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1.
Environ Toxicol Chem ; 2022 Jul 28.
Article in English | MEDLINE | ID: covidwho-1958738

ABSTRACT

Increased disinfection efforts in various parts of China, including Hong Kong, to prevent the spread of the novel coronavirus may lead to elevated concentrations of disinfectants in domestic sewage and surface runoff in Hong Kong, generating large quantities of toxic disinfection by-products (DBPs). This study investigated the presence and distribution of four trihalomethanes (THMs), six haloacetic acids (HAAs) and eight nitrosamines (NAMs) in rivers and seawater in Hong Kong. The concentrations of THMs (mean concentration: 1.6 µg/L [seawater], 3.0 µg/L [river water]), HAAs (mean concentration: 1.4 µg/L [seawater], 1.9 µg/L [river water]) and NAMs (mean concentration: 4.4 ng/L [seawater], 5.6 ng/L [river water]) did not significantly differ between river water and seawater. The total DBP content in river water in Hong Kong was similar to that in Wuhan and Beijing, and the total THM concentration in seawater was significantly higher than that before the COVID-19 pandemic. Among the regulated DBPs, none of the surface water samples exceeded the maximum index values for THM4 (80 µg/L), HAA5 (60 µg/L) and nitrosodimethylamine (100 ng/L) in drinking water. Among the DBPs detected, bromoform in rivers and seawater poses the highest risk to aquatic organisms, which warrants attention and mitigation efforts. This article is protected by copyright. All rights reserved.© 2022 SETAC.

2.
Front Med (Lausanne) ; 9: 801255, 2022.
Article in English | MEDLINE | ID: covidwho-1952355

ABSTRACT

Purpose: We aimed to analyze the changes in the disease spectrum data of a pediatric intensive care unit (PICU) in Nanjing, China, during the COVID-19 outbreak and explore a feasible plan for the treatment of critically ill children. Methods: This retrospective study used data from our PICU from 1 January 2018 to 31 December 2020. Patient demographics, distribution of disease spectrum, results of etiological examinations, and the PICU length of stay (LOS) were compared during the COVID-19 period (2020) and the previous years (2018 and 2019). Results: In 2020, the number of PICU admissions was 46.8 and 47.8% lower than that in 2018 and 2019, respectively. There were significant differences in the number of patients in PICU among different age groups, and these differences were mainly found in children aged <4 years and older than 14 years. The percentage of the number of patients in PICU with respiratory diseases decreased significantly, while those with hematological diseases, poisoning, and rare diseases increased significantly. Moreover, the number of patients with rare diseases increased significantly, while the number of patients with mitochondrial diseases exceeded that of those with autoimmune encephalitis. The PICU LOS in 2020 was higher than that observed in 2018 and 2019, indicating that the changes in the PICU disease spectrum did not directly affect the PICU LOS. Etiological examinations revealed that during the COVID-19 period, the number of patients in PICU with bacterial infections increased, and those with viral infections decreased, although not statistically significant. Conclusions: A striking decrease in the number of PICU admissions was observed during the COVID-19 outbreak, which caused a significant change in the PICU disease spectrum. Changes in the number and characteristics of patients admitted to PICUs should be considered for facilitating the effective working of PICUs during the COVID-19 pandemic.

3.
Mathematics ; 10(14):2517, 2022.
Article in English | MDPI | ID: covidwho-1938898

ABSTRACT

In this paper, we would like to propose a (2+1)-dimensional fractional-order epidemic model with pulse jumps to describe the spread of the Omicron variant of COVID-19. The problem of identifying the involved parameters in the proposed model is reduced to a minimization problem of a quadratic objective function, based on the reported data. Moreover, we perform numerical simulation to study the effect of the parameters in diverse fractional-order cases. The number of undiscovered cases can be calculated precisely to assess the severity of the outbreak. The results by numerical simulation show that the degree of accuracy is higher than the classical epidemic models. The regular testing protocol is very important to find the undiscovered cases in the beginning of the outbreak.

