EFFECT OF NIV WITH BILEVEL COMBINED WITH AEROBIC EXERCISE IN LONG COVID: POST HOC CLINICAL TRIAL STUDY

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Introduction: Non-invasive ventilation (NIV) with bilevel positive airway pressure (BiPAP) has been shown to reduce muscle overload and improve airflow during exercise in patients with chronic cardiac and pulmonary diseases. Objective: To evaluate the hemodynamic effects and the perception of dyspnea and fatigue with BiPAP during an aerobic exercise (AE) session in individuals recovering from severe COVID-19. Methodology: This post hoc cross-sectional observational study is part of the COVIDReab clinical trial. Participants with severe COVID-19 and an mMRC symptom score of 2 or 3 were divided into two groups: AE and AE combined with BiPAP (AE + NVI). The exercise protocol included 5 minutes of warm-up, 15 minutes of treadmill aerobic exercise at 50% of the training heart rate (HR) based on the peak HR from a cardiopulmonary exercise test, and 5 minutes of active cool-down. Results: The study included 26 participants (14 in AE group and 12 in AE + NVI group). The AE + NVI group showed a more pronounced reduction in HR during active cool-down (p< 0.001), a decrease in diastolic blood pressure (DBP) during active cool-down (p=0.01), and improved SpO2 post-exercise (p=0.03). Additionally, the AE + NVI group exhibited significantly lower dyspnea values post-exercise compared to peak levels (p<0.001) and during active cool-down compared to post-exercise (p=0.01), effects not observed in the AE group. Conclusion: The use of BiPAP during AE accelerates hemodynamic and HR recovery and reduces dyspnea perception in individuals recovering from severe COVID-19, highlighting its potential as an important adjunct in physical rehabilitation for Long COVID.

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