Respiratory rehabilitation for post-COVID19 patients in spa centers: first steps from theory to practice
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CORRESPONDENCE
Respiratory rehabilitation for post-COVID19 patients in spa centers: first steps from theory to practice Michele Antonelli 1,2
&
Davide Donelli 3
Received: 8 June 2020 / Revised: 23 June 2020 / Accepted: 29 June 2020 # ISB 2020
Abstract With this correspondence, we would like to briefly outline a practical perspective about a possible integrative and effective management in spa settings of COVID-19 long-term sequelae, with a keen focus on post-infective lung damage and fibrosis, which is expected to become epidemiologically relevant in the general population. In order to outline a standard/baseline model of care, we think that it can be useful to refer to already existing rehabilitative plans with a long-standing tradition in Italy, such as those ones prescribed for work-related respiratory diseases like pneumoconiosis, in which long-term outcomes share some clinical characteristics with post-infective lung fibrosis. Such programs include diagnostic procedures (spirometry, ECG, blood tests) and treatments like respiratory physio-kinesiotherapy and postural drainage of the lungs; mechanical pulmonary ventilation for rehabilitative purposes, with or without drugs, along with standard medical and, when required, oxygen therapy; inhalation therapies with mineral waters; physical activity and psychological support. In conclusion, we believe that spa facilities can be a proper setting for respiratory rehabilitation and that already existing programs employed in occupational medicine can be a good starting point to plan rehabilitative strategies for post-COVID-19 patients. In particular, health spa centers can be useful not only to offer tailored programs of physical rehabilitation but also to provide patients with a psychologically supportive and healthpromoting environment. Further studies on the topic are advised to properly assess and quantify with adequate outcome measurements the beneficial effect of a spa-based rehabilitative program in post-COVID-19 patients. Keywords Medical hydrology . COVID-19 . SARS-CoV-2 . Spa centers . Rehabilitation . Public health
Dear Editor, We have read with pleasure the letter recently written by Prof. Masiero et al. about rehabilitative programs in health spa (“salus per aquam”) centers for post-COVID-19 patients (Masiero et al. 2020). In line with what already affirmed by the authors in their correspondence, we believe that spa facilities can have interesting characteristics which enable them to meet specific health-related needs of rehabilitative patients, including those ones with pulmonary sequelae or other longterm consequences of SARS-CoV-2 infection (Spagnolo et al.
* Michele Antonelli [email protected] 1
Terme di Monticelli, via Basse 5, 43022 Monticelli Terme, Parma, Italy
2
Institute of Public Health, University of Parma, Parma, Italy
3
USCA (Medical Special Units for the management of COVID-19 patients), AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
2020). In particular, health spa centers can be useful not only to offer tailored prog
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