Cochrane Rehabilitation developed the REH-COVER action to provide the global rehabilitation community with the best available evidence to respond to the COVID-19 pandemic. However, currently we are also facing the long-term consequences of COVID-19, initially called “long covid” and now referred to as post COVID-19 condition (PCC). This situation led the WHO Rehabilitation Programme to request an evidence synthesis to support the development of specific recommendations. Starting from this need, Cochrane Rehabilitation developed a summary of “evidence relevant to” the rehabilitation of adults with PCC.
The PICO framework informs evidence production and synthesis: Interventions to achieve a specific Outcome for people with a disease (Population) are contrasted with a Comparison. We could call the output of such research the “evidence on” interventions for a specific population. However, within rehabilitation, the interventions do not target the disease but the impairments and the level of activity/participation, accounting for pathology-specific contraindications. In other words, in rehabilitation, the health conditions contextualise the interventions that are required to regain capacity that has previously been lost by the patient. This understanding of rehabilitation provides an opportunity for a different approach to evidence gathering for managing new diseases — at least until direct evidence is available. Rehabilitation interventions can be identified based on their effectiveness for impairments and activity limitations in other health conditions. These interventions become strong hypotheses (and constitute
the earliest evidence available) for clinical management and research until direct, more robust “evidence on” the rehabilitation for people with that health condition becomes available. This is what we call “evidence relevant to” rehabilitation.
The project provided a mapping synthesis of Cochrane Systematic Reviews on adults experiencing relevant PCC impairment. The results have been reported in five different papers in the following categories:
- Fatigue, post-exertional malaise and orthostatic intolerance;
- Dyspnea;
- Arthralgia;
- Dysphagia, dysphonia and olfactory dysfunction;
- Cognitive impairment, anxiety and depression.
Here are the introductory paper and the five papers reported above:
Negrini S, Kiekens C, Cordani C, Arienti C, DE Groote W. Cochrane "evidence relevant to" rehabilitation of people with post COVID-19 condition. What it is and how it has been mapped to inform the development of the World Health Organization recommendations. Eur J Phys Rehabil Med. 2022 Dec 5. doi: 10.23736/S1973-9087.22.07793-0. Epub ahead of print. PMID: 36468825. PubMed link
Arienti C, Cordani C, Lazzarini SG, Del Furia MJ, Negrini S, Kiekens C. Fatigue, post-exertional malaise and orthostatic intolerance: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition. Eur J Phys Rehabil Med. 2022 Dec;58(6):857-863. doi: 10.23736/S1973-9087.22.07802-9. Epub 2022 Dec 6. PMID: 36472558. PubMed link
Cordani C, Lazzarini SG, Del Furia MJ, Kiekens C, Arienti C, Negrini S. Arthralgia: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition. Eur J Phys Rehabil Med. 2022 Dec;58(6):870-874. doi: 10.23736/S1973-9087.22.07803-0. Epub 2022 Dec 6. PMID: 36472559. PubMed link
Cordani C, Lazzarini SG, Zampogna E, Del Furia MJ, Arienti C, Negrini S, Kiekens C. Dyspnea: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition. Eur J Phys Rehabil Med. 2022 Dec;58(6):864-869. doi: 10.23736/S1973-9087.22.07805-4. Epub 2022 Dec 13. PMID: 36511169. PubMed link
Cordani C, Battel I, Del Furia MJ, Lazzarini SG, Negrini S, Arienti C. Dysphagia, dysphonia and olfactory disease: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition. Eur J Phys Rehabil Med. 2022 Dec;58(6):875-879. doi: 10.23736/S1973-9087.22.07811-X. Epub 2022 Dec 19. PMID: 36534007. PubMed link
Cordani C, Young VM, Arienti C, Lazzarini SG, Del Furia MJ, Negrini S, Kiekens C. Cognitive impairment, anxiety and depression: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition. Eur J Phys Rehabil Med. 2022 Dec;58(6):880-887. doi: 10.23736/S1973-9087.22.07813-3. Epub 2022 Dec 19. PMID: 36534008. PubMed link