Perfil epidemiológico de óbitos decorrentes da Covid-19 em um município do sudoeste do Paraná / Epidemiological profile of death resulting from Covid-19 in a municipality in southwest of Paraná / Perfil epidemiológico de las muertes por Covid-19 en un municipio del suroeste de Paraná

Introdução: No final do ano de 2019 surgiu na China uma doença infectocontagiosa de característica respiratória e alto grau de disseminação até então desconhecida. No Brasil o primeiro caso de Covid-19 foi confirmado no final de fevereiro de 2020 e a primeira morte em meados de março. Segundo dados da plataforma Coronavírus Brasil, em 17 de março de 2021, houve registro de 11.603.535 casos confirmados e 282.127 óbitos. Objetivo: Descrever o perfil de pessoas que morreram tendo como causa básica do óbito a Covid-19, em um município do Sudoeste do Paraná, entre os anos de 2020 e 2021. Metodologia: Trata-se de um estudo transversal, descritivo, documental de caráter quantitativo que foi realizado na prefeitura municipal de Francisco Beltrão. Resultados: Houve prevalência de óbitos em pacientes do sexo masculino, idosos, com presença de alguma comorbidade associada, sendo hipertensão a mais citada (50,8%). Os sintomas mais prevalentes foram tosse (74,4%), dispneia (56,3%) e saturação < 95% (48,3%), necessitando ainda de hospitalização em algum período da doença (94,1%), sendo os leitos de Sistema Único de Saúde os mais procurados (74,4%). Quanto à taxa de ocupação 49,6% dos casos necessitou apenas de leitos de enfermaria e 42% unidades de terapia intensiva. Discussão: Diversas pesquisas apontam que o sexo masculino é o mais acometido por condições graves de saúde, devido à demora na busca de assistência médica. No que se refere à idade, neste estudo, a prevalência de óbitos se deu entre 71 e 75 anos (15,1%) o que justifica que o envelhecimento é um fator de risco elevado para complicações da doença. Durante a análise dos dados, notou- se que grande parte dos pacientes que tiveram como desfecho o óbito, possuíam algum fator associado, dentre os mais citados, verificou-se a Hipertensão Arterial Sistêmica (50,8%) Diabetes Mellitus (24,8%), doenças cardiovasculares (23,9%) e obesidade (14,7%). No que diz respeito à hospitalização, nesse estudo notou-se que 74,4% da amostra foram hospitalizadas em leitos de SUS, 18,5% em hospitais particulares e 7,1% não possuíam essa informação. Conclusão: É possível observar a importância do estudo epidemiológico para identificar o perfil da população em risco, podendo auxiliar no planejamento do atendimento, rastreamento e controle da doença, além de conhecer a evolução da patologia, a fim de buscar ações adequadas para seu enfrentamento.

Introduction: At the end of 2019, a previously unknown infectious disease with respiratory characteristics and a high degree of dissemination emerged in China. In Brazil the first case of Covid-19 was confirmed in late February 2020 and the first death in mid-March. According to data from the Coronavirus Brazil platform, as of March 17, 2021, 11,603,535 confirmed cases and 282,127 deaths were recorded. Objective: To describe the profile of people who died with Covid-19 as the underlying cause of death in a city in southwestern Paraná between the years 2020 and 2021. Methodology: This is a cross-sectional, descriptive, documental, quantitative study carried out at the Francisco Beltrão City Hall. Results: There was a prevalence of deaths in male patients, elderly, with the presence of some associated comorbidity, hypertension being the most cited (50.8%). The most prevalent symptoms were cough (74.4%), dyspnea (56.3%) and saturation < 95% (48.3%), requiring hospitalization in some period of the disease (94.1%), and the Unified Health System beds were the most sought (74.4%). As for the occupancy rate, 49.6% of the cases required only ward beds and 42% intensive care units. Discussion: Several studies show that men are the most affected by serious health conditions, due to the delay in seeking medical assistance. Regarding age, in this study, the prevalence of deaths was between 71 and 75 years (15.1%), which justifies that aging is a high risk factor for disease complications. During data analysis, it was noted that most patients who died had some associated factor, among the most cited were systemic arterial hypertension (50.8%), diabetes mellitus (24.8%), cardiovascular diseases (23.9%) and obesity (14.7%). Regarding hospitalization, in this study it was noted that 74.4% of the sample were hospitalized in SUS beds, 18.5% in private hospitals, and 7.1% did not have this information. Conclusion: It is possible to observe the importance of the epidemiological study to identify the profile of the population at risk, which can help in planning care, tracking and control of the disease, besides knowing the evolution of the pathology in order to seek appropriate actions for its confrontation

