PL-LBA-2214

J. Szczegielniak^1,2, A. Szczegielniak³, J. Łuniewski^1,4, K. Bogacz^1,2

¹Opole University of Technology, Physiotherapy Department, Opole, Poland, ²Ministry of Internal Affairs and Administration's Specialist Hospital of St. John Paul II, Glucholazy, Poland, ³Medical University of Silesia, Department of Psychoprophylaxis, Katowice, Poland, ⁴Stobrawskie Medical Center, Kup, Poland

Background: The course of SARS-CoV-2 infection is characterized by a wide range of symptoms, in some cases leading to severe acute respiratory failure and even death. Updated report of the Ministry of Health on the COVID-19 in Poland indicates that more than 6 million people suffered due to the infection and over 116 thousands died between March 2020 and August 2022. Research indicates that the presence of persistent COVID-19 symptoms of various severity and duration affecting diverse systems after the acute phase, is not dependent on the course of the infection, and the post-COVID syndrome itself may have several clinical subtypes. Published data show that even as much as ¼ of all patients with persistent COVID-19 symptoms suffer from mental health disorders, primarily due to depression and anxiety.

Purpose: To assess the impact of an unique in-hospital comprehensive rehabilitation pilot program developed on the basis of pulmonary physical therapy for adult post-COVID-19 patients on reducing severity of anxiety and depression symptoms.

Methods: The program was available for all patients who presented post-COVID symptoms after 12 weeks from recovery. Patients were examined before and after the treatment program through the Hospital Scale of Anxiety and Depression (HADS), a standardized measurement scale allowing to assess the severity of depressive and anxiety symptoms. The study group included a randomized sample from more than 3000 patients treated in the Pulmonary Rehabilitation Department of the Specialist Hospital of the Ministry of the Interior and Administration in Glucholazy between September 2020 and December 2022.

Results: The study group consisted of 337 patients (199 women, 59% vs 288 men, 41%) with age distribution as follows: mean age 63.41 ± 9.0 years, range 27 -85 years (women: mean age 64.48 ± 8.4 years, range 40 -85 years; men: mean age 61.87 ± 9.8 years, range 27 -83 years). The pre- therapy HADS-D scores in the study group categorize as follows: 53.5% (n = 180) normal, 25.8% (n = 87) mild, 16.6% (n = 56) moderate, and 4.1% (n=14) severe; the post-therapy scores categorized as normal present 92.5% (n=312) patients. The pre- therapy HADS-A scores in the study group categorize as follows: 50.2% (n = 169) normal, 23.1% (n = 78) mild, 20.8% (n = 70) moderate, and 5.9% (n=20) severe; the post-therapy scores categorized as normal present 88.7% (n=299) patients. Comparison of the results obtained by patients on the HADS scales in the pre and post rehabilitation assessment shows a significant improvement in reduction of the severity of both depressive and anxiety symptoms (p < 0.001; Wilcoxon test).

Conclusions: 1) The prevalence of depressive and anxiety symptoms in the post-COVID-19 recovery period is high. 2) Comprehensive in-hospital post-COVID-19 rehabilitation program, through varied multimodal action, reduce the symptoms of depression and anxiety as well as general emotional distress after the traumatic experiences.

Implications: The improvement of mental and somatic functioning accelerates the rehabilitation process and facilitate the return to general health and varied social roles. More consideration should be given to regular mental status assessment among patients with persistent COVID-19 symptoms.

Funding acknowledgements: The program was financed under the National Health Fund (the Regulation of the Minister of Health from 13 July 2020)

Keywords:
COVID-19
Mental health
In-hospital rehabilitation

Topics:
COVID-19
Mental health
Cardiorespiratory

Did this work require ethics approval? Yes

Institution: State Higher Vocational School in Nysa

Committee: Bioethics Committee of the State Higher Vocational School in Nysa

Ethics number: 44562