Purpose: Patients with COVID-19 often report persistent respiratory symptoms. Limited data exist on how to mitigate long-term sequelae of exercise intolerance and dyspnea. We aimed to study the role of pulmonary rehabilitation (PR) in patients with post-COVID-19. Methods: This was an observational study. Consecutive patients with post-COVID-19, admitted to three separate outpatient PR programs, were enrolled. The program consisted of 8-12 wk of PR sessions (3 times/wk). Data were gathered at the initial visit and discharge. The primary outcome was the change in the 6-min walk test (6MWT) distance. Secondary outcomes included the Shortness of Breath Questionnaire (SOBQ), modified Borg dyspnea scale, Patient Health Questionnaire-9 (PHQ-9), and Lung Information Needs Questionnaire (LINQ). Results: A total of 56 patients completed the PR program (age 62.8 ± 14.7 yr, 57% were men). At baseline, the mean 6MWT was 313.3 ± 193.8 m. On average, the 6MWT improved by 84.3 m after PR (P < .0001). Apart from the modified Borg dyspnea scale, there was improvement across secondary outcomes: SOBQ (−16.9 points), PHQ-9 (−2.6 points), and LINQ (−4.2 points); all P < .05. Conclusion: Pulmonary rehabilitation showed a promising positive effect on patients with with post-COVID-19. It improved exercise capacity, perception of dyspnea, depressive symptoms, and patient knowledge needed to manage their lung disease. Pulmonary rehabilitation should be considered for post-COVID-19 patients.

To evaluate the efficacy and safety of sotatercept, an activin signaling inhibitor, in pulmonary arterial hypertension (PAH). We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing sotatercept versus placebo in PAH. We calculated pooled risk ratios (RR) and mean differences (MD) with their 95% confidence intervals (CI) using a random-effects model. Heterogeneity was assessed with I² statistics. The GRADE approach was used to assess the certainty of evidence. Three RCTs comprising 601 patients were included. Compared to placebo, sotatercept significantly improved 6-minute walk distance (MD 40.57 m; 95% CI 26.64 to 54.5; p < 0.01), and WHO functional class (RR 2.04; 95% CI 1.53 to 2.7; p < 0.01). Sotatercept reduced pulmonary vascular resistance (MD -233.18 dyn·sec·cm^-5; 95% CI -295.84 to -170.52; p < 0.01) and pulmonary artery pressure (MD -14.94 mmHg; 95% CI -19.62 to -10.27; p < 0.01) at study end. No significant differences were observed in all-cause mortality or NT-proBNP levels. Sotatercept was associated with epistaxis, increased hemoglobin, and telangiectasia adverse events. Sotatercept improves exercise capacity, WHO functional class and pulmonary hemodynamics in PAH, with an acceptable safety profile. Long-term studies are needed to confirm sustained benefits. www.crd.york.ac.uk/prospero identifier is CRD420251032174.

To evaluate the efficacy and safety of ensifentrine in chronic obstructive pulmonary disease (COPD). We searched electronic databases and registries until 25 January 2025, for randomized clinical trials (RCTs) comparing ensifentrine vs placebo in patients with COPD. Primary outcomes include forced expiratory volume in one second (FEV₁) area under the curve (AUC), peak FEV₁, and morning trough FEV₁. Ten RCTs involving 2,589 patients were included. Compared with placebo, ensifentrine improved FEV₁ AUC by 104.24 ml (95% CI, 74.03 to 133.44; moderate certainty) on day 1 and by 90.37 ml (95% CI, 54.94 to 125.81; moderate certainty) at study end. Ensifentrine increased peak FEV₁ by 140.99 ml on day 1 (95% CI, 107.48 to 174.5; moderate certainty) and by 118.98 ml at the final assessment (95% CI, 86.49 to 151.47; moderate certainty). Ensifentrine improved morning trough FEV₁ by 42.15 ml (95% CI, 19.87 to 64.43; high certainty). Dose-response analysis showed a bell-shaped curve for all outcomes. Ensifentrine did not significantly differ from placebo in adverse events or improvements in COPD symptoms and quality of life. Compared with placebo, ensifentrine improved lung function in COPD. Larger RCTs are needed to integrate this bronchodilator benefit with patient-centered outcomes. CRD42024571928.