Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review

Abstract

There has been an apparent association between the risks of complications with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with a history of existing chronic respiratory diseases during the pandemic of coronavirus disease 2019 . SARS-CoV-2 poses a severe risk in cardiopulmonary management. Moreover, chronic respiratory diseases may further amplify the risk of morbidity and mortality among the afflicted population in the pandemic era. The present review outlines the importance of pulmonary rehabilitation (PR) in persons with chronic respiratory diseases (Chronic obstructive pulmonary disease (COPD) and Asthma) during the COVID-19 era. In this context, amongst the population with a pre-existing pulmonary diagnosis who have contracted SARS-CoV-2, following initial medical management and acute recovery, exercise-based pulmonary rehabilitation (PR) may play a crucial role in long-term management and recovery. The energy conservation techniques will play a pragmatic role in PR of mild to moderate severity cases to counter post-COVID-19 fatigue. Moreover, there is also an urgent need to effectively address post-COVID-19 anxiety and depression, affecting the PR delivery system.

Exercise modulates the immune system in cardiorespiratory disease patients: Implications for clinical practice during the COVID-19 pandemic

“…Self-management approaches are another core aspect in the remote management of COPD and asthma, which requires the patient to have sufficient knowledge and self-care skills 71 . An organized self-management strategy can decrease the number of episodes of exacerbations requiring hospitalization, improving the patient's mental, social and physical health 71 , 72 during the COVID-19 pandemic.…”

The Impact of COVID-19 Infection on Cognitive Function and the Implication for Rehabilitation: A Systematic Review and Meta-Analysis

“…Of course, most of the interventions, and therefore the current level of evidence, are focusing on pulmonary rehabilitation [70] and physical activity [71,72]. Significant differences were also found in quality-of-life related outcomes for both short and long term.…”

Developing Pulmonary Rehabilitation for COVID-19: Are We Linked with the Present Literature? A Lexical and Geographical Evaluation Study Based on the Graph Theory

“…Our results need to be corroborated over time and we recommend extreme caution in promoting specific recommendations due to a lack of evidence, especially in frail patients, who are now facing late side effects of acute COVID-19 infection [8,10,38,39]. The specific treatments should also be evaluated in the light of the guidelines, which are continuously updated.…”

“…Later on, the emerging awareness of the consequences of COVID-19 disease has allowed rehabilitation to assume an increasingly important role. For this reason, research about COVID-19 rehabilitation has seen a rapid growth, however most of the studies were based on experiences in acute care settings or provided only general recommendations [4][5][6][7][8]. Nevertheless, these studies have been useful in planning the early rehabilitation treatments during the acute phase of the pandemic.…”

“…At present, respiratory rehabilitation is considered an essential strategy in the management of patients with COVID-19 [6][7][8][9][10][11][12], however studies are mostly based on other respiratory diseases' guidelines (e.g., chronic obstructive pulmonary disease, interstitial lung disease, or asthma) rather than on specific protocols for COVID-19 [13][14][15]. Randomized and controlled trials on rehabilitation in patients with COVID-19 have been difficult to conduct due to the novelty of this disease and its acute impact on the health systems in the last two years throughout the world.…”