COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Treatment Liu K, Zhang W, Yang Y, et al. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020 May;39:101166. doi: 10.1016/j.ctcp.2020.101166. Epub 2020 Apr 1.

BACKGROUND: Different degrees of disorders are reported in respiratory function, physical function and psychological function in patients with corona virus disease 2019 (COVID-19), especially in elderly patients. With the experience of improved and discharged COVID-19 patients, timely respiratory rehabilitation intervention may improve prognosis, maximize functional preservation and improve quality of life (QoL), but there lacks of studies worldwide exploring the outcome of this intervention.

OBJECTIVE: To investigate the effects of 6-week respiratory rehabilitation training on respiratory function, QoL, mobility and psychological function in elderly patients with COVID-19.

METHODS: This paper reported the findings of an observational, prospective, quasi-experimental study, which totally recruited 72 participants, of which 36 patients underwent respiratory rehabilitation and the rest without any rehabilitation intervention. The following outcomes were measured: pulmonary function tests including plethysmography and diffusing lung capacity for carbon monoxide (DLCO), functional tests (6-min walk distance test), Quality of life (QoL) assessments (SF-36 scores), activities of daily living (Functional Independence Measure, FIM scores), and mental status tests (SAS anxiety and SDS depression scores).

RESULTS: After 6 weeks of respiratory rehabilitation in the intervention group, there disclosed significant differences in FEV1(L), FVC(L), FEV1/FVC%, DLCO% and 6-min walk test. The SF-36 scores, in 8 dimensions, were statistically significant within the intervention group and between the two groups. SAS and SDS scores in the intervention group decreased after the intervention, but only anxiety had significant statistical significance within and between the two groups.

CONCLUSIONS: Six-week respiratory rehabilitation can improve respiratory function, QoL and anxiety of elderly patients with COVID-19, but it has little significant improvement on depression in the elderly.

Discipline / Specialty Area Score
Physical Medicine and Rehabilitation
Family Medicine (FM)/General Practice (GP)
General Internal Medicine-Primary Care(US)
Hospital Doctor/Hospitalists
Internal Medicine
Infectious Disease
Comments from MORE raters

Geriatrics rater

With the COVID19 virus creating havoc around the world and adversely affecting the elderly, it is important to seek any method to improve the respiratory outcome in recovering patients. Although this is a small study, it is helpful to learn that respiratory rehabilitation can improve many functions post-COVID19 infection.

Hospital Doctor/Hospitalists rater

Interesting findings but very small population size. Respiratory rehab status post-COVID-19 infection may have benefits for patients with minimal risk.

Infectious Disease rater

The utility of pulmonary rehabilitation is not questioned for patients with respiratory diseases. It's not surprising these benefits also apply to patients recovering from ARDS from COVID-19.

Physical Medicine and Rehabilitation rater

This is the first RCT of rehabilitation in COVID-19. The reader needs to be aware that the rehabilitation intervention is not standard in pulmonary rehabilitation programs worldwide.

Respirology/Pulmonology rater

This small study suggests that pulmonary rehab produces improved pulmonary function in elderly patients who have had Covid-19 compared to patients who did not undergo rehab. Results are not particularly surprising, and there's no obvious reason that Covid-19 patients wouldn't benefit as do other patients with lung disease.