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Published on: November 8, 2013
Long COVID and rehabilitation
Hung-Jui Chuang1, Chia-Wei Lin1, Ming-Yen Hsiao1
1Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College Medicine, Taipei, Taiwan, ROC.
Insights
Long COVID, a condition affecting survivors of Coronavirus disease 2019 (COVID-19), presents with persistent symptoms like fatigue and cognitive impairment. Rehabilitation, including exercise-based therapy, is crucial for managing long COVID and improving patient quality of life.
Area of Science:
- Medical Rehabilitation
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) has resulted in significant global morbidity and mortality.
- A growing number of COVID-19 survivors are experiencing long COVID, necessitating effective management strategies.
- Long COVID presents diverse clinical manifestations in both adults and children, impacting daily life and quality of life.
Purpose of the Study:
- To review current knowledge on the epidemiology, mechanisms, and clinical presentations of long COVID.
- To examine rehabilitation principles, modules, and their effects on long COVID patients.
- To present Taiwan's nationwide framework for long COVID care.
Main Methods:
- Systematic review of existing literature on long COVID.
- Analysis of reported symptoms, potential mechanisms, and impact on function.
- Evaluation of rehabilitation strategies, including exercise-based therapy and telerehabilitation.
- Review of a national care framework implementation.
Main Results:
- Common persistent symptoms include dyspnea, chronic cough, fatigue, cognitive impairment, and psychological issues.
- Proposed mechanisms for long COVID symptoms remain largely unconfirmed.
- Rehabilitation, particularly exercise-based therapy, is vital for functional recovery.
- Early comprehensive evaluation and monitoring for post-exertional symptom exacerbation and orthostatic hypotension are recommended.
Conclusions:
- Long COVID significantly affects individuals' function and quality of life.
- Rehabilitation is a cornerstone in managing long COVID, aiming for functional improvement.
- Further large-scale randomized controlled trials are needed to optimize rehabilitation protocols for long COVID.
Abstract:
Coronavirus disease 2019 (COVID-19) has caused tremendous morbidity and mortality worldwide. The large number of post-COVID survivors has drawn attention to the management of post-COVID condition, known as long COVID. This review examines current knowledge of long COVID, regarding its epidemiology, mechanism, and clinical presentations in both adults and children. We also review the rehabilitation principles, modules, and effects, and share Taiwan's efforts to provide a top-down, nationwide care framework for long COVID patients. Dyspnea, chronic cough, and fatigue are the most commonly reported symptoms in the first 6 months after infection, but cognitive impairment and psychological symptoms may persist beyond this time. Several possible mechanisms behind these symptoms were proposed, but remained unconfirmed. These symptoms negatively impact individuals' function, activities, participation and quality of life. Rehabilitation is a key element of management to achieve functional improvement. Early management should start with comprehensive evaluation and identification of red flags. Exercise-based therapy, an essential part of management of long COVID, can be conducted with different modules, including telerehabilitation. Post-exertional symptom exacerbation and orthostatic hypotension should be carefully monitored during exercise. Randomized control trials with a large sample size are needed to determine the optimal timing, dosage, and modules.
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