4.
Frontiers in psychiatry ; 13, 2022.
Article in English | EuropePMC | ID: covidwho-1897783

ABSTRACT

Objectives This study aimed to evaluate the prevalence of anxiety among university teachers 1 year after the onset of the coronavirus disease 2019 (COVID-19) pandemic and provide empirical evidence of psychological intervention. Methods A multicenter study was conducted to examine the prevalence of anxiety among 10,302 teachers in 21 Chinese universities from February 12 to April 23, 2021. The generalized Anxiety Disorder 7-item Scale (GAD-7) was used to assess symptoms of anxiety. Multivariate logistic regression models were used to analyze the relationship between potential influence and anxiety symptoms. Results The overall prevalence of anxiety was 40.0% 1 year after the onset of the COVID-19 pandemic, which was found to be higher in women than in men (41.32% vs. 38.22%;p < 0.0001). The multivariate logistic regression showed that being the female (OR = 1.207;95%CI: 1.103–1.318), age ≥60 years (OR = 2.004;95%CI: 1.128–3.560), being married (OR = 1.319;95%CI: 1.150–1.513), and poor family economic status (OR = 1.580;95%CI: 1.321–1.891) were significantly associated with anxiety. Participants with moderate, slight, or no impact of COVID-19 on life (OR for moderate, 0.557;95%CI, 0.508–0.611;OR for slight/no, 0.377;95%CI, 0.323–0.439) showed a reduced risk of anxiety compared to those who reported a significant effect. Conclusions Symptoms of anxiety were found in about two-fifths of Chinese university teachers 1 year after the outbreak of the COVID-19 pandemic. Our findings suggest that the government should improve the dynamic tracking of mental health and adopt long-term intervention strategies.

5.
AIJ Journal of Technology and Design ; 28(69):798-803, 2022.
Article in English | J-STAGE | ID: covidwho-1896637
7.
Frontiers in medicine ; 9, 2022.
Article in English | EuropePMC | ID: covidwho-1863981

ABSTRACT

Purpose We aimed to analyze the changes in the disease spectrum data of a pediatric intensive care unit (PICU) in Nanjing, China, during the COVID-19 outbreak and explore a feasible plan for the treatment of critically ill children. Methods This retrospective study used data from our PICU from 1 January 2018 to 31 December 2020. Patient demographics, distribution of disease spectrum, results of etiological examinations, and the PICU length of stay (LOS) were compared during the COVID-19 period (2020) and the previous years (2018 and 2019). Results In 2020, the number of PICU admissions was 46.8 and 47.8% lower than that in 2018 and 2019, respectively. There were significant differences in the number of patients in PICU among different age groups, and these differences were mainly found in children aged <4 years and older than 14 years. The percentage of the number of patients in PICU with respiratory diseases decreased significantly, while those with hematological diseases, poisoning, and rare diseases increased significantly. Moreover, the number of patients with rare diseases increased significantly, while the number of patients with mitochondrial diseases exceeded that of those with autoimmune encephalitis. The PICU LOS in 2020 was higher than that observed in 2018 and 2019, indicating that the changes in the PICU disease spectrum did not directly affect the PICU LOS. Etiological examinations revealed that during the COVID-19 period, the number of patients in PICU with bacterial infections increased, and those with viral infections decreased, although not statistically significant. Conclusions A striking decrease in the number of PICU admissions was observed during the COVID-19 outbreak, which caused a significant change in the PICU disease spectrum. Changes in the number and characteristics of patients admitted to PICUs should be considered for facilitating the effective working of PICUs during the COVID-19 pandemic.