Introducción: A finales del año 2019 apareció en China una enfermedad infecto- contagiosa de característica respiratoria y alto grado de diseminación desconocida hasta entonces. En Brasil se confirmó el primer caso de Covid-19 a finales de febrero de 2020 y la primera muerte a mediados de marzo. Según los datos de la plataforma Coronavirus Brasil, hasta el 17 de marzo de 2021, había 11.603.535 casos confirmados y 282.127 muertes. Objetivo: Describir el perfil de las personas fallecidas con Covid-19 como causa subyacente de muerte en una ciudad del sudoeste de Paraná entre los años 2020 y 2021. Metodología: Se trata de un estudio transversal, descriptivo, documental de carácter cuantitativo que se realizó en la prefectura municipal de Francisco Beltrão. Resultados: Hubo una prevalencia de muertes en pacientes masculinos, de edad avanzada, con presencia de alguna comorbilidad asociada, siendo la hipertensión la más citada (50,8%). Los síntomas más prevalentes fueron la tos (74,4%), la disnea (56,3%) y la saturación < 95% (48,3%), requiriendo hospitalización en algún periodo de la enfermedad (94,1%), siendo las camas del Sistema Único de Salud las más solicitadas (74,4%). En cuanto a la tasa de ocupación, el 49,6% de los casos sólo necesitaban camas de sala y el 42% unidades de cuidados intensivos. Discusión: Varias investigaciones señalan que el género masculino es el más afectado por las condiciones de salud graves, debido al retraso en la búsqueda de asistencia médica. En cuanto a la edad, en este estudio, la prevalencia de muertes se produjo entre los 71 y los 75 años (15,1%), lo que justifica que el envejecimiento sea un factor de riesgo elevado para las complicaciones de la enfermedad. Durante el análisis de los datos, se observó que la mayoría de los pacientes que fallecieron tenían algún factor asociado, entre los más citados estaban la Hipertensión Arterial Sistémica (50,8%), la Diabetes Mellitus (24,8%), las enfermedades cardiovasculares (23,9%) y la obesidad (14,7%). En lo que respecta a la hospitalización, en este estudio se observó que el 74,4% de la muestra estaba hospitalizada en camas del SUS, el 18,5% en hospitales privados y el 7,1% no tenía esta información. Conclusión: Es posible observar la importancia del estudio epidemiológico para identificar el perfil de la población en riesgo, pudiendo ayudar en la planificación de la atención, el rastreo y el control de la enfermedad, además de conocer la evolución de la patología, con el fin de buscar las acciones adecuadas para su enfrentamiento.

Bronchodilator Response as a Possible Predictor of Lung Function Improvement After Pulmonary Rehabilitation in Post-COVID-19 Patients

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Fisioterapia respiratoria en pacientes post Covid-19 / Respiratory physiotherapy in post Covid-19 patients

La pandemia de Covid-19 ha modificado pautas en la práctica clínica de especialidades como la Medicina Física y Rehabilitación. Se realizó esta comunicación con el objetivo de abordar las principales técnicas de fisioterapia respiratoria en convalecientes de Covid-19 y la evidencia generada de sus resultados(AU)

