What happened?
This report describes two patients with persistent respiratory distress about one month after acute COVID-19 treatment. Cardiopulmonary exercise testing was used to identify limitations and individualize rehabilitation exercise.
Clinical findings
- Both patients showed reduced exercise tolerance and impairments involving ventilation, oxygenation, heart-rate reserve, stroke volume and muscle metabolism.
- One 80-year-old man required continuous supplemental oxygen and desaturated to 85% after walking 100 metres at rehabilitation admission.
Rehabilitation described in the report
- Rehabilitation exercise was prescribed and progressed according to cardiopulmonary exercise test findings and clinical monitoring.
- Oxygen requirement, exercise capacity and functional status were followed over time.
Reported outcomes
- Both patients discontinued supplemental oxygen and improved peak exercise aerobic capacity.
- Reported peak aerobic capacity increased from 17.4 to 22.1 in case one and from 9.0 to 16.1 in case two; both were discharged home after approximately three months of training.
Clinical lessons to consider
- Persistent post-pneumonia limitation may involve multiple cardiopulmonary and peripheral factors.
- CPET can help individualize exercise prescription when available and clinically appropriate.
- Monitor oxygen saturation, symptoms and stopping criteria; do not generalize a case-based exercise dose to all post-COVID patients.
Limitations — what this case cannot tell us
- Only two cases are described and there is no control group.
- Improvement cannot be attributed to CPET-guided exercise alone, and findings do not establish safety for unstable patients.
Original source
Ken Kouda, Hideki Konishi, Toshikazu Kubo, Fumihiro Tajima. “Rehabilitation Assessment and Exercise Using Cardiopulmonary Exercise Testing After Coronavirus-Disease Pneumonia: A Case Report.” Frontiers in Rehabilitation Sciences, 2025. DOI: 10.3389/fresc.2025.1533239
View the original publicationThis page is an independently written educational summary, not a reproduction of the full paper. Check the original article for complete methods, outcome tables, references and licensing.