8.
J Med Microbiol ; 71(5)2022 May.
Article in English | MEDLINE | ID: covidwho-1853315

ABSTRACT

Introduction. As a novel global epidemic, corona virus disease 2019 (COVID-19) caused by SARS-CoV-2 brought great suffering and disaster to mankind. Recently, although significant progress has been made in vaccines against SARS-CoV-2, there are still no drugs for treating COVID-19. It is well known that traditional Chinese medicine (TCM) has achieved excellent efficacy in the treatment of COVID-19 in China. As a treasure-house of natural drugs, Chinese herbs offer a promising prospect for discovering anti-COVID-19 drugs.Hypothesis/Gap Statement. We proposed that Rhei Radix et Rhizome-Schisandrae Sphenantherae Fructus (RS) may have potential value in the treatment of COVID-19 patients by regulating immune response, protecting the cardiovascular system, inhibiting the production of inflammatory factors, and blocking virus invasion and replication processes.Aim. We aimed to explore the feasibility and molecular mechanisms of RS against COVID-19, to provide a reference for basic research and clinical applications.Methodology. Through literature mining, it is found that a Chinese herbal pair, RS, has potential anti-COVID-19 activity. In this study, we analysed the feasibility of RS against COVID-19 by high-throughput molecular docking and molecular dynamics simulations. Furthermore, we predicted the molecular mechanisms of RS against COVID-19 based on network pharmacology.Results. We proved the feasibility of RS anti-COVID-19 by literature mining, virtual docking and molecular dynamics simulations, and found that angiotensin converting enzyme 2 (ACE2) and 3C-like protease (3 CL pro) were also two critical targets for RS against COVID-19. In addition, we predicted the molecular mechanisms of RS in the treatment of COVID-19, and identified 29 main ingredients, 21 potential targets and 16 signalling pathways. Rhein, eupatin, (-)-catechin, aloe-emodin may be important active ingredients in RS. ALB, ESR1, EGFR, HMOX1, CTSL, and RHOA may be important targets against COVID-19. Platelet activation, renin secretion, ras signalling pathway, chemokine signalling pathway, and human cytomegalovirus infection may be important signalling pathways against COVID-19.Conclusion. RS plays a key role in the treatment of COVID-19, which may be closely related to immune regulation, cardiovascular protection, anti-inflammation, virus invasion and replication processes.


Subject(s)
COVID-19 , Drugs, Chinese Herbal , COVID-19 Vaccines , Drugs, Chinese Herbal/pharmacology , Drugs, Chinese Herbal/therapeutic use , Feasibility Studies , Flavonoids , Humans , Molecular Docking Simulation , Rhizome , SARS-CoV-2
10.
Front Psychiatry ; 13: 804538, 2022.
Article in English | MEDLINE | ID: covidwho-1731852

ABSTRACT

INTRODUCTION: The B.1.617.2 (Delta) variant of SARS-COV-2 has caused a surge in COVID-19 cases worldwide, placing a great burden on the health care system under the zero-tolerance epidemic prevention policy in China. The present study aimed to investigate the prevalence of anxiety among health care workers during the spread of the SARS-CoV-2 Delta variant, and to discuss the mediating role of positive coping style between resilience and anxiety, and the moderating role of general self-efficacy. METHOD: Connor-Davidson Resilience scale (CD-RISC), Generalized Anxiety Disorder Scale (GAD-7), General Self-efficacy Scale (GSES) and Simplified Coping Style Questionnaire (SCSQ) were used in this cross-sectional study among 390 healthcare workers in Jiangsu Province, China. Mackinnon's four-step procedure was applied to test the mediation effect, and Hayes PROCESS macro was conducted to examine the moderated mediation model. RESULTS: The prevalence of anxiety among Chinese healthcare workers during the spread of the SARS-CoV-2 Delta variant was 41.8%. Male, unmarried, childless and younger subjects reported higher levels of anxiety. Positive coping partially mediated the effect of resilience on anxiety among healthcare workers and the indirect effect was stronger with the increase of general self-efficacy. CONCLUSIONS: Anxiety was prevalent among healthcare workers during the spread of SARS-CoV-2 Delta variant. This research sheds new light on the potential mechanism underlying the association between resilience and anxiety and provides new insight into the prevention of anxiety among healthcare workers during the spread of the SARS-CoV-2 Delta variant.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315326

