The Role of Cardiopulmonary Rehabilitation in Patients with Infected COVID-19

The 2019 new type of coronavirus, or 2019-nCoV (with new name is SARS-CoV-2), is closely related to the coronavirus (batSL-CoVZC45 and bat-SL-CoVZXC21), which have similar characteristics like as severe acute respiratory syndromes. Spread of the virus happens from person to person with droplets or direct contact. The average incubation period of the infection is 5-6 days (2-14 days). In patients recovered from Covid-19 pneumonia and acute respiratuar disstress sendrome (ARDS). However, post-acute physiotherapy and rehabilitation needs for the patients are not ompletely known. According to the informations from other viral infections such as H1N1 and SARS, respiratory and physical function losses (muscle mass and muscle function loss, myopathy, contractures, neuropathy and/or weakness acquired in intensive care) are observed after acute illness, ARDS and intensive care processes. Furthermore cognitive and emotional dysfunctions (anxiety, depression, post traumatic stress syndrome) may affect participation and quality of life. Rehabilitation interventions should be started as early as possible in mild and moderate cases. The short-term goal of cardiopulmonary rehabiliation is to alleviate dyspnea, anxiety and depression, the long-term goal is to maximize the funcutionality of the patient, improve the quality of life and facilitate her return to society. Cardiopulmonary rehabilitation programme should be done mainly via videos, brochures, remote consultations or online to prevent cross infection for the patients with Covid-19. Guidelines for Covid-19 show that physiotherapy and rehabilitation practices should practised an individual basis, based on the results of multidisciplinary evaluation, when clinically necessary. Current guidelines and protocols state that applications using airway cleaning techniques, breathing exercises and assistive devices, exercise training and respiratory muscle training should not be applied in the acute period.

Keywords:

Coronavirus, Covid-19, cardiac rehabilitation pulmonary rehabilitation,

PDF

___

Australian and New Zealand Intensive Care Society Anzics Covid-19 Guidelines, ANZICS, Melbourne 16 March 2020.
Brugliera, L., Spina, A., Castellazzi, P., Cimino P., Tettamanti, A., Houdayer, E., Pietro Arcuri, P., Alemanno, F., Mortini, P., Sandro Iannaccone, S. (2020). Letter to the editor: rehabilitation of Covid-19 patients. J Rehabil Med, 52
Beeching, N. F., Fletcher, T. E., Fowler, R. (2020). Coronovirus disease 2019 (Covid 19) symptoms, diagnosis and treatment. BMJ Practice, London
Gómez, V., Carlos, J., Carmen, P. G., Segura, R., Nadia, A. (2020). When Chronic Diseases Meet Infectious Diseases: A Proposal Toward Healthy Aging: Lessons from Covid-19 Outbreak Preprints; Basel, May 3, 2020. Eduardo. Neuroimmunomodulation, Basel 1-3.
İnce, D., Yağlı, N., Sağlam, M., Kütükçü, E. (2020). Acute and Subacute Physiotherapy and Rehabilitation in Covid-19 Infection. Turkish Journal of Physiotherapy and Rehabilitation, 31(1), 81-93
Kim, C., Jidong S. J., Lee, J. H., Won-Seok, K., Lee, G. J., Jee, S., Jung, Y., Rah, U. W., Kim, B.O., Choi, K. H., Kwon, B. S., Yoo, S. D, Bang, H. J., Shin, H. I., Kim, Y. W., Heeyoune Jung, H., Kim, E. J., et al. (2019). Clinical practice guideline for cardiac rehabilitation in Korea. Ann Rehabil Med., 43(3), 355–443
Lazzaeri, M., Lanza, A., Bellini, R., Bellofiore, A., Cecchetto, S., Colombo, A. (2020). Respiratory physiotherapy in patients with Covid-19 infection in acute setting: a position paper of Italian Association of Respiratory Physiotherapists. Monaldi Arch Chest Dis. 90, 1285. Doi: 10.4081/monaldi.2020.1285
Litao, Z., Xinsheng, Y., Qingkun, F., Haiyan, L., Xintian, L. (2020). D-dimer levels on admission to predict inhospital mortality in patients with Covid-19 J Thromb Haemost. 2020;18:1324–1329. Doi:10.1111/jth.14859.
Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J., Carone, M., Celli, B., Engelen, M., Fahy, B., Garvey, C., Goldstein, R., Gosselink, R., Suzanne Lareau, S., MacIntyre, N., Maltais, F., Morgan, M., O’Donnell, D., Christian Prefault, C., Jane Reardon, J., Rochester, C., Schols, A., Singh, S., Troosters,T. (2006).ATS/ERS statement on pulmonary rehabilitation. Am J Respir Crit Care Med,173, 1390-413
Polastri, M., Nava, S., Clini, E., Vitacca, M., Gosselink, R. (2020). Covid-19 and pulmonary rehabilitation: preparing for phase three 1. Eur Respir J, 55, 2001822 https://doi.org/10.1183/13993003.01822-2020
Scherrenberg, M., Frederix, I., De Sutter, J., Dendale, P. (2020). Use of cardiac telerehabilitation during Covid-19 pandemic in Belgium, Acta Cardiologica. Doi:10.1080/00015385.2020.1786625.
Sheehy, L. M. (2020). Considerations postacute rehabilitation for survivors of covid 19 Public health JMIR Public Health Surveill. 2020 May 8, 6(2), e19462. Doi: 10.2196/19462
Thomas, P. A., Baldwin, C., Bissett, B., Boden, I., Gosselink, R., Granger, C. L. (2020). Physiotherapy management for Covid-19 in the acute hospital setting: recommendations to guide clinical practice. J Physiotherapy, https://doi.org/10.1016/j. jphys.2020.03.011
Thomas, P. B., Baldwin, C., Bissett, B., Boden, I., Gosselink, R., Granger, C. L., Hodgson, C., Jones, A. Y. M., Ekho, M., Moses, R., Ntoumenopoulos, G., Parry, S. M., Patman, S., Lee, l. (2020). Physiotherapy management for Covid-19 in the acute hospital setting: clinical practicerecommendations. Journal of Physiotherapy, 66(2), 73-82.
Vanessa, J. (2020). Coronavirus (Covid 19): İnfection control and prevention measures Journal of Primary Health Care, 12(1), 96-97. Doi: 10.1071/HC15950