The effect of COVID rehabilitation for ongoing symptoms Post HOSPitalisation with COVID-19 (PHOSP-R): protocol for a randomised parallel group controlled trial on behalf of the PHOSP consortium

Enya Daynes*, Molly Baldwin, Neil J. Greening, Thomas Yates, Nicolette C. Bishop, George Mills, Matthew Roberts, Malik Hamrouni, Tatiana Plekhanova, Ioannis Vogiatzis, Carlos Echevarria, Rashmita Nathu, Hamish J. C. Mcauley, Lorna Latimer, Jennifer Glennie, Francesca Chambers, Ruth Penfold, Emily Hume, Dimitrios Megaritis, Charikleia AlexiouSebastian Potthoff, Mitchell James Hogg, Catherine Haighton, Bethany Nichol, Olivia C. Leavy, Matthew Richardson, Omer Elneima, Amisha Singapuri, Marco Sereno, Ruth M. Saunders, Victoria C. Harris, Claire M. Nolan, Charlotte Bolton, Linzy Houchen-wolloff, Ewen M. Harrison, Nazir Lone, Jennifer Quint, James D. Chalmers, Ling-pei Ho, Alex Horsley, Michael Marks, Krisnah Poinasamy, Betty Ramen, Louise V. Wain, Christopher Brightling, William D.-c. Man, Rachael Evans, Sally J. Singh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
27 Downloads (Pure)


Many adults hospitalised with COVID-19 have persistent symptoms such as fatigue, breathlessness and brain fog that limit day-to-day activities. These symptoms can last over 2 years. Whilst there is limited controlled studies on interventions that can support those with ongoing symptoms, there has been some promise in rehabilitation interventions in improving function and symptoms either using face-to-face or digital methods, but evidence remains limited and these studies often lack a control group.

Methods and analysis
This is a nested single-blind, parallel group, randomised control trial with embedded qualitative evaluation comparing rehabilitation (face-to-face or digital) to usual care and conducted within the PHOSP-COVID study. The aim of this study is to determine the effectiveness of rehabilitation interventions on exercise capacity, quality of life and symptoms such as breathlessness and fatigue. The primary outcome is the Incremental Shuttle Walking Test following the eight week intervention phase. Secondary outcomes include measures of function, strength and subjective assessment of symptoms. Blood inflammatory markers and muscle biopsies are an exploratory outcome. The interventions last eight weeks and combine symptom-titrated exercise therapy, symptom management and education delivered either in a face-to-face setting or through a digital platform ( The proposed sample size is 159 participants, and data will be intention-to-treat analyses comparing rehabilitation (face-to-face or digital) to usual care.

Ethics and dissemination
Ethical approval was gained as part of the PHOSP-COVID study by Yorkshire and the Humber Leeds West Research NHS Ethics Committee, and the study was prospectively registered on the ISRCTN trial registry (ISRCTN13293865). Results will be disseminated to stakeholders, including patients and members of the public, and published in appropriate journals.

Article summary
Strengths and limitations of this study

• This protocol utilises two interventions to support those with ongoing symptoms of COVID-19

• This is a two-centre parallel-group randomised controlled trial

• The protocol has been supported by patient and public involvement groups who identified treatments of symptoms and activity limitation as a top priority
Original languageEnglish
Article number61
Number of pages10
Issue number1
Publication statusPublished - 26 Jan 2023


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