Library Subscription: Guest
Critical Reviews™ in Physical and Rehabilitation Medicine

Published 4 issues per year

ISSN Print: 0896-2960

ISSN Online: 2162-6553

SJR: 0.141 SNIP: 0.129 CiteScore™:: 0.6 H-Index: 18

Indexed in

A Review of Pulmonary Rehabilitation in Patients with COVID-19

Volume 32, Issue 4, 2020, pp. 269-283
DOI: 10.1615/CritRevPhysRehabilMed.2020036542
Get accessGet access

ABSTRACT

Coronavirus disease−2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus disease-2, is the first pandemic that has been caused by a coronavirus. The COVID-19 pandemic has already led to a marked increase in burdens including disease, disability, and health-care system costs. Patients with COVID-19 may present with a broad spectrum of clinical features such as fever, cough, shortness of breath, myalgia, fatigue, sore throat, hemoptysis, and diarrhea. To our knowledge, no specific antiviral or vaccine is available for COVID-19 treatment and prevention. Present-day management includes supportive care, oxygen supplementation, and mechanical ventilatory support when indicated, along with infection control measures. Apart from physical symptoms, patients usually face various social or psychological problems; hence, comprehensive health status assessment is essential. During the first year following acute respiratory distress syndrome of any cause, more than two-thirds of survivors reported clinically significant fatigue symptoms. This proves the need for appropriate rehabilitation for COVID-19 survivors. Pulmonary rehabilitation aims to improve respiratory function and quality of life in patients with various disorders. Studies are required to define those patients with impaired health conditions after COVID-19 infection during follow-up. However, an easy method for prescribing pulmonary rehabilitation is according to disease severity. Rehabilitation must start at admission and continue after discharge. At the time of discharge from a COVID care center, patients must be educated for home-based rehabilitation.

REFERENCES
  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506.

  2. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: Classifying 2019-nCoV and naming it SARS-CoV-2. Nature Microbiol. 2020;5:536-44.

  3. who.int [homepage on Internet]. WHO director-general's remarks at the media briefing on 2019-CoV on Feb 11, 2020. Geneva, Switzerland [cited2020Aug 20]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020.

  4. Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar;55(3):105924.

  5. who.int [homepage on Internet]. WHO director-general's opening remarks at the media briefing on COVID-19; 11 March 2020. Geneva, Switzerland [cited 2020 Aug 20]. Available from https://www. who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19.

  6. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation, and treatment of coronavirus (COVID-19) [monograph on the Internet]. Treasure Island, FL: StatPearls Publishing; 2020 [cited 2020 Aug 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554776/.

  7. Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020 Apr;10(2):102-8.

  8. cdc.gov [homepage on the Internet]. Information for clinicians on investigational therapeutics for patients with COVID-19 [cited 2020 Aug 24]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html.

  9. Pan H, Peto R, Karim QA, Alejandria M, Restrepo AM, Garcia CH, Kieny MP, Malekzadeh R, Murthy S, Preziosi MP, Reddy S. Repurposed antiviral drugs for COVID-19-Interim WHO solidarity trial results. New Engl J Med. 2020 Dec 2. doi: 10.1056/NEJMoa2023184.

  10. fightcovid19.hku.hk [homepage on the Internet]. Hong Kong University documents the world's first case of COVID-19 reinfection [cited 2020 Aug 24]. Available from: https://fightcovid19.hku.hk/ hku-documented-the-worlds-first-case-of-covid-19-reinfection/.

  11. Salawu A, Green A, Crooks MG, Brixey N, Ross DH, Sivan M. A proposal for multidisciplinary tele-rehabilitation in the assessment and rehabilitation of COVID-19 survivors. Int J Environ Res Public Health. 2020 Jan;17(13):4890.

  12. Hui DS, Joynt GM, Wong KT, Gomersall CD, Li TS, Antonio G, Ko FW, Chan MC, Chan DP, Tong MW, Rainer TH. Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax. 2005 May 1;60(5):401-9.

  13. who.int [homepage on the Internet]. WHO coronavirus disease (COVID-19) dashboard [cited 2020 Aug 26]. Available from: https://covid19.who.int/.

