Effectiveness of Pulmonary Rehabilitation among COVID-19 Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Many COVID-19 patients presented with detrimental features, such as impaired respiratory function, physical capacity, and overall poor quality of life. The present study evaluates the effectiveness of pulmonary rehabilitation on COVID-19 patients. Methods: We searched PubMed, Scopus, ScienceDirect, and Google Scholar from 2019 to 2021. The protocol was registered in PROSPERO with the registration number CRD42021273618. We performed statistical analyses via random effects and expressed the outcomes as standardized mean difference (SMD) for continuous variables, with 95% confidence intervals (CI). Results: We included six trials involving 432 patients. The primary outcome showed a significant improvement in physical function (SMD 0.83, 95% CI −0.58 to 1.09; p < 0.001; four trials, 266 participants; high-quality evidence). There was significant difference in anxiety (SMD −0.80, 95% CI −1.23 to −0.37; p = 0.003), physical activity intensity levels (SMD −1.27, 95% CI −2.23 to −0.32; p = 0.009), sleep quality (MD −0.05, 95% CI −0.83 to −0.16; p = 0.004), peripheral muscle performance of lower limbs (SMD 0.90, 95% CI −0.60 to 1.20; p < 0.001), and dyspnoea outcomes (SMD −0.55, 95% CI −0.87 to −0.23; p = 0.007). Conclusions: Pulmonary rehabilitation is an effective adjuvant therapy that minimizes COVID-19 severity in the intervention group compared to the conventional treatment. The findings of this study will need to be considered in the framework of the clinical outcome as observed in the intervention outcome. Additionally, safer data on guideline rehabilitation would be needed to examine whether pulmonary rehabilitation would be a fruitful intervention to reduce COVID-19 severity.

Impact of Rehabilitation on Physical and Neuropsychological Health of Patients Who Acquired COVID-19 in the Workplace

“…When discussing our results against the current literature, the natural recovery process of the disease and the different study designs used (sample size, date of rehabilitation after acute COVID-19, length of rehabilitation, contents of inpatient/outpatient rehabilitation) must be considered [ 35 , 39 ]. Nevertheless, systematic reviews and meta-analyses investigating COVID-19-related physical activity-based rehabilitations confirmed significant increases in functional capacity, quality of life, as well as mental health [ 34 , 35 ].…”

“…Findings by Ahmed et al [ 34 ] supported these results in acute- and post-COVID patients. A meta-analysis also showed significant improvements in physical function (6MWD), physical activity intensity levels (Perceived Exertion Scale), and peripheral muscle performance of lower limbs (30 s STST) after pulmonary rehabilitation [ 39 ]. No study examined the effects of rehabilitation on physical performance in healthcare workers.…”

“…Rehabilitation programs may have a positive impact on mental health outcomes. During a three-to-six-week pulmonary rehabilitation program, the corresponding values for anxiety and depression decreased significantly [ 39 , 55 , 56 ].…”

Effect of Pulmonary Rehabilitation on Exercise Capacity in Post Hospitalized Covid-19 Patients: An Experimental Study

“…9 Pulmonary rehabilitation has a significant effect on improving physical function, pulmonary function, dyspnoea, anxiety, depression, physical activity intensity level, and sleep quality. 10 Limitation of present study was descriptive multivariate analysis was not done.…”

Pulmonary Rehabilitation for Post-COVID-19

“…Guidelines societies continue to call for additional data. As evidence on this topic is evolving,9 we aimed to further study the role of PR on patients with post-COVID-19.…”