Patients with a new coronavirus infection (COVID-19) need rehabilitation. Rehabilitation approaches of patients with another pathology also require to be reviewed under the conditions of the SARS-CoV-2 epidemic. It is necessary to develop clinical recommendations for the rehabilitation care delivery in patients with COVID-19 and other diseases during a pandemic. A group of experts analyzed the data of current reviews on rehabilitation with COVID-19, as well as previous studies on rehabilitation in patients with Post-intensive care syndrome (PICS) and acute respiratory distress syndrome of non-coronavirus etiology, and developed thereupon the main positions of clinical recommendations. We discuss the main rehabilitation problems in patients with COVID-19, in particular structures and functions impairments, leading to limitations and restrictions of self-care, mobility, domestic life, communication, interpersonal interactions and relationships, professional activities and those determining care requirement. The article also provides general recommendations on medical rehabilitation management in a pandemic at all three stages, including patients routing, ensuring the infectious safety of medical personnel and patients. The necessary individual rehabilitation program components for patients with COVID-19 at all stages of rehabilitation have been identified, including patients examination, nutritional deficiency correction, restoration of respiratory function, exercise tolerance, muscle strength, self-monitoring and training in new movement conditions, psychoemotional state disorders and cognitive functions, as well as independence in everyday life recovery. Medical rehabilitation during the COVID-19 epidemic should include all rehabilitation care components and helps to optimize vital functions, to prevent complications and to improve the patients life quality.

The emergence of SARS-CoV-2 and its worldwide spread has become a challenge for healthcare professionals related to rapid diagnosis of infection caused by the new coronaviruses, provision of specialized medical care, rehabilitation and secondary prevention. Currently, there is limited information on primary, secondary prevention and medical rehabilitation of this disease. The most common clinical manifestation of the new variant of coronavirus infection is bilateral pneumonia, with 34% of patients developing acute respiratory distress syndrome (ARDS). Given the unusual pandemic situation and the peculiar COVID-19 pathogenesis, the stereotyped application of generally accepted methods may be unsafe or ineffective. The Union of Rehabilitologists of Russia has prepared Temporary guidelines that are based on the advice on medical rehabilitation of patients with COVID-19 at various stages of special medical care published by WHO specialists, analysis of reports from clinics currently involved in rehabilitation of COVID-19 patients, as well as on the results of clinical studies conducted earlier on the rehabilitation of patients with Post-intensive care syndrome and adult respiratory distress syndrome (ARDS) of non-coronavirus etiology, regulatory documents of the Russian Ministry of Health and Federal Service on Surveillance for Consumer rights protection and human well-being. A syndrome-based approach to the use of means and methods of physical and rehabilitation medicine is also considered. The guidelines are intended for heads of medical organizations and their structural divisions, general practitioners, physicians, infectious disease doctors, pediatricians, emergency physicians of intensive care units in infectious hospitals, physiotherapy and sports medicine doctors, physiotherapists, medical psychologists, physical therapy instructors, nurses and other specialists of multidisciplinary rehabilitation teams working in the field of medical care for patients with COVID-19 at various stages.

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