  14. Wu J, Pan J, Teng D, Xu X, Feng J, Chen YC. Interpretation of CT signs of 2019 novel coronavirus (COVID-19) pneumonia. Eur Radiol. 2020 May 3:30(10):5455-62.

  15. Neufeld KJ, Leoutsakos J-MS, Yan H, Lin S, Zabinski JS, Dinglas VD, Hosey MM, Parker AM, Hopkins RO, Needham DM. Fatigue symptoms during the first year after ARDS. Chest. 2020 Sepr;158(3):999-1007.

  16. World Health Organization. Clinical management of COVID-19: Interim guidance, 27 May 2020 [cited 2020 August 26]. Available from: https://apps.who.int/iris/handle/10665/332196.

  17. cdc.gov [homepage on the Internet]. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19) [updated 2020 Sept 10; cited 2020 Oct 12]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html#clinical-management-treatment%3C.

  18. nih.gov [homepage on the Internet]. What's new in the guidelines: COVID-19 treatment guidelines [updated 2020 Oct 09; cited 2020 Oct 12]. Available from: https://www.covid19treatmentguidelines. nih.gov/whats-new/.

  19. nih.gov [homepage on the Internet]. What's new in the guidelines: COVID-19 treatment guidelines [updated 2020 Nov 03; cited 2020 Nov 4]. Available from: https://www.covid19treatmentguidelines. nih.gov/whats-new/.

  20. Phillips M, Turner-Stokes L, Wade D, Walton K. Rehabilitation in the wake of COVID-19-A phoenix from the ashes [monograph on the Internet]. London: British Society of Rehabilitation Medicine; 2020 [cited 2020 Sept 1]. Available from: https://www.bsrm.org.uk/downloads/covid-19bsrmissue1-published-27-4-2020.pdf.

  21. Righetti RF, Onoue MA, Politi FVA, Teixeira DT, de Souza PN, Kondo CS, Moderno EV, Moraes IG, Maida ALV, Junio LP, Silva FD, Moran de Brito CM, Baia WRM, Yamaguti WP. Physiotherapy care of patients with coronavirus disease 2019 (COVID-19)-A Brazilian experience. Clinics. 2020 Jun 22;75:e2017.

  22. Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, Hodgson C, Jones AYM, Kho ME, Moses R, Ntoumenopoulos G, Parry SM, Patman S, van der Lee L. Physiotherapy management for COVID-19 in the acute hospital setting: Clinical practice recommendations. J Physiother. 2020 Apr;66(2):73-82.

  23. Paul V, Patel S, Royse M, Odish M, Malhotra A, Koenig S. Proning in non-intubated (PINI) in times of COVID-19: Case series and a review. J Intensive Care Med. 2020 Aug;35(8):818-24.

  24. Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Comp Ther Clin Pract. 2020 May;39:101166.

  25. Brugliera L, Spina A, Castellazzi P, Cimino P, Tettamanti A, Houdayer E, Arcuri P, Alemanno F, Mortini P, Iannaccone S. Rehabilitation of COVID-19 patients. J Rehabil Med. 2020 Apr 5;52(4). doi: 10.2340/16501977-2678.

  26. Ghelichkhani P, Esmaeili M. Prone position in management of COVID-19 patients: A commentary. Arch Acad Emerg Med. 2020;8(1):e48.

  27. Guerin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, Mercier E, Badet M, Mercat A, Baudin O, Clavel M. Prone positioning in severe acute respiratory distress syndrome. New Engl J Med. 2013 Jun 6;368(23):2159-68.

  28. Battaglini D, Robba C, Caiffa S, Ball L, Brunetti I, Loconte M, Giacobbe DR, Vena A, Patroniti N, Bassetti M, Torres A, Rocco PRM, Pelosi P. Chest physiotherapy: An important adjuvant in critically ill mechanically ventilated patients with COVID-19. Respir Physiol Neurobiol. 2020 Nov;282:103529.

  29. Cavalcanti AB, Suzumura EA, Laranjeira LN, Paisani DM, Damiani LP, Guimaraes HP, Romano ER, Regenga MM, Taniguchi LN, Teixeira C, Pinheiro de Oliveira R; Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) Investigators. Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs. low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA. 2017 Oct;318(14):1335-45.

