Enhanced external counterpulsation for management of symptoms associated with long COVID

Mohanakrishnan Sathyamoorthy; Monica Verduzco-Gutierrez; Swathi Varanasi; Robyn Ward; John Spertus; Sachin Shah

doi:10.1016/j.ahjo.2022.100105

Enhanced external counterpulsation for management of symptoms associated with long COVID

Am Heart J Plus. 2022 Feb 12:13:100105. doi: 10.1016/j.ahjo.2022.100105. eCollection 2022 Jan.

Authors

Mohanakrishnan Sathyamoorthy¹, Monica Verduzco-Gutierrez², Swathi Varanasi³, Robyn Ward⁴, John Spertus⁵, Sachin Shah^{3

6}

Affiliations

¹ Department of Internal Medicine, Texas Christian University and University of North Texas Health Science Center School of Medicine, Fort Worth, TX, USA.
² Department of Physical Medicine and Rehabilitation, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, TX, USA.
³ Flow Therapy, Fort Worth, TX, USA.
⁴ Texas Cardiovascular Institute, Fort Worth, TX, USA.
⁵ Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
⁶ University of the Pacific, Stockton, CA, USA.

Abstract

Study objective: Enhanced external counterpulsation (EECP) as a possible therapy for Long COVID.

Design: Retrospective analysis of a contemporary, consecutive patient cohort.

Setting: 7 outpatient treatment centers.

Participants: Long COVID patients.

Intervention: 15-35 EECP treatments.

Main outcome measures: The change from baseline in 1) Patient Reported Outcome Measurement Information System (PROMIS) Fatigue; 2) Seattle Angina Questionnaire (SAQ); 3) Duke Activity Status Index (DASI); 4) 6-Minute Walk Test (6MWT); 5) Canadian Cardiovascular Society (CCS) Angina Grade; 6) Rose Dyspnea Scale (RDS); and 7) Patient Health Questionnaire (PHQ-9).

Results: Compared to baseline, the PROMIS Fatigue, SAQ, DASI, and 6MWT improved by 4.63 ± 3.42 (p < 0.001), 21.44 ± 16.54 (p < 0.001), 18.08 ± 13.82 (p < 0.001), and 200.00 ± 180.14 (p = 0.002), respectively. CCS and RDS improved in 63% and 44% of patients, respectively. All patients unable to work prior to EECP were able to return post-therapy.

Conclusions and relevance: EECP significantly improved validated fatigue and cardiovascular-related markers in patients with Long COVID.

Keywords: COVID-19; EECP; Long COVID; Long Haul Syndrome; PASC.