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European Journal of Physical and Rehabilitation Medicine 2020 Jul 24

DOI: 10.23736/S1973-9087.20.06501-6


language: English

Rehabilitation and Covid-19: the Cochrane Rehabilitation 2020 rapid living systematic review

Maria Gabriella CERAVOLO 1, Chiara ARIENTI 2, Alessandro DE SIRE 3, 4, Elisa ANDRENELLI 1 , Francesco NEGRINI 5, Stefano LAZZARINI 2, Michele PATRINI 2, Stefano NEGRINI 5, 6, The International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER action 

1 Department of Experimental and Clinical Medicine, “Politecnica delle Marche” University, Ancona, Italy; 2 IRCCS Fondazione Don Gnocchi, Milan, Italy; 3 Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy; 4 Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy; 5 IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; 6 Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, Milan, Italy

INTRODUCTION: This paper improves the methodology of the first edition of the rapid living systematic review started in April 2020, with the aim to gather and present the current evidence informing rehabilitation of patients with COVID-19 and/or describing the consequences due to the disease and its treatment.
METHODS: The Cochrane methodology for a rapid living systematic review was applied. Primary research papers, published from January 1st to June 30th, 2020, reporting patients’ data, with no limits of study design were included. Studies were categorized for study design, research question, COVID-19 phase, limitations of functioning (disability) of rehabilitation interest and type of rehabilitation service involved. Methodological quality assessment was based on the Cochrane Risk of Bias tools, and the level of evidence table (OCEBM 2011) for all the other studies.
RESULTS: Thirty-six, out of 3703 papers, were included. One paper was of level 2 (RCT), 7 were of level 3 (2 cohort studies, 2 cross-sectional studies and 3 case-control studies), and 28 papers of level 4 (descriptive studies); 61% of papers reported epidemiological data on clinical presentations, 5 investigated natural history/determining factors, 1 searched prevalence, 2 studies reported on intervention efficacy (though not on harms), and 5 studies looked at health service organization.
DISCUSSION: Main issues emerging from the review: it is advised to test for COVID-19 people with neurological disorders presenting with symptom changes; dysphagia is a frequent complication after oro-tracheal intubation in COVID-19 patients admitted to the ICU; after discharge, COVID-19 survivors may report persistent restrictive ventilatory deficits regardless of disease severity; there is only sparse and low quality evidence concerning the efficacy of any rehabilitation intervention to promote functional recovery; a substantial increase in resource (staff and equipment) is needed for rehabilitation.

KEY WORDS: Covid-19; Severe Acute Respiratory Syndrome Coronavirus 2; Coronavirus; Rehabilitation; Exercise

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