Pulmonary Rehabilitation Principles After SARS-CoV-2 (COVID-19): A Guideline for the Management of Acute and Subacute Course

Abstract

BİLİMSEL MEKTUP SCIENTIFIC LETTER ÖZET Coronavirus Hastalığı 2019 (COVID-19) solunumsal, fiziksel, psikolojik ve yaygın sistemik işlev bozukluğuna yol açabilen bulaşıcı bir hastalıktır. Hastalığın ciddiyeti asemptomatik enfeksiyondan, hafif hastalık, pnömoni, ciddi pnömoni, akut solunum sıkıntısı sendromu, solunum yetmezliği ve ölüme kadar değişebilmektedir. COVID-19 solunum sistemi önemli şekilde etkilenmektedir. Hastalığın uzun dönem sonuçları ve muhtemel sekellerine ilişkin yeterli bilgi olmadığı gibi, rehabilitasyonu konusunda da henüz kanıt yoktur. Bu klinik uygulama rehberi erişkin COVID-19 hastaları için pulmoner rehabilitasyon önerileri içermektedir ve Dünya Sağlık Örgütü ile T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü tarafından hazırlanan COVID-19 tanı ve tedavi rehberleri, yakın zamanlı bilimsel yayınlar, uzman görüşü olarak yayınlanan COVID-19 için pulmoner rehabilitasyon önerileri ışığında ve pulmoner rehabilitasyonun temel prensipleri doğrultusunda hazırlanmıştır Bu öneriler geliştirilirken, COVID-19'un bulaşıcılığı, sınırlı sayıda personelin hasta ile teması ilkeleri ile pulmoner rehabilitasyonun sağlayacağı yararların düzeyi göz önünde bulundurulmuştur. Anah tar Ke li me ler: COVID-19; akut solunum sıkıntısı sendromu; pulmoner rehabilitasyon; rehber ABS TRACT Coronavirus disease 2019 (COVID-19) is a contagious infection disease, which may cause respiratory, physical, psycological and generalised systemic dysfunction. The severity of disease ranges from an asymptomatic infection, mild illness, mild or severe pneumonia with respiratory failure, acute respiratory distress syndrome and/or death. COVID-19 affects the pulmonary system crucially. There is a lack of knowledge about the longterm outcomes of the disease and the possible sequeles and rehabilitation, as well. This clinical practice guideline includes pulmonary rehabilitation (PR) recommendations for adult COVID-19 patients and is developed in the light of the guides on the diagnosis and treatment of COVID-19 provided by World Health Organisation and Turkish Republic Ministery of Health, and recently published scientific literature, PR recommendations for COVID-19 regarding basic principles of PR. In this guideline, the contagiousness of COVID-19, recommendations on limited contact of patient with health care providers, and the evidence about possible benefits of PR were taken into consideration.

The Role of Exercise as a Treatment and Preventive Strategy during Covid-19 Pandemic

“…The exercise program should be started with relatively simple, gradual functional strengthening exercises without using equipment or body weight. Training intensity should be increased slowly over days (41,42).…”

Respiratory rehabilitation in patients recovering from severe acute respiratory syndrome: A systematic review and meta-analysis

“…Recently many reviews, consensus reports, guidelines, expert opinions have been published on recommending RR in patients recovering from SARS-CoV infection. [3][4][5][6][7][8][9][10] However, most of these reviews are based on previous experience managing other chronic lung diseases, not on patients" research data on SARS infection. Therefore, it is essential to accumulate data for RR programs' evidence, clarify the benefit, and strengthen its rationale for incorporating standard clinical management in patients with SARS-CoV infection.…”

The effects of 6 weeks home rehabilitation program for non-ventilated COVID-19 patients after discharge: A case report

“…Reducing the symptoms of the respiratory system and strengthening the immune system is possible with physiotherapy and rehabilitation programs [2,4]. Especially aerobic and respiratory exercise programs are recommended because of the healing and protective effect of exercise against COVID-19 comorbidity and risk factors [5]. However, the long-term effects of COVID-19 pandemic are not clear.…”