ABSTRACT

Background: Mandatory mask wearing policy for general population in public areas were the most controversial mitigative measure for the coronavirus disease 2019 (COVID-19) pandemic. Thus, it was imperative to investigate its influence on the incidence of face touching behaviors. Methods: Videos displaying mask-wearing and face-touching behaviors of general population in public areas were analyzed. Period before the COVID-19 epidemic were defined as January 2018 to October 2019, and those during the pandemic were from February 2020 to August 2020 in East Asia, and March to August 2020 in Europe and United States (US). Findings: 37 videos (4699 individuals) before the pandemic with 135 videos (8217 individuals) were included. The mask wearing rates all increased significantly during the pandemic. However, the incidence of face touching behaviors maintained. The incidence of eyes, nose and mouth touching behaviors decreased in East Asia and Europe, instead of US. Mask wearing rates was negatively related to incidences of face touching behaviors, especially in East Asia. Surprisingly, when mask wearing rates were >0% and <75%, mask wearing rates was positively related to the incidence of face touching behaviors in East Asia significantly (p=0.017). Interpretation: The incidence of face touching behaviors of general population in public areas was negatively associated with mask wearing rates. However, Mandatory mask wearing polices were risky in population with low adherence to masks, among whom, the face touching behaviors in public areas might increase with mask wearing rates rise. Funding: This study was supported by Guangzhou Science and Technology Project (201904010461).Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: This study was approved by the Clinical Ethics Review Board of the Third Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University. Informed consent was waived according to ethical review of biomedical research involving humans by Order of the National Health and Family Planning Commission of the People’s Republic of China No. 11.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313432

ABSTRACT

Background: The aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19. Methods: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features(“feather sign”,“dandelion sign”,“pomegranate sign”, and “rime sign”) and to summarize the follow-up results. Results: There were 22 patients (65.2 %) with typical “feather sign”and 18 (52.9%) with “dandelion sign”, while few patients had “pomegranate sign” and “rime sign”. The “feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity(GGO), thickened blood vessels, and small-thickened interlobular septa. The “pomegranate sign” was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage. The “rime sign” was characterized by numerous alveolar edemas. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients. Conclusion: “Feather sign” and “dandelion sign” were typical chest CT features in patients with COVID-19;“pomegranate sign” was an atypical feature, and “rime sign” was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.

13.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-310723

ABSTRACT

Objectives: : To assess the mental status of Chinese teachers during the COVID-19 epidemic, and to provide theoretical evidences for psychological intervention. Methods: : From October 23, 2020 to December 12, 2020, we conducted the online survey. Generalized Anxiety Disorder 7-item Scale (GAD-7) was used to assess anxiety symptoms. Classified and continuous data were reported as numbers, percentages, and Mean ± SD, respectively. Multivariate Logistic regression model was used to analyze the relationship between different factors and anxiety symptoms. Results: : A total of 10302 university teachers participated in this study, 4416 of them (40.0%) showed anxiety symptoms. Female gender ( OR =1.207) and the age of ≥60 years old ( OR =2.004) were associated with anxiety. Being married ( OR =1.319) was the risk factor for anxiety;being neutral ( OR =1.292), or not-support on returning school ( OR =1.620) was common risk factors for anxiety. Conclusions: : About two-fifths of Chinese university teachers reported anxiety symptoms during the COVID-19 epidemic. The government should pay more attention to the mental health of teachers, take timely and appropriate psychological intervention measures, improve the psychological adjustment ability of teachers, and reduce the psychological harm of COVID-19 epidemic to teachers.

14.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328819

ABSTRACT

Background: Moral injury among healthcare workers received considerable attention in China during the COVID-19 pandemic as a predictor of poor mental health outcomes. This study explored the relationship between moral injury, PTSD, and suicidal behaviors approximately 1 year after the pandemic peaked in this country. Methods An online survey was conducted from March 27 to April 26, 2021, across mainland China. A total of 3,465 health professionals completed the Chinese version of the Moral Injury Symptoms Scale-Health Professional (MISS-HP), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and PTSD Checklist for DSM-5 (PCL‐5). Unconditional logistic regression modeling was used to examine the association between these variables. Results The prevalence of PTSD and suicidal behavior among health professionals were 26.9% and 24.2%, respectively. The MISS-HP was positively correlated with PCL-5 (r = 0.43) and SBQ-R (r = 0.24) scores. Logistic regression revealed that MI was associated with a higher likelihood of PTSD (OR = 3.52, 95% CI: 3.01–4.13) and of suicidal behaviors (OR = 2.13, 95% CI:1.81–2.50) after controlling for socio-demographical variables. Conclusions Moral injury symptoms were associated with a higher risk of PTSD and more suicidal behaviors among health professionals 1 year after the peak of the COVID-19 pandemic. The findings underscore the importance of identifying and treating the moral injury as one way to manage PTSD and suicidal behaviors among health professionals during the post-pandemic period.