The Covid-19 pandemic has modified guidelines in the clinical practice of specialties such as Physical Medicine and Rehabilitation. This communication was carried out with the aim of addressing the main respiratory physiotherapy techniques in convalescents from Covid-19 and theevidence generated from their results(EU)

Modelo temporal del comportamiento de pacientes críticos con covid-19 durante su estadía en cuidados intensivos. Lombardía, Italia / Temporal model of the behavior of critically ill patients with COVID-19 during their staying in intensive care. Lombardy, Italy

RESUMEN Introducción: una serie temporal es el producto de la observación de una variable en el tiempo. Es una herramienta matemática que se aplica con frecuencia en la salud. No se han elaborado modelos temporales que predigan el comportamiento de los pacientes durante su ingreso en la Unidad de Cuidados Intensivos. Objetivos: crear una serie temporal que permita predecir el comportamiento, durante su ingreso en la Unidad de Cuidados Intensivos, de pacientes graves producto de la covid-19 en la región de Lombardía, Italia. Materiales y métodos: analítico, longitudinal prospectivo con un grupo de pacientes críticos que ingresaron del 1 de abril al 1 de mayo de 2020, con diagnóstico de covid-19, en el Hospital Mayor de Crema, en la región de Lombardía, Italia. El universo estuvo constituido por 28 pacientes y se trabajó con el total de ellos. Resultados: composición por sexo: 48 % masculino. Media de edad: 83 años. Serie temporal: Modelo 1 que ajusta (Hold) PO2/FiO2 p = 0,251; Modelo 2 (ARIMA) SatO2/FiO2 p = 0,674 (en los dos primeros modelos el resultado se incrementó con los días, siguiendo un comportamiento predecible); Modelo 3 (ARIMA) p = 0,406 (en este caso, el resultado esperado decreció a medida que transcurrió el tiempo). Las funciones obtenidas permiten calcular el valor esperado según el día desde el ingreso. Conclusiones: predecir la evolución del paciente en la Unidad de Cuidados Intensivos permitió detectar tempranamente aquellos con una curva inesperada y dirigir hacia a ellos las terapéuticas más agresivas (AU).

ABSTRACT Introduction: a time series is the product of the observation of a variable in time. It is a mathematical tool frequently applied in health. No temporal models have been developed to predict patients' behavior during their staying in the Intensive Care Unit. Objectives: to create a time series allowing to predict the behavior of seriously-ill patients due to COVID-19, during their staying in the Intensive Care Unit in the region of Lombardy, Italy. Materials and methods: analytic, longitudinal prospective study with a group of critical patients who were admitted from April 1st to May 1st, with COVID-19 diagnosis, to Ospedale Maggiore di Crema, in the Lombardy region, Italy. The universe was formed by 28 patients and all of them were worked on. Results: 48% of patients were male. Average age: 83 years; Time series: Model 1 holding PO2/FiO2 p = 0.251; Model 2 (ARIMA) SatO2/FiO2 p = 0.674 (in the two first models the result increased with the days, following a predictable behavior=; Model 3 (ARIMA) p = 0.406 (in this case the expected result decreased as time passed). The obtained functions allow to calculate the expected value according to the day from the admission. Conclusions: predicting patient's evolution in the Intensive Care Unit allowed early detecting those with unexpected curves and targeting more aggressive therapies toward them (AU).

Rehabilitation for COVID-19: WHO launches free online course

A new training devoted to the rehabilitation of COVID-19 patients is available for free on OpenWHO.org as part of the Clinical Management of Patients with COVID-19 course series.

