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SARS-CoV-2 (COVID-19) Sonrası Pulmoner Rehabilitasyon Prensipleri: Akut ve Subakut Sürecin Yönetimi İçin Rehber
Pulmonary Rehabilitation Principles After SARS-CoV-2 (COVID-19): A Guideline for the Management of Acute and Subacute Course
Received Date : 19 Apr 2020
Accepted Date : 20 Apr 2020
Available Online : 01 May 2020
Özet PDF Benzer Makaleler
Yeşim KURTAİŞ AYTÜRa, Belma Füsun KÖSEOĞLUb, Özden ÖZYEMİŞÇİ TAŞKIRANc, Nilüfer Kutay ORDU GÖKKAYAd, Sibel ÜNSAL DELİALİOĞLUe, Birkan SONEL TURa, Selda SARIKAYAf, Hülya ŞİRZAİg, Tülay TEKDEMİR TİFTİKh, Ebru ALEMDAROĞLUh, F. Figen AYHANi, Burcu DUYUR ÇAKITj, Aysun GENÇa, İbrahim GÜNDOĞDUk, Rengin GÜZELl, Derya DEMİRBAĞ KABAYELm, Başak BİLİR KAYAn, Öznur ÖKENo, Hande ÖZDEMİRm, Feray SOYUPEKp, Canan TIKIZr
aAnkara Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, TÜRKİYE bTOBB Ekonomi ve Teknoloji Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, TÜRKİYE cKoç Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, TÜRKİYE dSağlık Bilimleri Üniversitesi Hamidiye Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Gaziler Fizik Tedavi ve Rehabilitasyon SUAM, Ankara, TÜRKİYE eSağlık Bilimleri Üniversitesi Hamidiye Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara Abdurrahman Yurtaslan Onkoloji Sağlık Uygulama ve Araştırma Merkezi, Ankara, TÜRKİYE fZonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Zonguldak, TÜRKİYE gÖzel Liv Hospital Ulus Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE hSağlık Bilimleri Üniversitesi Hamidiye Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara Şehir Hastanesi, Fizik Tedavi ve Rehabilitasyon Hastanesi, Ankara, TÜRKİYE iMedicana International Ankara Hastanesi, Fiziksel Tıp ve Rehabilitasyon Bölümü, Ankara, TÜRKİYE jSağlık Bilimleri Üniversitesi Hamidiye Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara Eğitim ve Araştırma Hastanesi, Fiziksel Tıp Tedavi ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE kSağlık Bilimleri Üniversitesi Hamidiye Tıp Fakültesi, Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE lÇukurova Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Adana, TÜRKİYE mTrakya Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Edirne nErenköy Fizik Tedavi ve Rehabilitasyon Hastanesi, İstanbul, TÜRKİYE oAnkara Liv Hospital, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE pIsparta Süleyman Demirel Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Isparta, TÜRKİYE rManisa Celal Bayar Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Manisa, TÜRKİYE
Doi: 10.31609/jpmrs.2020-75492 - Makale Dili: TR
J PMR Sci. 2020;23(2):111-28
ÖZET
Coronavirus Hastalığı 2019 (COVID-19) solunumsal, fiziksel, psikolojik ve yaygın sistemik işlev bozukluğuna yol açabilen bulaşıcı bir hastalıktır. Hastalığın ciddiyeti asemptomatik enfeksiyondan, hafif hastalık, pnömoni, ciddi pnömoni, akut solunum sıkıntısı sendromu, solunum yetmezliği ve ölüme kadar değişebilmektedir. COVID-19 solunum sistemi önemli şekilde etkilenmektedir. Hastalığın uzun dönem sonuçları ve muhtemel sekellerine ilişkin yeterli bilgi olmadığı gibi, rehabilitasyonu konusunda da henüz kanıt yoktur. Bu klinik uygulama rehberi erişkin COVID-19 hastaları için pulmoner rehabilitasyon önerileri içermektedir ve Dünya Sağlık Örgütü ile T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü tarafından hazırlanan COVID-19 tanı ve tedavi rehberleri, yakın zamanlı bilimsel yayınlar, uzman görüşü olarak yayınlanan COVID-19 için pulmoner rehabilitasyon önerileri ışığında ve pulmoner rehabilitasyonun temel prensipleri doğrultusunda hazırlanmıştır Bu öneriler geliştirilirken, COVID-19’un bulaşıcılığı, sınırlı sayıda personelin hasta ile teması ilkeleri ile pulmoner rehabilitasyonun sağlayacağı yararların düzeyi göz önünde bulundurulmuştur.
