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Systematic review of changes and recovery in physical function and fitness after severe acute respiratory syndrome-related coronavirus infection: implications for COVID-19 rehabilitation
Rooney S, Webster A, Paul L
Physical Therapy 2020 Oct;100(10):1717-1729
systematic review

OBJECTIVES: (1) Compare physical function and fitness outcomes in people infected with SARS-CoV to healthy controls; (2) quantify the recovery of physical function and fitness following SARS-CoV infection; (3) determine the effects of exercise following SARS-CoV infection. METHODS: Four databases (CINAHL, Medline, ProQuest, and Web of Science Core Collections) were searched in April 2020 using keywords relating to SARS-CoV, physical function, fitness, and exercise. Observational studies or randomised controlled trials were included if they involved people following SARS-CoV infection and either assessed the change or recovery in physical function/fitness or evaluated the effects exercise postinfection. RESULTS: 10 articles were included in this review. Evidence from nine articles demonstrated that SARS-CoV patients had reduced levels of physical function and fitness postinfection in comparison to healthy controls. Furthermore, patients demonstrated incomplete recovery of physical function, with some experiencing residual impairments 1 to 2 years postinfection. Evidence from one randomised controlled trial found that a combined aerobic and resistance training intervention significantly improved physical function and fitness postinfection in comparison to a control group. CONCLUSIONS: Physical function and fitness are impaired following SARS-CoV infection, and impairments may persist up to 1 to 2 years postinfection. Researchers and clinicians can use these findings to understand the potential impairments and rehabilitation needs of people recovering from the current COVID-19 outbreak. While one study demonstrated that exercise can improve physical function and fitness postinfection, further research is required to determine the effectiveness of exercise in people recovering from similar infections (eg, COVID-19). IMPACT STATEMENT: Considering the similarities in pathology and clinical presentation of SARS-CoV and COVID-19, it is likely that COVID-19 patients will present with similar impairments to physical function. Accordingly, research is required to measure the extent of functional impairments in COVID-19 cohorts. In addition, research should evaluate whether rehabilitation interventions such as exercise can promote postinfection recovery.

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