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Journal Article Systematic Review Meta-Analysis Ppublish

PubMed: 40083165 DOI: 10.1177/17534666251323482

Effect of pulmonary rehabilitation for patients with long COVID-19: a systematic review and meta-analysis of randomized controlled trials.

Ther Adv Respir Dis 19:17534666251323482

Authors: Shige Li, Bing Dai, Yusheng Hou, Liang Zhang, Jie Liu, Haijia Hou, Dandan Song, Shengchen Wang, Xiangrui Li, Hongwen Zhao, Wei Wang, Jian Kang, Wei Tan

Affiliations

  • Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.
  • Department of Endocrinology, The First Affiliated Hospital of China Medical University, Shenyang, China.
  • Department of Rehabilitation Medicine, The People's Hospital of Liaoning Province, Shenyang, China.
  • Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China.
  • Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang 110000, China.

Abstract

BACKGROUND

Pulmonary rehabilitation (PR) has demonstrated efficacy in managing long COVID-19, underscoring the need to refine and tailor PR strategies for optimal patient outcomes.

OBJECTIVES

To evaluate the impact of PR on patients with long COVID-19 and to compare the efficacy of different types and durations of PR interventions.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES AND METHODS

We systematically searched randomized controlled trials (RCTs) of the effectiveness of PR in long COVID-19 patients published before April 2024. The primary outcomes were physical capacity assessed by the 6-minute walking test (6MWT), lung function measured by forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC), health-related quality of life (HRQoL), and fatigue. Secondary outcomes were thirty-second sit-to-stand test (30STST), handgrip strength tests, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), dyspnea, depression, anxiety, perceived effort, and adverse events.

RESULTS

A total of 37 studies with 3363 patients were included. Compared to controls, PR improved physical capacity (6MWT, 30STST, handgrip), lung function (FEV1, FVC, MIP, MEP), HRQoL, fatigue, dyspnea, and anxiety but did not reach statistical significance for depression. Subgroup analyses of PR duration indicated that programs of ⩽4 weeks improved 6MWT; those between 4 and 8 weeks significantly improved 6MWT, lung function (FEV1, FVC), HRQoL, and reduced fatigue; and programs over 8 weeks improved HRQoL and reduced fatigue. Exercise type analysis revealed that breathing exercises improved 6MWT, lung function (FEV1, FVC), and HRQoL; multicomponent exercises enhanced 6MWT performance and reduced fatigue; the combination of both types improved 6MWT, FEV1 (L), FVC (%pred), HRQoL, and reduced fatigue.

CONCLUSION

PR improves physical capacity, lung function, and quality of life and alleviates dyspnea, fatigue, and anxiety in long COVID-19 patients. A 4- to 8-week PR program and a combination of both breath exercises and multicomponent training is most effective for managing long-term COVID-19 syndromes.

TRIAL REGISTRATION

PROSPERO ID: CRD42024455008.

MeSH

Depression, Exercise, Quality Of Life, Lung, Maximal Respiratory Pressures, Respiratory Tract Diseases, Rehabilitation, Covid-19, Fatigue, Dyspnea, Vital Capacity, Post-Acute Covid-19 Syndrome