Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College Medicine, Taipei, Taiwan, ROC.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College Medicine, Taipei, Taiwan, ROC; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan, ROC.
J Formos Med Assoc. 2024 Jan;123 Suppl 1:S61-S69. doi: 10.1016/j.jfma.2023.03.022. Epub 2023 Apr 13.
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.
新型冠状病毒病(COVID-19)在全球范围内造成了巨大的发病率和死亡率。大量的 COVID-19 幸存者引起了人们对 COVID-19 后状况(即长新冠)管理的关注。这篇综述探讨了长新冠的最新知识,包括其在成人和儿童中的流行病学、发病机制和临床表现。我们还综述了康复原则、模块和效果,并分享了台湾为长新冠患者提供自上而下、全国性的护理框架所做的努力。感染后 6 个月内,最常报告的症状是呼吸困难、慢性咳嗽和疲劳,但认知障碍和心理症状可能会持续更长时间。提出了几个可能导致这些症状的机制,但尚未得到证实。这些症状会对个人的功能、活动、参与和生活质量产生负面影响。康复是实现功能改善的管理的关键要素。早期管理应从全面评估和识别危险信号开始。以运动为基础的治疗是长新冠管理的重要组成部分,可采用不同的模块进行,包括远程康复。运动后症状加重和体位性低血压应在运动过程中密切监测。需要进行具有大样本量的随机对照试验,以确定最佳的时间、剂量和模块。