Does pulmonary rehabilitation improve fatigue in patients with post-COVID-19 syndrome? A meta-analysis of randomized clinical trials
Laura Pérez-Gisbert, Beatriz Brea-Gómez, Marie Carmen Valenza, Andrés Calvache-Mateo, Araceli Ortiz-Rubio, Irene Torres-Sánchez
Purpose
To assess the efficacy of pulmonary rehabilitation (PR) on fatigue in patients with post-COVID-19 syndrome (PCS).
Methods
A systematic review and a meta-analysis were performed until 21 October 2024 in 4 databases (CINAHL, Medline, Scopus and Web of Science). Inclusion criteria: Population: patients (≥18 years) with PCS; Intervention: PR; Comparison: control group (CG) vs. placebo; Outcome: fatigue assessed before and after the intervention; Study: randomized clinical trials. Methodological quality was assessed with Downs and Black scale and risk of bias with Cochrane risk-of-bias tool. Meta-analysis was conducted with RevMan 5.4.
Results
Thirteen studies were included in the systematic review and 10 in the meta-analysis. The meta-analysis showed a moderate effect size (SMD = –0.59, 95% CI = –0.89, −0.28; p = 0.0002, n = 973) in favor of PR compared to CG for fatigue, with significant differences. Compared to CG, fatigue in patients with PCS was reduced to a greater extent in PR group (both center-based PR and home-based PR, and both <12 weeks of PR and ≥12 weeks of PR), with significant differences.
Conclusion
This review demonstrates the efficacy of PR as a promising intervention for alleviating fatigue in patients with PCS, revealing a significantly greater reduction in fatigue in PR group compared to CG.
PROSPERO registration number
CRD42022310791.
Implications for rehabilitation
Laura Pérez-Gisbert, Beatriz Brea-Gómez, Marie Carmen Valenza, Andrés Calvache-Mateo, Araceli Ortiz-Rubio, Irene Torres-Sánchez
Purpose
To assess the efficacy of pulmonary rehabilitation (PR) on fatigue in patients with post-COVID-19 syndrome (PCS).
Methods
A systematic review and a meta-analysis were performed until 21 October 2024 in 4 databases (CINAHL, Medline, Scopus and Web of Science). Inclusion criteria: Population: patients (≥18 years) with PCS; Intervention: PR; Comparison: control group (CG) vs. placebo; Outcome: fatigue assessed before and after the intervention; Study: randomized clinical trials. Methodological quality was assessed with Downs and Black scale and risk of bias with Cochrane risk-of-bias tool. Meta-analysis was conducted with RevMan 5.4.
Results
Thirteen studies were included in the systematic review and 10 in the meta-analysis. The meta-analysis showed a moderate effect size (SMD = –0.59, 95% CI = –0.89, −0.28; p = 0.0002, n = 973) in favor of PR compared to CG for fatigue, with significant differences. Compared to CG, fatigue in patients with PCS was reduced to a greater extent in PR group (both center-based PR and home-based PR, and both <12 weeks of PR and ≥12 weeks of PR), with significant differences.
Conclusion
This review demonstrates the efficacy of PR as a promising intervention for alleviating fatigue in patients with PCS, revealing a significantly greater reduction in fatigue in PR group compared to CG.
PROSPERO registration number
CRD42022310791.
Implications for rehabilitation
- Pulmonary rehabilitation is a promising intervention for alleviating fatigue in patients with post-COVID-19 syndrome.
- Including pulmonary rehabilitation in care protocols may markedly enhance the quality of life of patients with post-COVID-19 syndrome, who frequently face physical and psychological constraints due to fatigue.