15.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328682

ABSTRACT

Evaluations of the pandemic to endemic phase are a great concern, especially in Zero-COVID-19 countries. Herein, we developed a mathematical model to simulate future scenarios for the variants of concern (VOCs) in the condition of several immune barriers and controlling measures. The results demonstrated that the Omicron variant would lead to 592.0 (mean ± standard deviation (SD): 433.9–750.0) million symptomatic, 24.3 (mean ± SD: 17.4–312.8) million hospital admission, 9.6 (mean ± SD:7.0–12.3) million ICU admission, and 5.4 (mean ± SD:3.7–7.5) million death cases after simulation with 1,000 days. At the endemic phase, there were nearly 500 death cases per day attributed to reinfection (66% [range: 62–70%]), infection from birth (18% [range: 16–21%]), and infection from migration (16% [range: 14–17%]). Actively treating more than 80% of cases could effectively reduce disease severity and death rates. It is feasible to transmit pandemic to endemic with Omicron variant and other milder VOCs. We recommend that the successful transition strategy is to improve medical resource allocation and enhance the prevention and control capabilities of health agencies.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323784

ABSTRACT

Background: Moral injury among physicians and other health professionals has attracted attention in the mainstream literature, this study aim to assess the psychometric properties of the 10-item Moral Injury Symptoms Scale-Health Professional (MISS-HP) among healthcare professionals in China. Methods: A total of 583 nurses and 2,423 physicians were recruited from across mainland China. An online survey was conducted from March 27 to April 26, 2020 (during the middle of the COVID-19 pandemic) using the Chinese version of the MISS-HP. Reliability was assessed by internal consistency reliability and test-retest reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to determine scale structure. Results: : Cronbach’s α of the scale for both samples was acceptable (0.71 for nurses and 0.70 for physicians), as was test-retest reliability ( ICCs for the individual items ranged from 0.41 to 0.74, with 0.77 for the overall scale in physicians). EFA suggested three factors, and the CFA indicated good fit to the data. Convergent validity was demonstrated with the 4-item Expressions of Moral Injury Scale (r=0.45 for physicians, r=0.43 for nurses). Discriminant validity was demonstrated by correlations with burnout and well-being (r=0.34–0.47), and concurrent validity was suggested by correlations with depression and anxiety symptoms (r=0.37–0.45). Known groups validity was indicated by a higher score in those exposed to workplace violence (B=4.16, 95%CI: 3.21-5.10, p<0.001). Conclusions: The MISS-HP demonstrated acceptable reliability and validity in a large sample of physicians and nurses in mainland China, supporting its use as a screening measure for moral injury symptoms among increasingly stressed health professionals in this country during the COVID-19 pandemic.

17.
Front Psychiatry ; 12: 738610, 2021.
Article in English | MEDLINE | ID: covidwho-1686547

ABSTRACT

OBJECTIVE: Lack of information about mental health status among medical staff during the epidemic of COVID-19 in China is one of the major barriers to psychological interventions. This paper aims to evaluate the contributions of perceived psychological feelings to the symptoms of common mental disorders among medical staff during the epidemic of COVID-19 in China. METHOD: A large sample of medical staff based on a non-probability sampling design was collected from February 17 to 24, 2020. The symptoms of common mental disorders were screened based on self-reported instruments to evaluate psychological distress, anxious symptoms, and depressive symptoms during the past week. Perceived psychological feelings were based on self-report. Logistic regressions and elastic net regularizations were used to evaluate the independent effect of the psychological feelings controlled by hospitals and participants characteristics. RESULTS: Totally 4,677 medical staff completed the survey. The prevalence of psychological distress, anxious symptoms, and depressive symptoms were 15.9% (95% CI 14.8-16.9), 16.0% (95% CI 15.0-17.1), and 34.6% (95% CI 33.2-35.9). Feelings of having adequate personal protective equipment, receiving enough emotional supports from both family members and colleagues were significantly associated with fewer symptoms of common mental disorders, while the feelings of overloaded work and insufficient rest times contributed to more psychological problems. CONCLUSIONS: Psychological feelings make important contributions to the symptoms of common mental disorders of medical staff during the epidemic of COVID-19. Strategies of psychological aids or interventions could be developed based on these feelings.

