The effectiveness of pulmonary rehabilitation for Post-COVID symptoms: A rapid review of the literature

Background: Multi-disciplinary rehabilitation is recommended for individuals with post-acute sequelae of COVID19 infection (i.e., symptoms 3-4 weeks after acute infection). There are emerging reports of use of pulmonary rehabilitation (PR) in the post-acute stages of COVID-19, however the appropriateness of PR for managing postCOVID symptoms remains unclear. To offer practical guidance with regards to post-COVID PR, a greater understanding of the clinical effectiveness literature is required. Methods: A rapid review of the published literature was completed. An electronic database search of the literature published between July 1, 2020 and June 1, 2021 was performed in MEDLINE, Pubmed, and EMBASE. Primary studies evaluating the clinical effectiveness of PR for individuals with post-COVID symptoms were included. Results: Nine studies evaluating the effectiveness of PR were identified; most were small, experimental or quasi experimental studies, including 1 RCT, and were primarily of low quality. After attending PR, all studies reported improvements in exercise capacity, pulmonary function, and/or quality of life for individuals with post-COVID symptoms who had been hospitalized for their acute COVID-19 infection. Few studies evaluated changes in postCOVID symptom severity or frequency and, of these, improvements in dyspnea, fatigue, anxiety and depression were observed following PR. Further, no studies evaluated non-hospitalized patients or long-term outcomes beyond 3 months after initiating PR. Conclusions: With limited high-quality evidence, any recommendations or practical guidance for PR programmes for those with post-COVID symptoms should consider factors such as feasibility, current PR capacity, and resource constraints.

Automated summary

Limited clinical effectiveness studies have been conducted on post-COVID PR, but existing research suggests that PR can improve exercise capacity, pulmonary function, and quality of life for individuals hospitalized with acute COVID-19 infection. It may also alleviate symptoms such as dyspnea, fatigue, anxiety, and depression. However, there is a lack of research on non-hospitalized patients or long-term outcomes beyond 3 months after initiating PR.