Effect of Pulmonary Rehabilitation Approaches on Dyspnea, Exercise Capacity, Fatigue, Lung Functions, and Quality of Life in Patients With COVID-19: A Systematic Review and Meta-analysis.

Only 8 trials and 449 people in total, each trial small (32 to 118 participants) and mostly from a single country. Results for walking capacity were very inconsistent between trials (I² = 80%), so the pooled average hides wide variation in what individual studies found. Only a quarter of the trials analysed everyone as originally randomised, and only half kept participants and staff from knowing who received which treatment. Programmes differed in content, length (1 to 12 weeks) and number of sessions, so the review cannot say which components produced the benefit. Participants differed in age and in other illnesses, and disease severity ranged from mild to severe. The positive findings for lung function and quality of life come from subgroup analyses of single studies, not from the pooled comparison. Quality of life was measured with four different questionnaires, and one trial's data could not be pooled at all.

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Do not take the review's conclusion that rehabilitation improves lung function at face value. Forced vital capacity showed no difference between rehabilitation and control overall (0.12 L, P>.05), and the single positive signal comes from one study of face-to-face rehabilitation, not from the pooled analysis. The same applies to quality of life, where the pooled result was also null.