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，呼吸训练干预是否能使长新冠（Long COVID-19）患者获益尚不明确。本研究的核心目的为分析呼吸训练对长新冠患者的干预效果，具体聚焦于呼吸肌力量、肺功能、呼吸困难及功能能力四个维度。我们遵循PRISMA声明开展系统综述，检索了PubMed、Scopus及PEDro数据库（最后一次检索时间为2023年11月），采用科克伦偏倚风险评估工具对研究的偏倚风险进行评价。本综述纳入以长新冠患者为研究对象、对比呼吸训练干预与无干预、常规对照或安慰剂干预的随机对照试验。我们对纳入研究的数据进行合并，并完成荟萃分析。最终共纳入7项研究，涉及572名患者。荟萃分析结果显示，呼吸训练在改善呼吸肌力量（均数差MD=13.71；95%置信区间CI=5.41~22.00；p=0.001）、呼吸困难（标准化均数差SDM=1.39；95%置信区间CI=0.33~2.46；p=0.01）及功能能力（标准化均数差SDM=0.90；95%置信区间CI=0.37~1.43；p=0.0009）方面存在显著优势，但对肺功能无显著改善作用（均数差MD=0.28；95%置信区间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能力，若联合治疗性运动还可缓解患者的呼吸困难症状，但对该类患者的肺功能无显著提升效果。CRD42022371820