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Background <p>Patients with chronic lung disease (CLD) and post-COVID syndrome suffer from multidimensional impairment that is often incompletely addressed by pharmacotherapy alone. We evaluated a ward-based multidisciplinary pathway integrating pharmacotherapy, psychological support, and pulmonary rehabilitation.</p> Methods <p>In this prospective controlled cohort study, 360 hospitalized patients with CLD and post-COVID syndrome received integrated multidisciplinary care (<i>n</i> = 120) or usual care (<i>n</i> = 240). The primary outcomes were changes in PaCO₂, FEV₁% predicted, and CT-assessed residual radiological abnormality extent. Patient-reported outcomes, functional capacity, inflammation, and 6-month follow-up data were also assessed. Analyses used adjusted regression and IPTW.</p> Results <p>Integrated care was associated with greater improvements in the three primary outcomes: PaCO₂, adjusted β − 0.98 mmHg (95% CI − 1.21 to − 0.75; <i>P</i> &lt; 0.001); FEV₁% predicted, adjusted β 2.35% points (95% CI 1.53 to 3.17; <i>P</i> &lt; 0.001); and CT-assessed residual abnormality extent, adjusted β − 0.55% points (95% CI − 0.87 to − 0.24; <i>P</i> &lt; 0.001). Integrated care was also associated with greater improvements in SGRQ score, SAS score, 15-minute walking distance, CRP, ESR, and sleep-quality score. The composite early clinical benefit rate was higher in the integrated-care group than in the usual-care group, with an adjusted OR of 1.91 (95% CI 1.21 to 3.01; <i>P</i> = 0.006). At 6 months, sleep quality was better and symptom-related medication use was lower, while rehospitalisation, acute exacerbation, and CT progression rates were similar between groups.</p> Conclusions <p>The integrated pathway was associated with broader short-term clinical improvement and lower symptom-related treatment burden at follow-up, although rehospitalisation, acute exacerbation, and CT progression rates were similar between groups.</p>

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A multidisciplinary pulmonary rehabilitation pathway for hospitalized patients with chronic lung disease and post-COVID syndrome: a prospective controlled cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月23日

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  • Aibo Zheng,
  • Kai Sun,
  • Shengjun Ma,
  • Yan Jin,
  • Wenjun Li,
  • Zhiyu Chen,
  • Feizhong Gong,
  • Juan Pen,
  • Xin Ming,
  • Aibo Zheng

摘要

Background

Patients with chronic lung disease (CLD) and post-COVID syndrome suffer from multidimensional impairment that is often incompletely addressed by pharmacotherapy alone. We evaluated a ward-based multidisciplinary pathway integrating pharmacotherapy, psychological support, and pulmonary rehabilitation.

Methods

In this prospective controlled cohort study, 360 hospitalized patients with CLD and post-COVID syndrome received integrated multidisciplinary care (n = 120) or usual care (n = 240). The primary outcomes were changes in PaCO₂, FEV₁% predicted, and CT-assessed residual radiological abnormality extent. Patient-reported outcomes, functional capacity, inflammation, and 6-month follow-up data were also assessed. Analyses used adjusted regression and IPTW.

Results

Integrated care was associated with greater improvements in the three primary outcomes: PaCO₂, adjusted β − 0.98 mmHg (95% CI − 1.21 to − 0.75; P < 0.001); FEV₁% predicted, adjusted β 2.35% points (95% CI 1.53 to 3.17; P < 0.001); and CT-assessed residual abnormality extent, adjusted β − 0.55% points (95% CI − 0.87 to − 0.24; P < 0.001). Integrated care was also associated with greater improvements in SGRQ score, SAS score, 15-minute walking distance, CRP, ESR, and sleep-quality score. The composite early clinical benefit rate was higher in the integrated-care group than in the usual-care group, with an adjusted OR of 1.91 (95% CI 1.21 to 3.01; P = 0.006). At 6 months, sleep quality was better and symptom-related medication use was lower, while rehospitalisation, acute exacerbation, and CT progression rates were similar between groups.

Conclusions

The integrated pathway was associated with broader short-term clinical improvement and lower symptom-related treatment burden at follow-up, although rehospitalisation, acute exacerbation, and CT progression rates were similar between groups.