  30. Mao Z, Gao L, Wang G, Liu C, Zhao Y, Gu W, Kang H, Zhou F. Subglottic secretion suction for preventing ventilator-associated pneumonia: An updated meta-analysis and trial sequential analysis. Critical Care. 2016 Dec 1;20(1):353.

  31. Lazzeri M, Lanza A, Bellini R, Bellofiore A, Cecchetto S, Colombo A, D'Abrosca F, Del Monaco C, Gaudellio G, Paneroni M, Privitera E, Retucci M, Rossi V, Santambrogio M, Sommariva M, Frigerio P. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: A position paper of the Italian association of respiratory physiotherapists (ARIR). Monaldi Arch Chest Dis. 2020 Mar 26;90(1). doi: 10.4081/monaldi.2020.1285.

  32. Lewis LK, Williams MT, Olds TS. The active cycle of breathing technique: A systematic review and meta-analysis. Respir Med. 2012 Feb 1;106(2):155-72.

  33. Mckoy NA, Wilson LM, Saldanha IJ, Odelola OA, Robinson KA. Active cycle of breathing technique for cystic fibrosis. Cochrane Database Syst Rev. 2016 Jul 5;(7):CD008762.

  34. Sikka G, Radhakrishnan J. Comparison of the effect of manual and ventilator hyperinflation on static lung compliance in mechanically ventilated patients with pulmonary acute lung injury/ARDS. J Anesth Crit Care Open Access. 2016;5(4):00196.

  35. Ferravante AF, Plazzi F, Valentini I, Mascetti S, Fabiano A, Pezzi S, Mussoni A, Bernardi E, Agli LA. Late breaking abstract: Usefulness of diaphragmatic ultrasound to evaluate the efficacy of EzPAP during the respiratory rehabilitation in post extubated COVID-19 patients. Eur Resp J. 2020;56(Suppl 64):830.

  36. Tung PH, Wu M-F, Wang T-Y, Chen D-S, Hu H-C, Lin S-M. The effects of mechanical insufflation-exsufflation on lung function and complications in post-cardiac surgery patients. Eur Resp J. 2020;56(Suppl 64):945.

  37. Antonelli M, Donelli D. Respiratory rehabilitation for post-COVID19 patients in spa centers: First steps from theory to practice. Int J Biometeorol. 2020 Jul 24;64:1811-3.

  38. Kwakkel G, Wagenaar RC, Koelman TW, Lankhorst GJ, Koetsier JC. Effects of intensity of rehabilitation after stroke: A research synthesis. Stroke. 1997 Aug;28(8):1550-6.

  39. Russell TG. Physical rehabilitation using telemedicine. J Telemed Telecare. 2007 Jul 1;13(5):217-20.

  40. Marquis N, Larivee P, Saey D, Dubois MF, Tousignant M. In-home pulmonary telerehabilitation for patients with chronic obstructive pulmonary disease: A pre-experimental study on effectiveness, satisfaction, and adherence. Telemed E-Health. 2015 Nov 1;21(11):870-9.

  41. Stickland MK, Jourdain T, Wong EY, Rodgers WM, Jendzjowsky NG, MacDonald GF. Using tele- health technology to deliver pulmonary rehabilitation to patients with chronic obstructive pulmonary disease. Can Respir J. 2011 Jul-Aug;18(4):216-20.

  42. Paneroni M, Colombo F, Papalia A, Colitta A, Borghi G, Saleri M, Cabiaglia A, Azzalini E, Vitacca M. Is telerehabilitation a safe and viable option for patients with COPD? A feasibility study. COPD. 2015 Apr;12(2):217-25.

CITED BY
  1. Reddy Ravi Shankar, Gautam Ajay Prashad, Tedla Jaya Shanker, Ferreira Arthur Sá, Reis Luis Felipe Fonseca, Bairapareddy Kalyana Chakravarthy, Kakaraparthi Venkata Nagaraj, Gular Kumar, The Aftermath of the COVID-19 Crisis in Saudi Arabia: Respiratory Rehabilitation Recommendations by Physical Therapists, Healthcare, 9, 11, 2021. Crossref

Begell Digital Portal Begell Digital Library eBooks Journals References & Proceedings Research Collections Prices and Subscription Policies Begell House Contact Us Language English 中文 Русский Português German French Spain