Anahtar Kelimeler: COVID-19; akut solunum sıkıntısı sendromu; pulmoner rehabilitasyon; rehber
ABSTRACT
Coronavirus disease 2019 (COVID-19) is a contagious infection disease, which may cause respiratory, physical, psycological and generalised systemic dysfunction. The severity of disease ranges from an asymptomatic infection, mild illness, mild or severe pneumonia with respiratory failure, acute respiratory distress syndrome and/or death. COVID-19 affects the pulmonary system crucially. There is a lack of knowledge about the longterm outcomes of the disease and the possible sequeles and rehabilitation, as well. This clinical practice guideline includes pulmonary rehabilitation (PR) recommendations for adult COVID-19 patients and is developed in the light of the guides on the diagnosis and treatment of COVID-19 provided by World Health Organisation and Turkish Republic Ministery of Health, and recently published scientific literature, PR recommendations for COVID-19 regarding basic principles of PR. In this guideline, the contagiousness of COVID-19, recommendations on limited contact of patient with health care providers, and the evidence about possible benefits of PR were taken into consideration.
Keywords: COVID-19; acute respiratory distress syndrome; pulmonary rehabilitation; guideline
REFERENCES
  1. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi (Bilim Kurulu Çalışması). Ankara: T.C. Sağlık Bakanlığı; 2020. p.89. (https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf).
  2. World Health Organization (WHO). Coronavirus Disease 2019 (Covid-19) Technical Guidance. (https://www.who.int/health-topics/coronavirus#tab=tab_1).
  3. Jia HP, Look DC, Shi L, et al. ACE2 receptor expression and severe acute respiratory syndrome coronavirus infection depend on differentiation of human airway epithelia. J Virol. 2005:79:14614-21. [Crossref]  [PubMed]  [PMC] 
  4. Wan Y, Shang J, Graham R, et al. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus. J Virol. 2020;94:e00127-20. [Crossref]  [PubMed]  [PMC] 
  5. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020:579:270-3.
  6. Wrapp D, Wang N, Corbett KS, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020;367:1260-3. [Crossref]  [PubMed]  [PMC] 
  7. Donoghue M, Hsieh F, Baronas E, et al. A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circ Res. 2000;87:E1-9. [Crossref]  [PubMed] 
  8. Tortorici MA, Veesler D. Structural insights into coronavirus entry. Adv Virus Res. 2019;105:93-116. [Crossref]  [PubMed]  [PMC] 
  9. de Wilde AH, Snijder EJ, Kikkert M, et al. Host factors in coronavirus replication. Curr Top Microbiol Immunol. 2018;419:1-42. [Crossref]  [PubMed]  [PMC] 
  10. Sawicki SG, Sawicki DL. Coronavirus transcription: a perspective. Curr Top Microbiol Immunol. 2005;287:31-55. [Crossref]  [PubMed]  [PMC] 
  11. Hussain S, Pan J, Chen Y, et al. Identification of novel subgenomic RNAs and noncanonical transcription initiation signals of severe acute respiratory syndrome coronavirus. J Virol. 2005;79:5288-95. [Crossref]  [PubMed]  [PMC] 
  12. Tian S, Hu W, Niu L, et al. Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 2020 Feb 28. Doi: 10.1016/j.jtho.2020.02.010. Online ahead of print. [Crossref]  [PubMed]  [PMC] 
  13. Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7:4.
