OBJECTIVE: To establish the effects of pulmonary rehabilitation (PR) in patients with persistent symptoms following COVID-19 infection. In addition, to compare the modalities of PR services (face-to-face and telerehabilitation) and the duration of PR in weeks (4 to 8 weeks and > 8 weeks). DATA SOURCES: PubMed/Medline; Embase (Elsevier); Central/Cochrane Library; SciELO Citation Index (Web of Science); and CINAHL. STUDY SELECTION: Studies determining the effects of PR in patients with Post-COVID-19 syndrome were included and grouped according to PR delivery modality. DATA EXTRACTION: Data extraction and quality assessment were independently performed by 2 reviewers. The methodological quality was assessed using the Cochrane risk of bias tool 1 (RoB-1). DATA SYNTHESIS: The literature search retrieved 1,406 articles, of which seven studies explored the effects of PR on patients with post-COVID-19 syndrome, with 188 patients randomised to PR. The mean age of participants was 50 years and 49% were female. Meta-analysis showed an increase in exercise capacity with PR compared to control (six-minute walking test: mean difference 60.56 m, 95% confidence interval 40.75 to 80.36), a reduction in fatigue (Fatigue Severity Scale -0.90, -1.49 to -0.31) but no change in dyspnea (-0.57, -1.32 to 0.17) and muscle strength (3.03, -1.89 to 7.96). There were no differences between telerehabilitation and face-to-face PR regarding effects on peripheral muscle strength (p = 0.42), dyspnea (p = 0.83) and fatigue (p = 0.34). There were no differences between programs 4 to 8 weeks and > 8 weeks regarding exercise capacity (p = 0.83), peripheral muscle strength (p = 0.42), and dyspnea (p = 0.76). CONCLUSIONS: Pulmonary rehabilitation improves exercise capacity and reduces fatigue in patients with post-COVID-19 syndrome. Duration of PR (4 to 8 weeks versus > 8 weeks) or PR modality (telerehabilitation versus face-to-face) did not impact on outcomes but data were limited and based on subgroup analysis. Further evidence is required to determine the optimal delivery mode and duration of PR for post-COVID-19 syndrome.

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