Pulmonary Rehabilitation for individuals with persistent symptoms following COVID-19

Abstract

Topic importance: COVID-19 can cause ongoing and persistent symptoms (such as breathlessness and fatigue) that lead to reduced functional capacity. There are parallels in symptoms and functional limitations in adults with post-COVID symptoms and adults with chronic respiratory diseases. Pulmonary Rehabilitation is a key treatment for adults with chronic respiratory diseases with the aims to improve symptom management, increase functional capacity. Given the similarities in presentation and aims, a Pulmonary Rehabilitation programme may be optimally placed to meet the needs of those with ongoing symptoms following COVID-19. Review findings: Aerobic and strength training has shown benefit for adults living with Long COVID though there is little evidence on structured education in this population. Breathing pattern disorder is common in adults with Long COVID and considerations to treatment prior to rehabilitation, or alongside rehabilitation are necessary. Considerations to Post Exertional Malaise is important in this population and evidence from the Chronic Fatigue Syndrome literature supports the need for individualisation of exercise programmes, and considerations for those that have an adverse reaction to activity and/or exercise. Summary: This narrative review summarises the current evidence of Pulmonary Rehabilitation programmes in a long COVID population. Where the evidence is lacking in long COVID the supporting evidence of these programmes in chronic respiratory diseases has highlighted the importance of aerobic and strength training, considerations for fatigue, potential mechanism for immunology improvement and management of breathing pattern disorders in these programmes.