Coronavirus disease 2019 (COVID-19) has caused tremendous morbidity and mortality worldwide. The large number of post-COVID survivors has drawn attention to the management of post-COVID condition, known as long COVID. This review examines current knowledge of long COVID, regarding its epidemiology, mechanism, and clinical presentations in both adults and children. We also review the rehabilitation principles, modules, and effects, and share Taiwan's efforts to provide a top-down, nationwide care framework for long COVID patients. Dyspnea, chronic cough, and fatigue are the most commonly reported symptoms in the first 6 months after infection, but cognitive impairment and psychological symptoms may persist beyond this time. Several possible mechanisms behind these symptoms were proposed, but remained unconfirmed. These symptoms negatively impact individuals' function, activities, participation and quality of life. Rehabilitation is a key element of management to achieve functional improvement. Early management should start with comprehensive evaluation and identification of red flags. Exercise-based therapy, an essential part of management of long COVID, can be conducted with different modules, including telerehabilitation. Post-exertional symptom exacerbation and orthostatic hypotension should be carefully monitored during exercise. Randomized control trials with a large sample size are needed to determine the optimal timing, dosage, and modules. Open access, https://www.sciencedirect.com/science/article/pii/S0929664623001079
Marketing claim. There is no evidence that it makes any difference, and a shockingly high number of serious deterioration that are completely unrecorded and unacknowledged by clinicians, which makes the entire paradigm unsafe, in addition to being useless. It's shocking to see the widespread indifference to causing harm. As if disbelieving it makes it OK. As if refusing to record it makes it not exist. Also a marketing claim. What does essential mean here? The vast majority of patients, including many who recovered, never made it to such programs. They simply mean that it's commonly used, so continuing the trend in healthcare where the more an intervention is used, the less evidence it needs, because its very use is highlighted as evidence that it is, well, "essential". Because why would something be commonly used, but useless? Even though it's common to go ahead with trying something without evidence, which then locks in years of this circular lack of reasoning. And yet, oddly enough, they are honest about the fact that there is zero evidence for this, that it's essentially nothing but copy-catting what everyone is doing, for no other reason than they are doing it: No evidence of the effectiveness. And yet it is "essential". How does anyone even wonder why the outcomes are so bad? Other than simply pretending they're good. Based on no evidence at all. This is complete lack of reasoning, and makes a mockery of the idea of evidence-based medicine, when they freely admit there is no evidence, but feel like doing it anyway. And still call it evidence-based medicine. This is as valid as simply applying stickers with "Quality control checked" without an actual quality control process. Weird, but people who clearly don't understand the problem are not the people to solve it. This is beyond ridiculous, it's real death of expertise stuff. Really this is just a jumble of various things people are doing without any sense or reason. It's meandering and blatant in its attempt to manufacture an outcome.
