THE ROLE OF PHYSICAL MEDICINE AND REHABILITATION IN LONG COVID-19 MANAGEMENT

Abstract

COVID-19 is an infectious disease that can have a multi-system involvement, most notably, the respiratory tract. After acute infection, a considerable proportion of patients suffer from persistent symptoms and signs, defined as long COVID-19. Depending on the affected systems and organs, patients can experience  various clinic pictures. Rehabilitation approaches serve a crucial role in providing functional recovery and improving quality of life for COVID-19 survivors. As a result of the wideness of the clinical spectrum of the long COVID-19, rehabilitation practices differ according to the affected systems. Therefore, the formation of multidisciplinary rehabilitation teams is an inevitable necessity. The establishment of specific centers for long COVID-19 rehabilitation will be beneficial. If it is not possible, existing rehabilitation centers should be strengthened for this purpose. Since the pulmonary system and respiratory tract are the most affected structures, one of the main issues to be considered in long COVID-19 cases is cardiopulmonary rehabilitation. Patients experience musculoskeletal disorders such as atrophy, sarcopenia, poor physical performance and contracture due to long-term hospitalization, intensive care treatment, quarantine practices and immobilization. Rehabilitation practices also focus on these disorders. All rehabilitation practices in long COVID-19 patients should start with low intensity, and parameters such as intensity and frequency should be increased as the patient's tolerance improves. In high-risk cases, parameters including oxygen saturation, blood pressure, and heart rhythm should be monitored. Health-care authorities should prioritize the rehabilitation of the long COVID-19 syndrome and invest in this area. Authorities, physicians and patients should collaborate to facilitate long COVID-19 rehabilitation and to establish a self-contained system.