Feasibility, capacity, resources key factors for post-COVID-19 pulmonary rehab programs

A new review highlights future pulmonary rehabilitation programs for patients with symptoms after COVID-19 and identifies key factors including feasibility, current pulmonary rehabilitation capacity and resource constraints.

“Given that acute COVID-19 frequently includes respiratory complications, and the prevalence of post-COVID respiratory symptoms, many suggest that participation in a pulmonary rehabilitation program may be appropriate for COVID-19 survivors,” Lesley J.J. Soril, MSc, assistant scientific director of the medicine strategic clinical network at Alberta Health Services in Edmonton, Canada, and colleagues wrote in Respiratory Medicine. “To support the development of practical guidance for post-COVID pulmonary rehabilitation, a rapid literature review was completed to determine the clinical effectiveness of pulmonary rehabilitation for individuals with post-COVID symptoms.”

Researchers reviewed studies published from July 2020 to June 2021 from the MEDLINE, PubMed and Embase databases. They identified nine studies that evaluated the clinical effectiveness of pulmonary rehabilitation for individuals with post-COVID-19 symptoms. Most studies were small, experimental or quasi-experimental, with one randomized controlled trial, according to the researchers.

All studies reported improvements in exercise capacity, pulmonary function and/or quality of life after pulmonary rehabilitation among individuals with post-COVID-19 symptoms who were hospitalized for acute COVID-19 infection.

Only a few studies evaluated post-COVID-19 symptom severity or frequency changes after pulmonary rehabilitation initiation. Of these, researchers reported improvements in dyspnea, fatigue, anxiety and depression.

No studies evaluated nonhospitalized patients or long-term outcomes past 3 months after beginning pulmonary rehabilitation.

According to the researchers, one of the biggest challenges in understanding the potential benefits of post-COVID-19 pulmonary rehabilitation is the current limited knowledge of long-term outcomes of post-COVID-19 symptoms.

“It is unclear whether natural recovery occurs over time and, if so, at what rate and to what extent. Further, the appropriateness and effectiveness of pulmonary rehabilitation vs. other forms of rehabilitation for post-COVID conditions is unknown,” the researchers wrote. “Such comparative studies are needed to better elucidate the ideal form of rehabilitation for this growing patient population.”