  14. Guo YR, Cao QD, Hong ZS, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak-an update on the status. Mil Med Res. 2020;7:11. [Crossref]  [PubMed]  [PMC] 
  15. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al. Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis. Travel Med Infect Dis. 2020;101623. [Crossref]  [PubMed]  [PMC] 
  16. Tian Y, Rong L, Nian W, et al. Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission. Aliment Pharmacol Ther. 2020;51:843-51. [Crossref]  [PubMed]  [PMC] 
  17. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395:809-15. [Crossref] 
  18. Borges do Nascimento IJ, Cacic N, Abdulazeem HM, et al. Novel coronavirus infection (COVID-19) in humans: a scoping review and meta-analysis. J Clin Med. 2020;9:E941.
  19. T.C. Sanayi ve Teknoloji Bakanlığı, TÜBİTAK. COVID-19 Türkiye Web Portalı. Türkiye'de Son Durum. (https://covid19.tubitak.gov.tr/turkiyede-durum).
  20. World Health Organization (WHO). Clinical management of severe acute respiratory infection when COVID-19 is suspected Interim guidance. WHO; 2020. p.21. (https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected).
  21. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr. 2020;87:281-6. [Crossref]  [PubMed]  [PMC] 
  22. Vaira LA, Salzano G, Deiana G, et al. Anosmia and ageusia: common findings in COVID-19 patients. Laryngoscope. 2020 Apr 1. Doi: 10.1002/lary.28692. Online ahead of print. [Crossref]  [PubMed] 
  23. Wu P, Duan F, Luo C, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China. JAMA Ophthalmol. 2020;31:e201291. [Crossref]  [PMC] 
  24. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. [Crossref] 
  25. Chiumello D, Coppola S, Froio S, et al. What's next after ARDS: long-term outcomes. Respir Care. 2016;61:689-99. [Crossref]  [PubMed] 
  26. Sigurdsson MI, Sigvaldason K, Gunnarsson TS, et al. Acute respiratory distress syndrome: nationwide changes in incidence, treatment and mortality over 23 years. Acta Anaesthesiol Scand. 2013;57:37-45. [Crossref]  [PubMed] 
  27. Herridge MS, Cheung AM, Tansey CM, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348:683-93. [Crossref]  [PubMed] 
  28. Herridge MS, Tansey CM, Matte A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364:1293-304. [Crossref]  [PubMed] 
  29. Doiron KA, Hoffmann TC, Beller EM. Early intervention (mobilization or active exercise) for critically ill adults in the intensive care unit. Cochrane Database Syst Rev. 2018,3:CD010754. [Crossref]  [PubMed]  [PMC] 
  30. Kooraki S, Hosseiny M, Myers L, et al. Coronavirus (COVID-19) outbreak: what the department of radiology should know. J Am Coll Radiol. 2020;17:447-51. [Crossref]  [PubMed]  [PMC] 
  31. T.C. Sanayi ve Teknoloji Bakanlığı, TÜBİTAK. COVID-19 Türkiye Web Portalı. Korunma ve Tedavi Yöntemleri. (https://covid19.tubitak.gov.tr/korunma-tedavi-yontemleri).
  32. Cascella M, rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19). (https://www.ncbi.nlm.nih.gov/books/NBK554776/).
  33. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:e13-64.
  34. Guell Rous MR, Diaz Lobato S, Rodriguez Trigo G, et al. Pulmonary rehabilitation. Sociedad Española de Neumologia y Cirugía Torácica (SEPAR). Arch Bronconeumol. 2014;50:332-44. [Crossref] 
  35. Bolton CE, Bevan-Smith EF, Blakey JD, et al. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013;68:ii1-30. [Crossref]  [PubMed] 
  36. Andrianopoulos V, Klijn P, Franssen FM, et al. Exercise training in pulmonary rehabilitation. Clin Chest Med. 2014;35:313-22. [Crossref]  [PubMed] 
  37. World Health Organization (WHO). Rational use of personal protective equipment (‎PPE)‎ for coronavirus disease (‎COVID-19)‎: interim guidance, 19 March 2020. World Health Organization; 2020. p.7. (https://apps.who.int/iris/handle/10665/331498).
