Pulmonary rehabilitation following the 2019 novel Coronavirus infection

Abstract

Abstract The treatment of an infectious disease is only one step to a cure and, in many cases, infectious diseases can lead to short-and long-term impairments, including physical, cognitive and psycho-emotional complications. In this paper, we perform a literature review to identify the appropriate rehabilitation interventions for responding to COVID-19 consequences, taking into consideration the current standards for pulmonary rehabilitation and the COVID-19 literature which has been developed during the pandemic’s evolution. Pulmonary, neurological, cardiac, musculoskeletal, nutritional, cognitive and psychological disabilities, as well as dysphasia, have been observed among patients who recovered after needing time in the intensive care unit (ICU), related either directly to COVID-19 or critical care treatments. Some have also been reported in patients who were asymptomatic or recovered from a mild or moderate form of the disease. Patients who still have dyspnea, exercise intolerance and fatigue, are unable to conduct activities of daily living and/or have difficulty in managing or coping with their disease, despite optimised pharmacological therapy, are most likely to benefit from pulmonary rehabilitation. Contraindications should be considered during patient selection. Rehabilitation prescription should be individually tailored, based on patient assessment and outcome measurements. Pulmonary rehabilitation interventions may involve airway clearance therapy, breathing exercises, mobilisation and strength training, flexibility training, balance training, neuromuscular electrical stimulation (NMES), activities of daily living, aerobic training, dysphagia management, nutrition therapy, cognitive training and psychological support. Medical management of comorbidities and patient-family education are key factors for achieving optimal gains from pulmonary rehabilitation.