Respiratory training effects in Long COVID-19 patients: a systematic review and meta-analysis

To date, it is unknown whether respiratory training interventions can benefit Long COVID-19 patients. The main objective was to analyze the effects of respiratory training on patients with Long COVID-19, concretely on respiratory muscle strength, lung function, dyspnea, and functional capacity. We performed a systematic review following PRISMA statement using PubMed, Scopus, and PEDro (last search November 2023). The risk of bias was assessed using the Cochrane tool. We included randomized controlled trials testing the effect of respiratory training interventions in Long COVID-19 patients versus no intervention, control, or placebo intervention. The data was pooled, and a meta-analysis was complete. We selected 7 studies, which included 572 patients. Meta-analysis results show significant differences in favor of respiratory training in respiratory muscle strength (MD = 13.71; 95% CI = 5.41; 22; p = 0.001), dyspnea (SDM = 1.39; 95% CI = 0.33; 2.46; p = 0.01) and functional capacity (SDM = 0.90; 95% CI = 0.37; 1.43; p = 0.0009), but not in lung function (MD = 0.28; 95%CI = −0.27; 0.83; p = 0.32). The results of this systematic review with meta-analysis suggest that respiratory training improves respiratory muscle strength and functional capacity in Long COVID-19 patients, as well as dyspnea if combined with therapeutic exercise. However, respiratory training does not improve lung function in these patients. CRD42022371820.

截至目前，呼吸训练干预是否对长新冠（Long COVID-19）患者有益仍未明确。本研究的主要目的为分析呼吸训练对长新冠患者的影响，具体聚焦于呼吸肌力量、肺功能、呼吸困难及功能容量。本研究遵循PRISMA声明开展系统综述，检索数据库包括PubMed、Scopus及PEDro（最后一次检索时间为2023年11月）。采用Cochrane偏倚风险评估工具对纳入研究的偏倚风险进行评价。本研究纳入比较长新冠患者接受呼吸训练干预与未干预、常规对照或安慰剂干预效果差异的随机对照试验（randomized controlled trial, RCT）。对纳入研究的数据进行合并，并完成荟萃分析。最终纳入7项研究，共计572名患者。荟萃分析结果显示，呼吸训练在呼吸肌力量（均数差（mean difference, MD）=13.71；95%置信区间（confidence interval, CI）=5.41~22；p=0.001）、呼吸困难（标准化均数差（standardized mean difference, SDM）=1.39；95%CI=0.33~2.46；p=0.01）及功能容量（SDM=0.90；95%CI=0.37~1.43；p=0.0009）方面均存在显著优势，但在肺功能方面未观察到显著改善（MD=0.28；95%CI=-0.27~0.83；p=0.32）。本项结合荟萃分析的系统综述结果表明，呼吸训练可改善长新冠患者的呼吸肌力量与功能容量，若联合治疗性运动还可缓解呼吸困难症状，但对该类患者的肺功能无显著改善作用。CRD42022371820。