Contribution of the professional in respiratory therapy in pulmonary rehabilitation of patients with pulmonary sequelae for COVID-19

Abstract

Introduction: the COVID-19 caused by the SARS-CoV-2 virus, is a mainly a respiratory disease, but it can also affect other systems, such as skeletal muscle, cardiovascular or neurological, leading to the development of short, medium and long-term symptoms. in the survivors. Several studies have shown important consequences in the respiratory system among those who suffered from it, mainly if they developed a serious illness. Objective: to identify the intervention of the respiratory therapist in the pulmonary rehabilitation of patients with sequelae due to COVID-19 and its application in services that provide pulmonary rehabilitation. Methods: a systematized narrative review study was carried out to meet the objective. Search engines included Pubmed, Scielo, Redalyc and Google Scholar. The descriptors were: “COVID-19”, “pulmonary rehabilitation”, “respiratory therapy” and “pulmonary sequelae” in their different combinations. 27 articles were included for this review, the majority of which (44%) were level V according to the Sackett level of evidence. Results: the main pulmonary sequelae associated with COVID-19 are those of pulmonary origin such as dyspnea, alterations of the lung parenchyma, alterations in gas exchange, thromboembolism, pulmonary fibrosis, weakness of the respiratory muscles, cough, post-activity polypnea. The contribution of the respiratory therapist in this pathology focuses on pulmonary rehabilitation through a diagnostic approach applying physical examination, chest x-ray, pulmonary function tests, dynamometry, six-minute walk and modified dyspnea scale. Likewise, they use a therapeutic approach such as respiratory physiotherapy, aerobic exercise, strength exercise, inspiratory muscle trainer, active respiratory cycle and positive pressure devices. Conclusions: the evaluations and interventions by the respiratory therapist were identified, which determine the level of physical and pulmonary limitation useful for carrying out individualized pulmonary rehabilitation programs, which generates a benefit for people with sequelae due to COVID-19.