18.
J Med Virol ; 94(5): 2237-2249, 2022 May.
Article in English | MEDLINE | ID: covidwho-1664417

ABSTRACT

As the coronavirus disease 2019 (COVID-19) pandemic is still ongoing and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants are circulating worldwide, an increasing number of breakthrough infections are being detected despite the good efficacy of COVID-19 vaccines. Data on 88 COVID-19 breakthrough cases (breakthrough infections group) and 41 unvaccinated cases (unvaccinated group) from June 1 to August 22, 2021, were extracted from a cloud database established at Beijing Ditan Hospital to evaluate the clinical, immunological, and genomic characteristics of COVID-19 breakthrough infections. Among these 129 COVID-19 cases, 33 whole genomes were successfully sequenced, of which 23 were Delta variants, including 15 from the breakthrough infections group. Asymptomatic and mild cases predominated in both groups, but two patients developed severe disease in the unvaccinated group. The median time of viral shedding in the breakthrough infections group was significantly lower than that in the unvaccinated group (p = 0.003). In the breakthrough infections group, the IgG titers showed a significantly increasing trend (p = 0.007), and the CD4 + T lymphocyte count was significantly elevated (p = 0.018). For people infected with the Delta variant in the two groups, no significant difference was observed in either the quantitative reverse-transcription polymerase chain reaction results or viral shedding time. In conclusion, among vaccinated patients, the cases of COVID-19 vaccine breakthrough infections were mainly asymptomatic and mild, IgG titers were significantly increased and rose rapidly, and the viral shedding time was shorter.


Subject(s)
COVID-19 , Beijing/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Genomics , Humans , SARS-CoV-2/genetics
19.
Academic Journal of Second Military Medical University ; 42(11):1267-1272, 2021.
Article in Chinese | GIM | ID: covidwho-1622904

ABSTRACT

Objective: To explore the mental health status of military personnel with closed-off management 1 year after the outbreak of coronavirus disease 2019 (COVID-19).

20.
Curr Opin Pulm Med ; 28(2): 152-161, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1483669

ABSTRACT

PURPOSE OF REVIEW: Pulmonary rehabilitation improves clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). Traditional centre-based (in-person) pulmonary rehabilitation was largely shut down in response to the COVID-19 pandemic, forcing many centres to rapidly shift to remote home-based programs in the form of telerehabilitation (tele-pulmonary rehabilitation). This review summarizes the recent evidence for the feasibility and effectiveness of remote pulmonary rehabilitation programs, and their implications for the delivery of pulmonary rehabilitation in a postpandemic world. RECENT FINDINGS: A number of innovative adaptations to pulmonary rehabilitation in response to COVID-19 have been reported, and the evidence supports tele-pulmonary rehabilitation as a viable alternative to traditional centre-based pulmonary rehabilitation. However, these studies also highlight the challenges that must be surmounted in order to see its widespread adoption. SUMMARY: There are outstanding questions regarding the optimal model for tele-pulmonary rehabilitation. In the post-COVID-19 world, a 'hybrid' model may be more desirable, with some components held in person and others via telehealth technology. This would be determined by the infrastructure and expertise of individual centres, and the needs of their patients. In order to achieve a truly patient-centred pulmonary rehabilitation program, high-quality studies addressing these outstanding questions, as well as multidisciplinary collaboration, are required.


Subject(s)
COVID-19 , Pulmonary Disease, Chronic Obstructive , Telerehabilitation , Feasibility Studies , Humans , Pandemics , SARS-CoV-2
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