Pulmonary rehabilitation and breathing exercise effectiveness for Post COVID-19 survivors

Objective(s): Residual effects of Covid-19 on respiratory system are often destructive and depilating. Several rehabilitation approach are suggested in literature. This review aims to summarize and compare the available evidence on the current pulmonary rehabilitation therapy following COVID-19.

Data Sources: A computer search was conducted using PubMed, CINAHL, and ERIC using keywords ‘COVID-19’,‘respiratory therapy,’ OR ‘rehabilitation,’ OR ‘physiotherapy,’ OR ‘physical therapy,’ OR ‘corticosteroid,’ OR ‘respiratory rehabilitation,’ OR ‘traditional Chinese medicine,’ OR ‘aerobic therapy’ AND ‘COVID-19 patients’. A narrative synthesis was used to evaluate the selected literature. The search was limited to the English language, human, and the year 2010 to present.

Study Selection: Studies were reviewed independently and those with the focus of COVID-19 and medication, traditional Chinese Medication, respiratory rehabilitation, and aerobic exercise interventions were included. Total of 27 articles were included in the final review.

Data Extraction: An independent extraction of data was performed on demographics, methodology, intervention, and outcomes.

Data Synthesis: Methods of medication (i.e. corticosteroids, antivirals, and Cardiopulmonary [CP] therapy), traditional Chinese Medicine (i.e. herbal medicine and pediatric massage and acupuncture), respiratory rehabilitation (i.e. incentive spirometer use, pursed-lip breathing, diaphragmatic techniques, and airway clearance techniques) and aerobic exercise were reviewed. Although all approaches showed some level of effectiveness, in medication approach, antivirals and CP therapy seems to be most effective for severe cases of COVID-19. Respiratory rehabilitation appears to best benefit inpatient/acute cases of COVID-19. Aerobic exercise is reported to have a promising positive effects, but a clear outline and parameters are yet to be determined.

Conclusions: Post COVID-19 pulmonary rehabilitation appears to vary significantly based on the severity of COVID-19 infection/symptoms and individual responses. There is a limited knowledge of the field due to recent occurrence of the disease and lack of information on the new strains of the virus.

Author(s) Disclosures: There is no conflict of interest associate with this study for any of the authors.