Beneficial effects of multi-disciplinary rehabilitation in postacute COVID-19: an observational cohort study

Puchner, Bernhard; Sahanic, Sabina; Kirchmair, Rudolf; Pizzini, Alex; Sonnweber, Bettina; Wöll, Ewald; Mühlbacher, Andreas; Garimorth, Katja; Dareb, Bernhard; Ehling, Rainer; Wenter, Johanna; Schneider, Sybille; Brenneis, Christian; Weiß, Günter; Tancevski, Ivan; Sonnweber, Thomas; Löffler‐Ragg, Judith

doi:10.23736/s1973-9087.21.06549-7

Cited by 132 publications

(222 citation statements)

References 35 publications

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“…Twenty-eight (23.3%) articles were regarding management options: 13 rehabilitation care [ 22 , 28 , 45 , 59 , 60 , 71 , 94 , 115 , 119 , 123 , 129 – 131 ], 5 general care [ 26 , 47 , 57 , 105 , 132 ], 1 designed and validated a psychometric tool for assessing mental health consequences of Long COVID [ 42 ], and 1 was about “how to return back to the pre-morbidity activity level” [ 63 ], and 8 articles were on more comprehensive “multidisciplinary-care” of long COVID patients [ 84 , 90 , 98 , 107 , 128 , 133 – 135 ].…”

Section: Resultsmentioning

confidence: 99%

“…There were 7 original studies on rehabilitation as the cornerstone management of Long COVID: 3 from Italy [ 28 , 45 , 71 ], 2 from China [ 59 , 60 ], 1 from Austria [ 22 ], and 1 from Malawi [ 115 ].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, the production of pro-inflammatory cytokines such as IL-7 and IFNγ (interferon-gamma) can result in post-stroke depression, which is highly similar to pathobiology of SARS-COV-2 [ 93 ]. The COVID-19 patients have a higher level of NLRP3 inflammasome activation that in combination with interleukin-18 and interleukin-1β have been shown to adversely impact cerebral function [ 22 ]. Also, NLRP3 inflammasome-mediated systemic inflammation can lead to pathological accumulation of the peptides/proteins such as fibrillar amyloid-β resulting in the induction and aggravation of neurodegenerative illnesses such as Alzheimer's disease [ 146 , 147 ].…”

Section: Discussionmentioning

confidence: 99%

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Long COVID, a comprehensive systematic scoping review

et al. 2021

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Purpose To find out what is known from literature about Long COVID until January 30, 2021. Methods We undertook a four-step search with no language restriction. A preliminary search was made to identify the keywords. A search strategy of all electronic databases resulted in 66 eligible studies. A forward and backward search of the references and citations resulted in additional 54 publications. Non-English language articles were translated using Google Translate. We conducted our scoping review based on the PRISMA-ScR Checklist. Results Of 120 papers, we found only one randomized clinical trial. Of the 67 original studies, 22 were cohort, and 28 were cross-sectional studies. Of the total 120 publications, 49.1% focused on signs and symptoms, 23.3% on management, and 10.8% on pathophysiology. Ten publications focused on imaging studies. The results are also presented extensively in a narrative synthesis in separated sections (nomenclature, diagnosis, pathophysiology, risk factors, signs/symptoms, management). Conclusions The controversies in its definition have impaired proper recognition and management. The predominant symptoms were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-021-01666-x.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long COVID, a comprehensive systematic scoping review

et al. 2021

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“…In an observational study of 23 discharged COVID-19 patients with on-going symptoms, a personalized multi-disciplinary rehabilitation approach involving breathing, mobilisation, and psychological interventions have improved lung function and physical capacity. However, most participants’ lung function did not heal completely, and persistent neurological symptoms remained [ 164 ]. A case series of seven discharged COVID-19 patients with on-going symptoms showed that combined breathing and light exercise rehabilitation healed and improved fatigue symptoms in five and two cases, respectively [ 165 ].…”

