COVID-19 recovery: benefits of multidisciplinary respiratory rehabilitation

Everaerts, Stephanie; Heyns, Arne; Langer, Daniël; Beyens, Hilde; Hermans, Greet; Troosters, Thierry; Gosselink, Rik; Lorent, Natalie; Janssens, Wim

doi:10.1136/bmjresp-2020-000837

Cited by 36 publications

(103 citation statements)

References 12 publications

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“…The early recommendation for timely referral to multidisciplinary rehabilitation services [ 15 , 16 ] remains relevant: as our data show, even beyond 3 months following acute disease, substantial recovery is possible, especially in severe disease patients. The benefits of multidisciplinary rehabilitation in physical and emotional well-being have been documented particularly for those who suffered severe to critical COVID-19 [ 44 ] and is also apparent in our HRQoL results. Milder cases may also benefit from a multidisciplinary rehabilitation intervention, but this remains to be ascertained [ 11 , 14 ].…”

Section: Discussionsupporting

confidence: 60%

Prospective longitudinal evaluation of hospitalised COVID-19 survivors 3 and 12 months after discharge

Lorent¹,

Weygaerde

Claeys³

et al. 2022

ERJ Open Res

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BackgroundLong-term outcome data of COVID-19 survivors are needed to understand their recovery trajectory and additional care needs.MethodsA prospective observational multi-centre cohort including adults hospitalised with COVID-19 from March through May 2020. Work-up at 3 and 12 months following admission consisted of clinical review, pulmonary function testing, 6-min walking distance (6MWD), muscle strength, chest computed tomography (CT), and quality of life questionnaires. We evaluated factors correlating with recovery by linear mixed effects modelling.ResultsOf 695 patients admitted, 299 and 226 returned at 3 and 12 months, respectively (median age 59 years, 69% male, 31% severe disease). About 1/2 and 1/3 reported fatigue, dyspnoea and/or cognitive impairment at 3 and 12 months, respectively. Reduced 6MWD and quadriceps strength were present in 20% and 60% at 3 months versus 7% and 30% at 12 months. A high anxiety score and body mass index correlated with poor functional recovery. At 3 months, diffusing capacity for carbon monoxide (DLCO) and total lung capacity were below the lower limit of normal in 35% and 18%, decreasing to 21% and 16% at 12 months; predictors of poor DLCO recovery were female sex, pre-existing lung disease, smoking, and disease severity. Chest CT improved over time; 10% presented non-progressive fibrotic changes at 1 year.ConclusionMany COVID-19 survivors, especially with severe disease, experienced limitations at 3 months. At 1 year, the majority showed improvement to almost complete recovery. To timely identify additional care or rehabilitation needs, we recommend a multidisciplinary follow-up visit following COVID-19 admission.

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Section: Discussionsupporting

confidence: 60%

Prospective longitudinal evaluation of hospitalised COVID-19 survivors 3 and 12 months after discharge

Lorent¹,

Weygaerde

Claeys³

et al. 2022

ERJ Open Res

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“…Figure 2 summarize the results of the risk of bias assessment for the non-randomized controlled trials evaluated in the present systematic review. The risk of bias was low in five studies [ 23 , 24 , 25 , 26 , 27 ], and there were some concerns in two studies [ 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…The aerobic exercise was performed at low- and moderate-intensity in the continuous and interval mode, respectively ( Table 1 ). According to Everaerts et al [ 29 ], the training program was interrupted in four patients due to interfering medical problems (myasthenia gravis, lumbar discus hernia, severe cognitive dysfunction). Another study showed that a short training period (i.e., 10 days) induced significant improvements in physical performance in post-COVID-19 patients [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Functional and Psychological Changes after Exercise Training in Post-COVID-19 Patients Discharged from the Hospital: A PRISMA-Compliant Systematic Review

Hekmatikar

Júnior

Shahrbanian

et al. 2022

IJERPH

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Millions of people worldwide are infected with COVID-19, and COVID-19 survivors have been found to suffer from functional disabilities and mental disorders such as depression and anxiety. This is a matter of concern because COVID-19 is still not over. Because reinfection is still possible in COVID-19 survivors, decreased physical function and increased stress and anxiety can lower immune function. However, the optimal exercise intensity and volume appear to remain unknown. Therefore, the current systematic review aimed to evaluate the effect of resistance or aerobic exercises in post-COVID-19 patients after hospital discharge. We conducted searches in the Scopus, SciELO, PubMed, Web of Science, Science Direct, and Google Scholar databases. Studies that met the following criteria were included: (i) English language, (ii) patients with COVID-19 involved with resistance or aerobic exercise programs after hospital discharge. Out of 381 studies reviewed, seven studies met the inclusion criteria. Evidence shows that exercise programs composed of resistance exercise (e.g., 1–2 sets of 8–10 repetitions at 30–80% of 1RM) along with aerobic exercise (e.g., 5 to 30 min at moderate intensity) may improve the functional capacity and quality of life (reduce stress and mental disorders) in post-COVID-19 patients. In addition, only one study reported reinfection of three subjects involved with the exercise program, suggesting that exercise programs may be feasible for the rehabilitation of the patients. A meta-analysis was not conducted because the included studies have methodological heterogeneities, and they did not examine a control group. Consequently, the results should be generalized with caution.

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“…The results of the current review revealed that acute rehabilitation in either mild to moderate [ 18 , 21 , 22 , 24 , 39 , 40 ] or severe patients [ 8 , 23 , 29 , 36 ] were associated with successful outcomes.…”

Section: Discussionmentioning

confidence: 83%

The effect of exercise rehabilitation on COVID-19 outcomes: a systematic review of observational and intervention studies

et al. 2022

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Purpose Disturbance to physical and psychological characteristics among COVID-19 survivors are not uncommon complications. In the current systematic review, we aimed to investigate the role of exercise rehabilitation programs, either in acute or post-acute phase, on COVID-19 patients’ outcomes. Methods A systematic search was conducted in November 2021 of Web of Sciences, PubMed-Medline, Google Scholar, and Scopus. Observational and intervention studies on COVID-19-infected patients undergoing a rehabilitation program including any type of exercise were included if they reported physical or psychological factors as outcomes. The Cochrane risk of bias tool for randomized controlled trials and Joanna Briggs Institute (JBI) critical appraisal checklist were used by two independent reviewers. Results A total number of 469, and 957 patients were included in 9 intervention studies, and 14 observational studies, respectively. Most factors reported by studies as outcomes fell in the categories of exercise capacity, respiratory function, as well as psychological aspects. The reported outcomes in almost all studies, disclosed the overall beneficial role of exercise rehabilitation in improving the outcomes. Conclusion The current review demonstrated that exercise rehabilitation generally could have a beneficial role in improvement of both physical and psychological related outcomes. As the best onset time, and FITT components are not yet completely clear, further large, well-designed RCTs are suggested to provide details of exercise rehabilitation program.

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COVID-19 recovery: benefits of multidisciplinary respiratory rehabilitation

Cited by 36 publications

References 12 publications

Prospective longitudinal evaluation of hospitalised COVID-19 survivors 3 and 12 months after discharge

Prospective longitudinal evaluation of hospitalised COVID-19 survivors 3 and 12 months after discharge

Functional and Psychological Changes after Exercise Training in Post-COVID-19 Patients Discharged from the Hospital: A PRISMA-Compliant Systematic Review

The effect of exercise rehabilitation on COVID-19 outcomes: a systematic review of observational and intervention studies

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