Importance for Our Field of the Newly Published Cochrane Special Collection on "Coronavirus (COVID-19): Evidence Relevant to Clinical Rehabilitation".

Abstract

To the Editor: Cochrane Rehabilitation is proud to announce that the Cochrane Library has published on October 21 a new special collection from its series on COVID-19 (https://www.cochrane.org/coronavirus-covid-19-resources/special-collections) titled “Coronavirus (COVID-19): evidence relevant to clinical rehabilitation” (https://rehabilitation.cochrane.org/special-collection-rehabilitation-covid19). This series is highly relevant for the rehabilitation community, because it exposes our field to the wide generalist readership of the Cochrane Library and, in doing so, is highlighting rehabilitation’s importance to COVID-19 management. Cochrane is the main international body collecting the best evidence in all fields of medicine, and the methodological quality of the Cochrane systematic reviews (CSRs) is considered the criterion standard.1 The scientific importance of the Cochrane Library is shown by its growing bibliometric data with an impact factor of 7.890, with 67.763 total citations in 2019. The COVID-19 special collections received 385,389 visits in 8 mos, constantly growing from March to August 2020. Ten months after the COVID-19 pandemic outbreak, it seems clear that the hospitalization period constitutes only a part of the story. Since the start, the World Health Organization underlined rehabilitation’s primary role in the COVID-19 emergency’s health management, which involves focusing on the overall functioning of the whole person and considering other potential consequences beside the ones strictly linked to the disease (https://www.who.int/publications-detail-redirect/clinical-management-of-covid-19; https://iris.paho.org/handle/10665.2/52035). In April 2020, Cochrane Rehabilitation started the REH-COVER (Rehabilitation–COVID-19 Evidence-based Response) action (https://rehabilitation.cochrane.org/resources/cochrane-rehabilitation-versus-covid-19), which has produced to date two editions of a rapid systematic review2,3 on the current available evidence (https://rehabilitation.cochrane.org/covid-19/reh-cover-rapid-living-systematic-reviews), with a regular monthly update, and an interactive living evidence mapping platform (https://rehabilitation.cochrane.org/covid-19/reh-cover-interactive-living-evidence). This work has also been supported by an international multiprofessional steering committee (https://rehabilitation.cochrane.org/resources/reh-cover-action/international-multiprofessional-steering-committee). The collaboration with the World Health Organization Rehabilitation Program has allowed us to define specific research questions for COVID-19 and rehabilitation (https://rehabilitation.cochrane.org/covid-19/priorities-research-defined-collaboration-who-rehabilitation-programme) and to identify some disorders that are relevant to the possible sequelae of COVID-19 and its acute management protocols. These include the following: acute respiratory distress syndrome and pulmonary restrictive syndrome, postintensive care syndrome, postextubation swallowing disorders, multiple organ failure and shock, and posttraumatic stress disorder in the context of rehabilitation. These disorders served as the basis for the production of the special collection, which focused on the evidence “relevant” to both COVID-19 and rehabilitation and not on the evidence coming from specific studies on COVID-19 sequelae. The production of the special collection followed a specific (and innovative) methodology (https://rehabilitation.cochrane.org/special-collection-rehabilitation-covid19) to identify all the listed disorders with the exclusion of posttraumatic stress disorder, which was managed by the Cochrane Mental Health and Neurosciences Network (https://mhn.cochrane.org/), with the final choice of CSRs performed in consultation. A systematic search of all CSRs on the identified topics was carried out, retrieving 25 CSRs dealing with acute respiratory distress syndrome and pulmonary restrictive syndrome and 14 dealing with postintensive care syndrome. We found no reviews about rehabilitation on postextubation swallowing disorders and multiple organ failure and shock. These areas are now prioritized by Cochrane. To produce the final list of the seven CSRs that were added to the four CSRs on posttraumatic stress disorder, we structured a prioritization process involving all of our stakeholders from the Cochrane Rehabilitation Advisory Board (https://rehabilitation.cochrane.org/about-and-contacts/advisory-board), the Executive Committee (https://rehabilitation.cochrane.org/about-and-contacts/executive-committee), and the REH-COVER Steering Committee. The final collection now includes 11 CSRs and a further 5 CSRs that have been prioritized for future production. The World Health Organization’s “Rehabilitation 2030: A Call for Action” initiative pushes for an increased awareness of the growing importance of rehabilitation in provision of care (https://www.who.int/rehabilitation/rehab-2030/en/). The COVID-19 pandemic as well as programs such as the Cochrane Rehabilitation REH-COVER action may offer a unique opportunity toward achieving this goal. This special collection also shows that Cochrane recognizes these needs. Stefano Negrini, MD Department of Biomedical Surgical and Dental Sciences University “La Statale” Milan, Italy Laboratory of Evidence-Based Rehabilitation IRCCS Istituto Ortopedico Galeazzi Milan, ItalyChiara Arienti, PhD IRCCS Fondazione Don Carlo Gnocchi Milan, ItalyValerio Iannicelli, PT IRCCS Istituto Ortopedico Galeazzi Milan, ItalyStefano Giuseppe Lazzarini, PTMichele Patrini, MD IRCCS Fondazione Don Carlo Gnocchi Milan, ItalyCarlotte Kiekens, MD Spinal Unit Montecatone Rehabilitation Institute Imola, Italy