Section: Potential Treatmentsmentioning

confidence: 99%

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Yong

2021

Infectious Diseases

944

795

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Long COVID or post-COVID-19 syndrome first gained widespread recognition among social support groups and later in scientific and medical communities. This illness is poorly understood as it affects COVID-19 survivors at all levels of disease severity, even younger adults, children, and those not hospitalized. While the precise definition of long COVID may be lacking, the most common symptoms reported in many studies are fatigue and dyspnoea that last for months after acute COVID-19. Other persistent symptoms may include cognitive and mental impairments, chest and joint pains, palpitations, myalgia, smell and taste dysfunctions, cough, headache, and gastrointestinal and cardiac issues. Presently, there is limited literature discussing the possible pathophysiology, risk factors, and treatments in long COVID, which the current review aims to address. In brief, long COVID may be driven by long-term tissue damage (e.g. lung, brain, and heart) and pathological inflammation (e.g. from viral persistence, immune dysregulation, and autoimmunity). The associated risk factors may include female sex, more than five early symptoms, early dyspnoea, prior psychiatric disorders, and specific biomarkers (e.g. D-dimer, CRP, and lymphocyte count), although more research is required to substantiate such risk factors. While preliminary evidence suggests that personalized rehabilitation training may help certain long COVID cases, therapeutic drugs repurposed from other similar conditions, such as myalgic encephalomyelitis or chronic fatigue syndrome, postural orthostatic tachycardia syndrome, and mast cell activation syndrome, also hold potential. In sum, this review hopes to provide the current understanding of what is known about long COVID.

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“…The evidence-based role of physiotherapy interventions arose as highly relevant in addressing COVID-19 rehabilitation. Acute and post-acute rehabilitation in hospital settings and long-term rehabilitation in outpatient practices were reported to be of notable benefit for patients [21][22][23]. The COVID-19 pandemic is currently changing physiotherapeutic practice and will further strongly affect the rehabilitation sector, including patient care, education and research.…”

Section: Introductionmentioning

confidence: 99%

Post-COVID-19 Rehabilitation: Perception and Experience of Austrian Physiotherapists and Physiotherapy Students

Scheiber

Spiegl

Wiederin

et al. 2021

IJERPH

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The rehabilitation needs of COVID-19 survivors are increasingly recognized, with a focus on combating respiratory and neuromuscular dysfunctions. The aim here was to explore the perception of Austrian physiotherapists and physiotherapy students on post-COVID-19 rehabilitation care and to identify barriers for the application of sufficient rehabilitation. We analysed current knowledge and practical skills in respiratory physiotherapy, performing a cross-sectional national survey among physiotherapists working in outpatient settings and physiotherapy students in their last academic year of bachelor-level education in Austria. Out of 255 survey participants, one-third already had inquiries to treat post-COVID-19 patients, and the majority of respondents expected a further increased inflow of patients with rehabilitation needs (64.2%). Only 11.2% of respondents reported feeling sufficiently informed about post-COVID-19 rehabilitation. A total of 68.2% of students and up to 48.1% of physiotherapists favoured a COVID-19-specific adaptation already in the basic academic education, and 74.1% of survey participants indicated interest in attending specific training. Concerning respiratory physiotherapy, our data showed discrepancies between the estimation of the importance of specific examination and treatment techniques and the level of current experience. There is a clear lack of experience in implementing effective device-based respiratory therapy. Our data indicate an urgent need to develop new education and training programs with a focus on the interdisciplinary rehabilitation of patients with post-COVID-19 syndrome.

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Beneficial effects of multi-disciplinary rehabilitation in postacute COVID-19: an observational cohort study

Cited by 132 publications

References 35 publications

Long COVID, a comprehensive systematic scoping review

Long COVID, a comprehensive systematic scoping review

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Post-COVID-19 Rehabilitation: Perception and Experience of Austrian Physiotherapists and Physiotherapy Students

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