Comportamiento de la covid-19 en Matanzas, a cien días de la pandemia en Cuba / COVID-19 behavior in Matanzas at 100 days of pandemic in Cuba

RESUMEN Introducción: la pandemia cambió el mundo y también el comportamiento de la provincia de Matanzas en los primeros cien días desde que apareció el primer caso en Cuba. Objetivo: caracterizar los factores sociodemográficos y clínico-epidemiológicos de los 207 pacientes confirmados con covid-19 en la provincia de Matanzas. Materiales y métodos: es una investigación descriptiva, longitudinal. Se estudió el comportamiento de los 207 pacientes positivos por covid-19 en la provincia de Matanzas. Los datos se tomaron a partir del 11 de marzo de 2020, fecha en que aparecen los primeros casos en Cuba, hasta el 18 de junio, en que se cumplieron cien días de la pandemia. Se analizaron factores sociodemográficos, como edad, sexo y lugar de convivencia, y factores clínico-epidemiológicos, como comorbilidades y fuente de infestación de los pacientes positivos. Resultados: predominaron los casos activos en los municipios Matanzas y Cárdenas, con dominio del sexo femenino y de las edades entre 40 y 59 años. La forma más frecuente de contagio fue la interna, y predominó el número de pacientes recuperados. Las comorbilidades de mayor incidencia en las muertes de pacientes de covid fueron la hipertensión arterial y la diabetes mellitus. Conclusiones: durante los primeros cien días de la pandemia en Cuba, el comportamiento varió en la provincia de Matanzas, motivado por los eventos de transmisión local abiertos en el territorio (AU).

ABSTRACT Introduction: the pandemic changed the world and also behavior in the province of Matanzas at 100 days from the first case in Cuba. Objective: to characterize socio-demographic and clinical-epidemiological factors of the 207 COVID-19-confirmed patients in the province of Matanzas. Materials and methods: this is a longitudinal, descriptive research where the behavior of the 207 COVID-19-positive patients found in the province of Matanzas was studied. Data were collected beginning from March 11, 2020, when the first cases ocurred in Cuba and until June 18, when it turned 100 days with the presence of cases infected with COVID-19. The authors analyzed socio-demographic factors, such as age, sex, living place, and clinical-epidemiological factors such as positive-patients comorbidities and infection source. Results: active cases predominated in the municipalities of Matanzas and Cardenas, with predominance of females and 40-59 years ages; the most frequent infection form was the internal one; recovered patients predominated, and as death causes prevailed several comorbidities such as arterial hypertension and diabetes mellitus. Conclusions: during the first 100 days of epidemic in Cuba, the behavior varied in the province due to the local transmission events opened in the territory (AU).

Acompañamiento emocional en adultos mayores ante la covid-19: una necesidad impostergable / Emotional support in elder people toward COVID-19: an urgent need

RESUMEN Los adultos mayores representan un grupo de importante vulnerabilidad ante la enfermedad, asociada muchas veces a pronósticos desfavorables. El presente trabajo tiene como objetivo fundamentar las posiciones teóricas que sustentan la importancia del acompañamiento emocional en adultos mayores ante la covid-19. Durante el proceso de investigación se buscaron los antecedentes históricos e investigativos sobre el tema, y se abordaron los principales preceptos relacionados con el mismo, así como estudios que demuestran su importancia. Se proponen herramientas teóricas para el apoyo social, que ofrecen la posibilidad de que los adultos mayores minimicen la presencia de estados emocionales negativos que se vivencian ante el virus SARS-CoV-2 en Cuba (AU).

ABSTRACT Elder people represent a group of significant vulnerability to the disease, often associated to unfavorable prognoses. The aim of the current work is substantiating the theoretical positions underpinning the importance of the emotional support in elder people toward COVID-19. The historical and research antecedents of the theme were looked for during the research and the main related precepts were approached, and also studies showing its importance. Theoretical tools for the social support are proposed; they offer the possibility for elder people to minimize the presence of negative emotional conditions that are experienced in Cuba with COVID-19 (AU).

