. Multidisciplinary rehabilitation services have been recommended to reduce the sequalae. However, the effectiveness of physical exercise interventions remains insufficiently documented. The aim of this study was to develop and implement a [...] Read more.

Background: Evidence suggests that COVID-19 infection can cause lasting health consequences. Multidisciplinary rehabilitation services have been recommended to reduce the sequalae. However, the effectiveness of physical exercise interventions remains insufficiently documented. The aim of this study was to develop and implement a specific and well-tolerated protocol-based intervention to reduce muscle weakness in older adults impacted by COVID-19. Methods: Forty-six older adults were randomized into intervention and control groups. Isometric and isokinetic strength assessments were conducted for selected muscle groups using a JBA Staniak^® torquemeter and Biodex System 3 dynamometer. Functional abilities were evaluated with the Time Up and Go test and Chair Stand Tests. Results: Men in the intervention group demonstrated a significant improvement in static conditions for knee flexors (KFs), trunk extensors (TEs) and trunk flexors (TFs) and in dynamic conditions for knee extensors (KEs). Women in the intervention group showed a significant improvement in static conditions for EFs, KFs, TEs and TFs and in dynamic conditions for a KE and a KF. The interaction GROUP × TESTING SESSION was significant for the Chair Test (s) and Chair Test (n). Conclusions: Our results demonstrate the effectiveness of a well-tolerated, protocol-based approach that can be used to diminish long-lasting functional deficits in post-COVID survivors. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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17 pages, 1592 KiB

Open AccessArticle

Improved Functioning and Activity According to the International Classification of Functioning and Disability after Multidisciplinary Telerehabilitation for Post-COVID-19 Condition—A Randomized Control Study

by Indre Bileviciute-Ljungar, Jan-Rickard Norrefalk and Kristian Borg

J. Clin. Med. 2024, 13(4), 970; https://doi.org/10.3390/jcm13040970 - 8 Feb 2024

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Abstract

This study investigates the outcomes and feasibility concerning the functioning and activity of multidisciplinary group telerehabilitation for a post-COVID-19 condition. Recruitment for the group rehabilitation was announced three times during 2021 and 2022 through the COVID-19 patient organization in Sweden. The key inclusion [...] Read more.

This study investigates the outcomes and feasibility concerning the functioning and activity of multidisciplinary group telerehabilitation for a post-COVID-19 condition. Recruitment for the group rehabilitation was announced three times during 2021 and 2022 through the COVID-19 patient organization in Sweden. The key inclusion criteria were remaining symptoms and functional impairments beyond 12 weeks after SARS-CoV-2 infection; medical assessment and treatment regarding comorbidities or new postinfection symptoms; the ability to use the Internet. Participants were randomized into a rehabilitation group or onto a waiting list using an Internet program. Multiple outcomes included self-scored questionnaires and physical tests before and after eight weeks, and at six months follow-up. Here, we present the self-scored outcomes on the International Classification of Functioning and Disability questionnaire (ICF, 22 body functions and 16 activity/participation categories) and breathing scales. Of the 164 participants who registered for the study, 67 (mean age 43, 78% women) participated in an eight-week group rehabilitation compared to 42 who served as waiting list controls (mean age 47, 88% women). At six months follow-up, 60 participants from the rehabilitation group and 21 from the waiting list completed the data. The results indicate that a larger number of ICF body functions and activity/participation categories had improved in the rehabilitation group after eight weeks and six months. Overall credibility, as assessed by the Credibility Expectancy Questionnaire, was high, and the attrition rate in rehabilitation was low. The results indicate beneficial outcomes for multidisciplinary telerehabilitation in people suffering from a post-COVID-19 condition. Therefore, rehabilitation interventions should be further developed and implemented in clinical practice. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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Other

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22 pages, 1431 KiB

Open AccessSystematic Review

Effects of Exercise Rehabilitation on Cardiorespiratory Fitness in Long-COVID-19 Survivors: A Meta-Analysis

by Sothida Nantakool, Piangkwan Sa-nguanmoo, Supatcha Konghakote and Busaba Chuatrakoon

J. Clin. Med. 2024, 13(12), 3621; https://doi.org/10.3390/jcm13123621 - 20 Jun 2024

Viewed by 1025

Abstract

Background: Poor cardiorespiratory fitness poses the highest risk of mortality. Long-COVID-19 survivors exhibit a reduced cardiorespiratory fitness (CRF). While exercise rehabilitation, such as cardiopulmonary exercise, is used for long-COVID-19 survivors, the effects of exercise on CRF in this population remain inconclusive. In [...] Read more.

Background: Poor cardiorespiratory fitness poses the highest risk of mortality. Long-COVID-19 survivors exhibit a reduced cardiorespiratory fitness (CRF). While exercise rehabilitation, such as cardiopulmonary exercise, is used for long-COVID-19 survivors, the effects of exercise on CRF in this population remain inconclusive. In this study, we aim to systematically summarise and synthesise whether exercise rehabilitation improves CRF among long-COVID-19 survivors. Methods: A comprehensive search was performed through PubMed, CINAHL, Embase, Scopus, and the Cochrane Library (since their inception to November 2023) and study reference lists. Studies presenting the effects of exercise rehabilitation on CRF (peak oxygen consumption (VO_2peak) and six-minute walk distance (6MWD)) in long-COVID-19 survivors were identified. The standardised mean difference (SMD), mean difference (MD), and 95% confidence interval (CI) were used for analyses. The certainty of evidence was measured using a Grading of Recommendation Assessment, Development and Evaluation approach. Results: Twelve eligible studies (five RCTs and seven non-RCTs) with 682 participants were analysed. The meta-analysis showed significantly improved 6MWDs (MD 76.47, 95% CI 59.19–93.71, low certainty) and significantly greater 6MWDs (SMD 0.85, 95% CI 0.11–1.59, very low certainty) in the exercise rehabilitation group compared to the control group. A significantly improved 6MWD was found in subgroups of young to middle-aged adults and subgroups of patients who undertook aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. Conclusions: Exercise rehabilitation is effective for improving CRF, as measured by the 6MWD in long-COVID-19 survivors. Improvements are likely to be more pronounced in specific subgroups of young to middle-aged adults and patients undertaking aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. However, recommendations for clinical practice are limited due to the very low evidence certainty. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation—2nd Edition)

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