DOI: 10.26068/mhhrpm/20231010-000
title: Telemedicine-supported Rehabilitation after COVID-19 infection (long-covid)

description: The data are a cross-sectional analysis, of a study (DRKS00026245) collected between September 2021 and June 2022. The study was conducted at Hannover Medical School (Lower Saxony, Germany) by the Department of Rehabilitation and Sports Medicine, the Department of Respiratory Medicine, the Department of Neurology, and the Department of Rheumatology and Immunology. Patients with post-COVID-19 syndrome were studied. We included patients from October 2021 to May 2022. The Clinic for Rehabilitation and Sports Medicine at Hannover Medical School in cooperation with the Department of Respiratory Medicine was responsible for the study design, statistical planning, inclusion of study participants, data collection and analysis. Medical evaluation and Exercise testing: After study inclusion, all subjects completed a comprehensive medical evaluation including pulmonary function testing measured by body plethysmography standardized to European Respiratory Society (ERS). We assessed height and weight in a standardized fashion and estimated fat and fat-free mass with a bioimpedance analysis (InBody 720, Biospace, Seoul, Korea). To determine steps per day, patients received a wearable (Forerunner 45, Garmin, Olathe, United States). For testing parameters of exercise capacity and maximum power output patients performed an incremental exercise test using a spirometric system (Oxycon CPX, CareFusion, Würzburg, Germany) on a speed independent bicycle ergometer (Ergoline P150, Bitz, Germany) with 60 to 70 revolutions per minute. The exercise test were carried out in the presence of a physician (specialist for cardiology or internal medicine) together with a sports scientist or a medical technical assistant, all experienced and trained in conducting, evaluating and interpreting exercise performance diagnostics. Except six examinations the incremental test started with a load of 20 Watt (W) increasing in 10 W steps every minute and was stopped with the onset of subjective overexertion because of peripheral muscle fatigue and/or pulmonary limitations. The subjective perceived exertion was assessed by the Borg-scale (Borg G. Borg's perceived exertion and pain scales. Champaign, IL, US: Human Kinetics; 1998.). Heart rate and oxygen uptake were continuously measured breath by breath. Body weight normalized values for maximum power output and VO2max were also expressed as percentage to age- and gender-adjusted reference values (Löllgen H, Leyk D. Exercise Testing in Sports Medicine. Dtsch Arztebl Int 2018 Jun 15;115(24):409-416.; Rapp D, Scharhag J, Wagenpfeil S, Scholl J. Reference values for peak oxygen uptake: cross-sectional analysis of cycle ergometry-based cardiopulmonary exercise tests of 10 090 adult German volunteers from the Prevention First Registry. BMJ Open 2018 Mar 5;8(3):e018697-018697.). The 6MWT is a test to assess submaximal exercise capacity by walking distance. Participants walked a slope-free corridor for a total of six minutes at their own speed and the reached distance was recorded in meters (ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002 Jul 1;166(1):111-117.). The tests were supervised by a trained sports scientists or medical technical assistants. Questionnaires: We distributed a questionnaire for the estimation of HrQoL (short form 36 [SF-36]). We assessed the severity of depression and anxiety with the Hospital Anxiety and Depression Scale (HADS) (Snaith RP. The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes 2003 Aug 1;1:29-29.) and the Fatigue was measured with the FAS (© FAS Fatigue Assessment Scale: ild care foundation [http://www.ildcare.nl]). Data format: The data is stored in an Excel spreadsheet with the .xlsx data format. Units: Questionnaires - points oxygen uptake - ml/min/kg ; % power output - W ; W/kg pulmonary capacity - ml 6MWT - m