Hospital physical therapy management in pediatric patients with covid-19: case reports / Manejo da fisioterapia no âmbito hospitalar no paciente pediátrico com covid-19: relato de casos

ABSTRACT Objective: To report the physiotherapeutic management of two pediatric cases with COVID-19 admitted in a reference state hospital to treat the disease in Porto Alegre, Southern Brazil. Cases description: Case 1, female, 10-month-old child, pre-existing chronic disease, hospitalized since birth, mechanical ventilation dependency via tracheotomy, progressed with hypoxemia, requiring oxygen therapy, and increased ventilator parameters, and a diagnosis of COVID-19 was confirmed. Airway clearance and pulmonary expansion maintenance therapies were performed. During hospitalization, the child acquired cephalic control, sitting without support, rolling, holding, and reaching objects. Recommendations were provided to a family member to maintain motor development milestones. Case 2, male, nine years old, previous psychiatric disease and obesity, showed worsening of the sensory state, requiring intensive care and invasive mechanical ventilation, with the diagnosis of SARS-Cov-2 infection. The physical therapy was performed to maintain airway clearance, pulmonary expansion, and early mobilization, showing ventilatory improvement during the intensive care hospitalization and successfully extubated after 17 days. The physical therapy evolved from passive to resistive exercises during the hospitalization, and the patient was able to walk without assistance at discharge, with the same previous functional status. Comments: The COVID-19 showed different manifestations in both cases. Physical therapy treatment was essential to maintain and to recover the functional status of the patients. Future studies are needed to improve the understanding of disease course and its functional consequences to offer an efficient treatment to pediatric patients with COVID-19.

RESUMO Objetivo: Relatar as condutas fisioterapêuticas dos dois casos de pacientes pediátricos com COVID-19 internados em hospital de referência estadual em Porto Alegre para tratamento da doença. Descrição dos casos: Caso 1, sexo feminino, 10 meses de idade com doença crônica preexistente, internada desde o nascimento, utilizava ventilação mecânica via traqueostomia, evoluiu com hipoxemia, necessidade de oxigenoterapia e aumento dos parâmetros ventilatórios, sendo confirmada COVID-19. Foram realizadas técnicas de desobstrução brônquica e manutenção da expansão pulmonar. Além disso, a criança durante a internação adquiriu controle cefálico, sedestação sem apoio, rolar e alcance de objetos e durante infecção por coronavírus foram passadas orientações ao familiar para manutenção dos marcos motores adquiridos. Caso 2, sexo masculino, 9 anos, com doença psiquiátrica prévia e obesidade, evoluiu com quadro de rebaixamento do sensório e necessidade de tratamento intensivo, sendo o paciente colocado em ventilação mecânica invasiva na chegada à unidade e confirmada a infecção por SARS-CoV-2. Realizou fisioterapia para desobstrução brônquica, reexpansão pulmonar e mobilização precoce, apresentando melhora ventilatória ao longo da internação, e após 17 dias foi extubado com sucesso. Evoluiu de cinesioterapia passiva para assistida e resistida na internação pediátrica, conseguindo deambular sem auxílio, e teve alta hospitalar com condição funcional prévia à internação hospitalar. Comentários: A COVID-19 apresentou-se de forma distinta nos casos, todavia a fisioterapia foi essencial para a manutenção e recuperação do quadro funcional dos pacientes. Estudos futuros são necessários para melhor compreensão do curso da doença e suas repercussões funcionais, a fim de traçar um tratamento eficiente para os pacientes pediátricos acometidos pela COVID-19.

Luchando contra la COVID-19: labor asistencial de los médicos rehabilitadores españoles. Estudio transversal / Fighting against COVID-19: clinical activities of spanish rehabilitation physicians: a cross-sectional study

