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Assessment and management of post-COVID-19 pulmonary complications: a rapid review
Wade Michaelchuk1,2, Lesley J J Soril3,4,2, Dacia Chiarieri-Hirsch1
1Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Insights
Post-COVID-19 condition (PCC) significantly impacts lung health. A review suggests multidisciplinary rehabilitation may effectively treat pulmonary PCC complications, though more research is needed.
Area of Science:
- Pulmonology
- Infectious Diseases
- Rehabilitation Medicine
Background:
- Post-COVID-19 condition (PCC) presents a growing global health challenge.
- Pulmonary complications are a significant concern for individuals with PCC.
- There is a need for updated guidelines on managing pulmonary PCC.
Purpose of the Study:
- To synthesize current research on the management and treatment of pulmonary complications in PCC.
- To identify evidence-based recommendations for assessment and treatment.
- To inform the development of clinical guidance.
Main Methods:
- A rapid review of published and grey literature was conducted.
- Searches focused on pulmonary-related PCC complications, updated in June 2025.
- PRISMA guidelines were followed, synthesizing findings from 73 articles.
Main Results:
- Guidance recommends pulmonary function testing and ruling out other conditions.
- Evidence for medical/pharmacological interventions is limited and inconclusive.
- Multidisciplinary rehabilitation shows potential effectiveness for pulmonary PCC.
Conclusions:
- Cautious interpretation is needed due to study heterogeneity and bias.
- Multidisciplinary rehabilitation offers a promising approach for pulmonary PCC.
- Updated, evidence-informed clinical guidance is essential.
Abstract:
The rising global prevalence of post-COVID-19 condition (PCC) underscores the substantial and ongoing burden faced by individuals following severe acute respiratory syndrome coronavirus 2 infection. The volume of emerging evidence regarding pulmonary-related PCC complications highlights the urgent need for current, evidence-informed guidelines to ensure timely assessment and effective treatment for those affected by PCC. Thus, the aim of this review was to synthesise existing research on the management and treatment of pulmonary complications in individuals with PCC. A rapid review of published and grey literature focused on pulmonary-related PCC complications was completed in November 2023 and updated in June 2025, in accordance with PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. We identified 73 unique articles, including 12 guidance documents, 24 secondary studies (including 11 systematic reviews with meta-analyses, eight systematic reviews and three scoping reviews) and 37 primary research studies (13 randomised controlled trials) and narratively synthesised their findings. Guidance documents addressed workup and management for pulmonary-related PCC complications, recommending the use of pulmonary function testing with diffusing capacity and the importance of ruling out other conditions. Although evidence regarding the use of medical and pharmacological interventions for treatment of pulmonary-related PCC complications were limited and inconclusive, the current evidence base suggested potential effectiveness of a multidisciplinary rehabilitation approach for pulmonary-related PCC treatment, involving specialist consultations and tailored rehabilitation programmes. The heterogeneity in study quality and risk of bias warrants cautious interpretation of the findings. The current evidence and evolving healthcare landscape suggest the need for updated, evidence-informed clinical guidance.
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