{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T03:10:50Z","timestamp":1774494650938,"version":"3.50.1"},"reference-count":75,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T00:00:00Z","timestamp":1724716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FI.R.S.Thermae"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: With limited pharmacological interventions, post-COVID-19 condition is a clinical challenge, and supplementary therapies are essential for symptom relief and enhancing quality of life (QoL). In our prospective observational study, we aimed to evaluate the impact of Salus per aquam (Spa) therapy on post-COVID-19 symptoms and QoL in individuals who suffer from chronic joint, musculoskeletal, skin, and\/or respiratory conditions. Methods: A total of 159 individuals undergoing Spa therapy were enrolled, and 78 of them had post-COVID-19 symptoms, assessed using Visual Analogue Scale (VAS) and modified British Medical Research Council Questionnaire (mMRC-DS scales), as well as the Short Form 36 Health Status Survey (SF-36) questionnaire for QoL. Results: Spa therapy significantly reduced most post-COVID-19 symptoms, especially chronic fatigue, pain, brain fog, and persistent cough (all p &lt; 0.05), as well as physical (+72%) and emotional (+66%) limitations. When stratified by sex, males showed a greater improvement from baseline, while females consistently displayed a higher amelioration in all QoL dimensions. Moreover, full vaccination with 3\u20134 doses significantly protected against SARS-CoV-2 re-infections and post-COVID-19 development (p &lt; 0.05). Conclusions: Spa therapy demonstrated effectiveness in mitigating post-COVID-19 symptoms and enhancing QoL in patients suffering from chronic diseases.<\/jats:p>","DOI":"10.3390\/jcm13175091","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T11:58:46Z","timestamp":1724759926000},"page":"5091","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Spa Therapy on Symptoms and Quality of Life in Post-COVID-19 Patients with Chronic Conditions"],"prefix":"10.3390","volume":"13","author":[{"given":"Maria","family":"Costantino","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy"},{"name":"University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d, 84121 Salerno, Italy"},{"name":"Non-Profit Association F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80078 Pozzuoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7492-6848","authenticated-orcid":false,"given":"Valentina","family":"Giudice","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy"},{"name":"University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d, 84121 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Farroni","sequence":"additional","affiliation":[{"name":"Non-Profit Association F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80078 Pozzuoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Marongiu","sequence":"additional","affiliation":[{"name":"Non-Profit Association F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80078 Pozzuoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9659-9940","authenticated-orcid":false,"given":"Francesco","family":"De Caro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy"},{"name":"University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d, 84121 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-9118","authenticated-orcid":false,"given":"Amelia","family":"Filippelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy"},{"name":"University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d, 84121 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.4014\/jmb.2003.03011","article-title":"Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19)","volume":"30","author":"Ahn","year":"2020","journal-title":"J. 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