OBJETIVO: El objetivo de este estudio es analizar el impacto y la organización tanto asistencial como docente en los Servicios de Medicina Física y Rehabilitación de España ante el nuevo y cambiante escenario debido a la pandemia por la COVID-19. MÉTODOS: Se realiza una encuesta dirigida a los tutores de los Servicios de Rehabilitación. Un total de 31 preguntas divididas en 6 apartados: información general de los Servicios, adaptación del Servicio durante el periodo COVID, labor asistencial de los médicos rehabilitadores, abordaje rehabilitador de pacientes COVID, consecuencia de la pandemia sobre la salud de los rehabilitadores y labores de tutoría durante ese periodo. RESULTADOS: Se recibieron un total de 54 encuestas. Casi la mitad de los Servicios cancelaron todas las consultas presenciales (40%) y las salas de terapias se destinaron a camas de pacientes COVID (48%). En 30 hospitales (55,6%) los facultativos han trabajado en plantas COVID. La gran mayoría de los Servicios han elaborado material gráfico y audiovisual con ejercicios, así como protocolos de derivación y tratamiento rehabilitador de pacientes COVID ingresados. Casi la mitad de los Servicios encuestados han tenido algún caso de ansiedad en el personal médico. Las labores de tutoría se han anulado (40,7%) o disminuido (35,2%). CONCLUSIONES: La organización de los Servicios de Rehabilitación para hacer frente a la pandemia ha sido similar en todo el territorio español. La respuesta de los Servicios a la crisis sanitaria ha visualizado la versatilidad de trabajo de los médicos rehabilitadores

OBJECTIVE: The aim of this study was to analyse both the impact of the pandemic and clinical and teaching organisation in Spanish Physical Medicine and Rehabilitation Departments during the COVID-19 pandemic. METHODS: A survey was conducted of the tutors of rehabilitation departments. The questionnaire contained 31 questions divided into 6 parts about the following: general information on the department, adaptation of rehabilitation departments to the COVID pandemic, clinical work of rehabilitation physicians, the approach to rehabilitation in COVID patients, and the effects of the pandemic on the health and teaching activity of rehabilitation physicians during this period. RESULTS: A total of 54 responses were obtained. Almost half of the departments cancelled face-to-face medical consultations (40%) and 48% of the treatment rooms were turned into COVID beds. In 30 hospitals (55.6%), the physicians worked in COVID units. Most of the rehabilitation departments developed both graphic and audiovisual material with exercises, referral protocols and guidelines for the rehabilitation management and treatment of COVID 19 patients. Half of the departments reported some anxiety symptoms in medical staff. Tutorial work has been cancelled (40.7%) or reduced (35.2%). CONCLUSIONS: The organisation of Spanish rehabilitation departments in response to the COVID pandemic has been very similar throughout the country. The response of these departments to the healthcare crisis has revealed the versatility of rehabilitation physicians

Crisis de la enfermedad por coronavirus 2019. El reto para dar el paso definitivo a la telerrehabilitación / Coronavirus disease 2019 crisis. The challenge to take the final step to telerehabilitation

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COVID-19 y cronicidad. Una oportunidad de reinventar los servicios de Medicina Física y Rehabilitación / COVID-19 and chronic diseases. An opportunity to reinvent the services of Physical Medicine and Rehabilitation

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Rehabilitación respiratoria en pacientes con COVID-19 / Respiratory rehabilitation in patients with COVID-19

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Rehabilitación en época de confinamiento / Rehabilitation during the lockdown

El sistema sanitario se encuentra ante una pandemia mundial en relación con la enfermedad por coronavirus 2019 (COVID-19). Los planes de preparación para emergencias a menudo no consideran cuestiones específicas de rehabilitación para pacientes hospitalizados ni para ambulatorios, aunque la Organización Mundial de la Salud aconseja incluir a profesionales de rehabilitación lo antes posible. Los planes de contingencia de los Servicios de Rehabilitación deben realizarse en coordinación con las otras áreas asistenciales. En esta revisión, se ha resumido y analizado la información disponible basada en una búsqueda cuidadosa de la literatura científica de COVID-19 y en la experiencia de un entorno concreto, para planificar la continuidad asistencial de rehabilitación para todos los pacientes y para ayudar a los equipos de rehabilitación en este periodo de confinamiento /desconfinamiento incierto

