Long COVID and Physical Therapy: A Systematic Review

Abstract

Prolonged COVID is a persistent condition following the initial COVID-19 infection, which is characterized by a variety of symptoms that may include fatigue, muscle pain, sleep disturbances, “brain fog”, respiratory, cardiovascular, digestive, neurological and dermatological symptoms. Physical therapy has been identified as a crucial aspect of the management of patients with long COVID, as it can help improve symptoms and overall physical function. The investigation of long COVID poses significant challenges due to the diversity and variability of symptoms, lack of clear diagnostic criteria, and limited understanding of the underlying mechanisms. The aim of this study is to conduct a systematic review of studies conducted in patients with long COVID in conjunction with interventions targeting respiratory function, particularly involving physical activity. To this end, we conducted a systematic review to analyze studies conducted on treatment programs for long COVID based on some form of physical activity. The protocol of the review was registered in the PROSPERO website, and the databases PubMed, Scopus, CINAHL and WOS were searched. Of the 62 initial articles, six were included in the review. The results obtained have positive implications for the advancement of physical activity as a therapeutic intervention for individuals with long COVID-19 and the conceptualization of evidence-based treatment protocols. Statistically significant results have been observed in studies of at least 6 weeks duration, in which inspiratory muscle training exercises are proposed. Further research is needed to better understand long COVID and develop effective treatment strategies.

Pulmonary rehabilitation in patients with prior COVID-19 infections

“…Sanchez-Garcia et al published a systematic review of studies of physical therapy in patients with long COVID. 11 They define prolonged COVID as a persistent condition characterized by fatigue, muscle pain, sleep disturbances, brain fog, and symptoms involving the cardiovascular, respiratory, digestive, neurologic systems. Their literature search eventually recovered 6 articles that were included in the review.…”

A Practical Framework for Long COVID Treatment in Primary Care

“…It is imperative that patients are counseled that this diverges fundamentally from conventional high intensity exercise regimens, which can induce PEM and be counterproductive. Conversely, a supervised, intentional regimen that diligently monitors physiological parameters and is carefully titrated to energy capacity can at a minimum prevent deconditioning, and if done well enhance mobility and aerobic function [45][46][47] . Cognitive rehabilitation, which can be facilitated by providers like speech-language pathologists or neuropsychologists, provides tailored assessments and can deliver evidence-based interventions for common PASC cognitive symptoms including aTention deficits and memory problems.…”

Electrophysiological Impact of SARS-CoV-2 Envelope Protein in U251 Human Glioblastoma Cells: Possible Implications in Gliomagenesis?

“…The symptoms associated with SARS-CoV-2 infections are varied and include not only fever, cough, and pulmonary diseases, but also gastrointestinal ailments and, at least in the case of pre-Omicron variants, neurological diseases, such as muscle soreness, headaches, dizziness, altered smell and taste as well as confusion and even psychiatric disorders [ 4 ]. Neurological symptoms are also a characteristic of the long COVID, a multisystemic syndrome that persists beyond the acute phase of the infection [ 5 ]. A clinical retrospective study reported that one-third of COVID-19 survivors presents neurological or psychiatric symptoms six months after the infection [ 6 ].…”

“…Expected number of genes in the analyzed list for this category, based on the reference list 4. Fold enrichment of the genes observed in the analyzed list over the expected 5. Raw p-value as determined by Fisher's exact test 6.…”