Respiratory rehabilitation in patients recovering from severe acute respiratory syndrome: A systematic review and meta-analysis

Background: With an increase in published reports on respiratory rehabilitation (RR) in severe acute respiratory syndrome (SARS), there is a need for a meta-analysis and systematic review to measure the effects of the RR in SARS. Objective: Objective of the review was to evaluate the efficacy and safety of RR in patients recovering from SARS. Methods: PubMed/ MEDLINE, CENTRAL, EMBASE, and Clinical Trial Registries were systematically searched (between January 1, 2003, to July 31, 2021) to identify all patients who received RR, at least for six days, following SARS. The primary outcome was exercise capacity [6-meter walking distance (6-MWD)], and secondary outcomes were change in pulmonary function test (PFT) parameters, activities in daily livings (ADLs), and quality of life (QoL). Meta-analysis was performed by using RevMan 5.4. Results: Twenty-one observational studies, including eight comparative studies, were included. Eight comparative studies participated in quantitative meta-analysis. The intervention group, who received RR, improved significantly in exercise capacity (6-MWD) [mean difference (MD):45.79, (95% CI:31.66-59.92)] and PFT parameters, especially in forced vital capacity (FVC%) [MD:4.38, (95% CI:0.15 -8.60)], and diffusion lung capacity for carbon monoxide (DLCO%) [MD:11.78, (95% CI:5.10-18.46)]. The intervention group failed to demonstrate significant improvement in ADLs and QoL outcomes. No significant adverse events were reported during the intervention. Conclusion: Respiratory rehabilitation can improve exercise capacity and PFT parameters in patients recovering from SARS infection. The RR does not cause serious adverse events. Clinical trials to determine the best RR program (in terms of initiation, duration, and components) in SARS and its treatment efficacy, both in the short and long- term are needed. (C) 2022 Elsevier Inc. All rights reserved.

Automated summary

The study evaluated the efficacy and safety of respiratory rehabilitation in patients recovering from SARS. Results showed that respiratory rehabilitation significantly improved exercise capacity and pulmonary function test parameters in SARS patients, with no significant adverse events reported. However, the improvement in activities of daily living and quality of life outcomes were limited. Further clinical trials are needed to determine the optimal respiratory rehabilitation program for SARS patients.