The health system is facing a global pandemic due to coronavirus disease 2019 (COVID-19). Emergency plans often fail to consider specific rehabilitation issues, whether inpatient or outpatient, although the World Health Organisation advises the inclusion of rehabilitation professionals as soon as possible. The contingency plans of rehabilitation services must be carried out in coordination with the other healthcare areas. This review was prepared with the current available evidence on COVID-19 and was based on the experience of a specific environment, to plan the continuity of rehabilitation care for all patients and to help rehabilitation teams in this period of lockdown and uncertain lifting of restrictions

Rehabilitación médica y COVID-19: impacto actual y retos futuros en los servicios de rehabilitación / Medical rehabilitation and COVID-19: current impact and future challenges in rehabilitation services

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Telemedicina en rehabilitación: necesidad y oportunidad post-COVID / Telemedicine in rehabilitation: post-COVID need and opportunity

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La atención al paciente con patología linfática y lipedema en la pandemia COVID-19. Recomendaciones del Grupo Español de Linfología (GEL) / Management of patients with lymphatic diseases and lipoedema during the COVID-19 pandemic. Recommendations of the Spanish Group of Lymphology

La pandemia de COVID-19 es un desafío para el manejo de las patologías no COVID como la enfermedad linfática y el lipedema. La telemedicina puede evitar la propagación del coronavirus. Se necesita un sistema que nos ayude a determinar la prioridad clínica y la selección de la asistencia presencial o telemática para cada paciente y la forma de realizarlas durante la pandemia. El Grupo Español de Linfología ha realizado un documento de consenso con recomendaciones basadas en la bibliografía y experiencia clínica, como guía de práctica clínica en el manejo de anomalías linfáticas y lipedema durante la pandemia de COVID-19. Estas recomendaciones deben adaptarse a las características del paciente, las condiciones locales de los centros y las decisiones de los profesionales de la salud. Es un documento de criterios mínimos, sujeto a modificaciones según evolucione la pandemia, los conocimientos científicos y las instrucciones de las autoridades sanitarias

The COVID-19 pandemic poses a challenge to the management of non-COVID pathologies such as lymphatic diseases and lipoedema. The use of telemedicine can prevent the spread of the disease. A system is needed to help determine the clinical priority and selection of face-to-face or telemedicine options for each patient and how to carry them out during the pandemic. The Spanish Lymphology Group has drafted a consensus document with recommendations based on the literature and clinical experience, as clinical practice guidelines for the management of lymphatic abnormalities and lipoedema during the COVID-19 pandemic. These recommendations must be adapted to the characteristics of each patient, the local conditions of the centres, and the decisions of health care professionals. The document contains minimum criteria, subject to modifications according to the evolution of the pandemic, scientific knowledge and instructions from health authorities

Traditional Chinese exercise for COVID-19: A protocol for systematic review and meta-analysis.

BACKGROUND: A new type of coronavirus (COVID-19), is spreading all over the world. Under the background of the comprehensive medical treatment and strict prevention and control in China, the number of discharged patients increased substantially. By the end of July, more than 80,000 patients had been cured and discharged from hospital in China. In order to effectively promote the full recovery of the patient's physical and mental functions and quality of life, gradually shift the emphasis of clinical work to convalescence therapy is very important, thus Chinese experts draw up Expert Consensus on Rehabilitation of Chinese Medicine for COVID-19. This systematic review and meta-analysis will assess studies of the effects of traditional Chinese exercise (TCE) for COVID-19 patients. METHODS AND ANALYSIS: We will search 6 English and 4 Chinese databases by 01, December 2020. After a series of screening, Randomized Clinic Trials (RCTs) will be included related to TCE for COVID-19. Two assessors will use the Cochrane bias risk assessment tool to assess the RCTs. Finally, the evidence grade of the results will be evaluated. RESULTS: This study will provide a reliable evidence for the selection of TCE therapies for COVID-19. CONCLUSION: The results of this study will provide references for the selection of TCE treatment for COVID-19, and provide decision making references for clinical research. PROSPERO REGISTRATION NUMBER: CRD42020179095.