  38. Lazzeri M, Lanza A, Bellini R, et al. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Arch Chest Dis. 2020;90. [Crossref] 
  39. Thomas P, Baldwin C, Bissett B, et al. Physiotherapy management for COVID-19 in the acute hospital setting. Recommendations to guide clinical practice. Journal of Physiotherapy. 30 March 2020. [Crossref]  [PubMed]  [PMC] 
  40. Türkiye Fiziksel Tıp ve Rehabilitasyon Uzman Hekimleri Derneği. COVID-19 Sonrası Pulmoner Rehabilitasyon. (http://www.tsprm.org/haber.php?id=118).
  41. Brouwers MC, Kho ME, Browman GP, et al. Development of the AGREE II, part 1: performance, usefulness and areas for improvement. CMAJ. 2010;182:1045-52. [Crossref]  [PubMed]  [PMC] 
  42. Richardson WS, Wilson MC, Nishikawa J, et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club. 1995;123:A12-3.
  43. Nathens AB, Neff MJ, Jurkovich GJ, et al. Randomized, prospective trial of antioxidant supplementation in critically ill surgical patients. Ann Surg. 2002;236:814-22. [Crossref]  [PubMed]  [PMC] 
  44. Hanson C, Lyden E, Rennard S, et al. The relationship between dietary fiber intake and lung function in the national health and nutrition examination surveys. Ann Am Thorac Soc. 2016;13:643-50. [Crossref]  [PubMed] 
  45. Patel V, Dial K, Wu J, et al. Dietary antioxidants significantly attenuate hyperoxia-induced acute inflammatory lung injury by enhancing macrophage function via reducing the accumulation of airway HMGB1. Int J Mol Sci. 2020;21:977. [Crossref]  [PubMed]  [PMC] 
  46. Fowler AA 3rd, Truwit JD, Hite RD, et al. Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure: the CITRIS-ALI randomized clinical trial. JAMA. 2019;322:1261-70.
  47. Mahmoodpoor A, Hamishehkar H, Shadvar K, et al. The effect of intravenous selenium on oxidative stress in critically ill patients with acute respiratory distress syndrome. Immunol Invest. 2019;48:147-59. [Crossref]  [PubMed] 
  48. Boudreault F, Pinilla-Vera M, Englert JA, et al. Zinc deficiency primes the lung for ventilator-induced injury. JCI Insight. 2017;2:e86507. [Crossref]  [PubMed]  [PMC] 
  49. Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: the Italian position paper. p.17. (https://ers.app.box.com/s/825awayvkl7hh670yxbmzfvcw5medm1d).
  50. Resmi Gazete (19.04.2011, Sayı: 27910) sayılı Hemşirelik Yönetmeliğinde Değişiklik Yapılmasına Dair Yönetmelik; 2011. p.25.
  51. Chinese Association of Rehabilitation Medicine, Respiratory rehabilitation committee of Chinese Association of Rehabilitation Medicine, Cardiopulmonary rehabilitation Group of Chinese Society of Physicai Medicine. [Recommendations for respiratory rehabilitation of COVID-19 in adult]. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:E029.
  52. Ambrosino N, Clini EM. Response to pulmonary rehabilitation: toward personalised programmes? Eur Respir J. 2015;46:1538-40. [Crossref]  [PubMed] 
  53. Zhao HM, Xie YX, Wang C. Recommendations for respiratory rehabilitation in adults with COVID-19. Chin Med J (Engl). 2020 Apr 9. Doi: 10.1097/CM9.0000000000000848. Online ahead of print. [Crossref]  [PubMed] 
  54. The First Affiliated Hospital ZUSoM: Handbook of COVID-19 prevention and treatment; 2020.
  55. Yang F, Liu N, Hu JY, et al. [Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV)]. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:180-2.
  56. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi (Bilim Kurulu Çalışması) 12 Nisan 2020 [https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf]
  57. COVID-19 Polikliniğine/Acilde Hasta Kabulü ve Takibi (15 yaş ve üzeri vakalar için) [https://covid19.tubitak.gov.tr/sites/default/files/docs/2020-03/covid19-hasta-yonetimi-ve-tedavisi-15-yas-uzeri-icin-23032020.pdf.pdf]
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