https://orcid.org/0000-0001-8731-689X
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ABSTRACT
Introduction: The coronavirus disease-2019 (COVID-19) is a highly contagious respiratory viral disease for both the general population and healthcare professionals caring for infected patients. Of particular concern is the potential for significant respiratory, cardiovascular, physical, and psychological dysfunctions.
Areas covered: In this context, the current review will focus on the following areas: 1) staying physically active during the COVID-19 pandemic; 2) highlighting the importance of understanding COVID-19 mechanisms; 3) preventing infections for healthcare workers by using personal protective equipment; 4) highlighting importance of respiratory care and physical therapy during hospitalization in patients with COVID-19; and 5) facilitating referral to a rehabilitation program in patients recovering from COVID-19.
Expert opinion: We recommend daily physical exercise, outdoors or at home, as physical exercise increases the synthesis of anti-inflammatory cytokines; Patients with COVID-19 may develop severe acute respiratory syndrome, hypoxemia, diffuse alveolar damage, ACE2 reduction in the cardiovascular system and muscle weakness acquired through a prolonged hospital stay; The role of the physiotherapist in the hospital environment is of fundamental importance-early mobilization is highly recommended in severe cases of COVID-19.
Article highlights
The exercise at home is only recommended if the situation requires it or if advised by policy makers. In addition, outdoor exercises with social distance have been shown to be safer than when performed indoors;
Correct and accurate assessment of patients to analyze the need for oxygen therapy, ventilatory support, prone position or advanced gas exchange strategy;
We highly recommend use of the personal protective equipment for healthcare professionals involved in the care of patients infected with severe acute respiratory syndrome 2 (SARS-CoV-2);
The role of the physiotherapist in the hospital environment is of fundamental importance - early mobilization is highly recommended in severe cases of Coronavirus disease 2019 (COVID-19) and is associated with a decreased likelihood of developing intensive care unit acquired weakness; and
Post-discharge rehabilitation for patients hospitalized for SARS-CoV-2 infection is essential, not only to monitor the evolution of respiratory function, but also to restore or ensure a gain in functional capacity.
Abbreviation
| Coronavirus disease 2019 - COVID-19; | = | |
| World Health Organization – WHO; | = | |
| 2019 novel coronavirus - 2019-nCoV; | = | |
| Public Health Emergency of International Concern – PHEIC; | = | |
| Healthcare professionals – HCPs; | = | |
| Intensive care unit – ICU; | = | |
| Severe acute respiratory syndrome – SARS; | = | |
| General COVID-19 ward – GW; | = | |
| Personal protective equipment – PPE; | = | |
| Tumor necrosis factor – TNFα; | = | |
| Severe acute respiratory syndrome coronavirus 2 - SARS-CoV-2 | = | |
| American College Sports Medicine guidelines - ACSM; | = | |
| Heart failure – HF; | = | |
| Centers for Disease Control and Prevention – CDC; | = | |
| Angiotensin converting enzyme 2 - ACE2; | = | |
| Oxygen - O2; | = | |
| Peripheral oxygen saturation - SpO2; | = | |
| Non-invasive ventilation – NIV; | = | |
| Positive end expiratory pressure - PEEP; | = | |
| ICU-acquired weakness – ICUAW. | = |
Acknowledgments
The authors would like to thank FAPESP (grant numbers 2018/03233-0 and 2015/26501-1) and Ministry of Education/CAPES-Brazil.
Author contributions
Cássia da Luz Goulart, Rebeca Nunes Silva, Murilo Rezende Oliveira, Solange Guizilini, Isadora Salvador Rocco, Vanessa Marques Ferreira Mendez, José Carlos Bonjorno Jr, Flavia Rossi Caruso, Ross Arena and Audrey Borghi-Silva substantially contributed to the conception and design of the review article and interpreting the relevant literature; and been involved in writing the review article or revised it for intellectual content.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.