Challenges and approaches to medical rehabilitation of patients with COVID-19 complications

Abstract

The Covid-19 pandemic could reach several million people worldwide. Presumably, 5-15% of them will need medical rehabilitation after suffering from pneumonia and acute respiratory distress syndrome. A comprehensive search was performed in the databases MEDLINE, CENTRAL, EMBASE, Web of Science and MedPilot, CyberLeninka, and eLIBRARY on-drug rehabilitation methods that prevent the development of Covid-19 complications. The goals of medical rehabilitation at the preclinical stage are to achieve the correction of diseases that contribute to the development of Covid-19 complications (COPD, bronchial asthma, rhinosinusitis, diabetes mellitus), mainly due to non-drug methods. Non-drug technologies have a number of advantages over medications that have a side effect, and such as glucocorticoids and antibiotics lead to a worse prognosis of the underlying disease. Medical rehabilitation in the intensive care unit is aimed at reducing the risk of complications and increasing the functional reserves of the body, as well as reducing the area and degree of lung damage, preventing extrapulmonary complications, including secondary infection. The main goal of medical rehabilitation in a hospital is to reduce the severity of symptoms, resorption and repair in the lesion of lung tissue, reduce the development of fibrosis, and provide bronchial drainage to prevent secondary infection. In addition, timely transfer of the patient to a specialized stage of medical rehabilitation can increase the functional reserve of the respiratory muscles and exercise tolerance. The second, specialized stage of medical rehabilitation can be carried out in the conditions of a sanatorium-resort organization. The goals of this stage are not only to reduce symptoms and increase tolerance to physical activity, but also to improve the quality of life, psychological rehabilitation, and recovery.

Telemedicine platform COVIDREHAB for remote rehabilitation of patients after COVID-19

“…Apart from cardiorespiratory system dysfunctions, some patients suffer from digestive system disorders: diarrhoea, abdominal pain, complete lack of appetite, nausea. [1][2][3][4] Moreover, the tolerance of these patients to physical activity and quality of life in general decreases sharply. 5 Again, the risk of long-term physical, cognitive, and emotional complications, the so-called PICS syndrome (Post Intensive Care Syndrome, Post-Reanimation Syndrome), increases in severe and critical patients who stay in intensive care units (ICU) for a long time.…”

Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes?

“…12 Nevertheless, regardless of the aim of the rehabilitation program, physical exercise is always included. However, as it was noted in our previous work Fesyun et al(2020) 13 and by other researchers, 14,15 90% of patients who have had a COVID-19 infection present among other conditions impairments related to verticality, stability, spatial orientation, making difficult gym physical exercises. Therefore, we have developed an aquatic walking-recovery technique to be applied in the initial stages of medical rehabilitation, exploiting immersion up to mid-thorax and shoulder level.…”

Pain Syndromes Associated with COVID-19 and Main Approaches to Their Treatment

“…Принципиальное значение имеют структурированные реабилитационные программы, включающие дозированное повышение физической активности, аэробные Терапия Therapy упражнения, регулярные прогулки на свежем воздухе, психофизические упражнения и контроль веса. Столь же важны образовательные программы для пациентов, рациональная психотерапия и социальная поддержка, особенно для лиц с выраженными психоэмоциональными и функциональными нарушениями [33]. Необходимо отметить, что нормализация сна является необходимым условием в лечении различных болевых синдромов.…”