First published on 4 November 2020 and updated on an ongoing basis; last updated on 6 January 2021 (changes detailed below); all the reviews in this Special Collection are free to access.

This Special Collection is one of a series of collections on COVID-19. It was originally published in English and is also available in Simplified Chinese, Farsi, French, German, Japanese, Korean, Malay, Portuguese, Russian, and Spanish.

Rehabilitation has been identified by the World Health Organization (WHO) as an essential health strategy, alongside promotion, prevention, treatment, and palliative care. For the WHO, rehabilitation is a core component of universal health coverage and a central target of the United Nations Sustainable Development Goal 3: Ensure healthy lives and promote wellbeing for all at all ages. Rehabilitation focuses on the overall functioning of the whole person, including comorbidities. Consequently, rehabilitation of individuals who have experienced COVID-19 must consider not only the consequences of the disease but also the effects of treatments applied during the acute phase. For the WHO, functioning (the target of rehabilitation) is a key indicator of health, alongside mortality and morbidity, capturing the impact of diseases and injuries on body functions, human activities and participation. Rehabilitation inherently serves to reduce disability, with broad health, social, and economic impacts.

This Special Collection is the result of collaboration within Cochrane Rehabilitation, with rigorous involvement from stakeholders: the Steering Committee of the REH-COVER (Rehabilitation COVID-19 Evidence-based Response) action and the Cochrane Rehabilitation Advisory Board. The agreed list of relevant conditions is the product of a structured prioritization process for identifying the list of conditions, and subsequently review inclusion, except post-traumatic stress disorder (PTSD), for which Cochrane Mental Health and Neuroscience was consulted.

This collaborative work identified the following conditions as relevant to the WHO rehabilitation programme:

• Acute respiratory distress syndrome (ARDS) and pulmonary restrictive syndrome

• Post-intensive care syndrome (PICS)

• Post-extubation swallowing disorders

• Multiple organ failure and shock

• PTSD, in the context of rehabilitation

This Special Collection focuses on rehabilitation interventions for each of these conditions, but it should be noted that the rehabilitation process of COVID-19 patients in practice will be performed by multi-professional teams with a strict interdisciplinary collaboration, in accordance with the individual’s needs.

Some of the reviews in this Collection have search dates older than would usually be considered for inclusion in a Special Collection. They have been included for completeness as they address the relevant questions raised by the prioritization exercise. Please also note that the included reviews summarize evidence, but this does not mean that the interventions reviewed have been shown to be effective.

This Special Collection includes systematic reviews from Cochrane Emergency and Critical Care, Cochrane Neuromuscular, Cochrane Pain, Palliative and Supportive Care and Cochrane Common Mental Disorders.

Updated 6 January 2021: added link to translation into Korean and added Cochrane Clinical Answers for Reviews 'Diaries for recovery from critical illness', 'Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation' and 'Respiratory muscle training in children and adults with neuromuscular disease'

This section includes reviews related to rehabilitation of ARDS, the most important known condition linked to severe COVID-19. It also includes pulmonary restrictive syndrome due to parenchymal fibrosis.

Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation

Cough augmentation techniques, such as lung volume recruitment or manually and mechanically assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short‐ and long‐term outcomes for people with acute respiratory failure. This review aims to determine extubation success using cough augmentation techniques compared to no cough augmentation for critically‐ill adults and children with acute respiratory failure admitted to a high‐intensity care setting capable of managing mechanically‐ventilated people (such as an intensive care unit, specialized weaning centre, respiratory intermediate care unit, or high‐dependency unit). Associated Cochrane Clinical Answer: For critically ill people, do cough augmentation techniques help extubation or weaning from mechanical ventilation?

Respiratory muscle training in children and adults with neuromuscular disease

Physical disability in neuromuscular diseases can be due to progressive loss of strength in limb muscles, and for some people, there may also be respiratory muscle weakness. Respiratory muscle training (RMT) might be expected to improve respiratory muscle weakness, but its effects are still uncertain. This review assesses the effects of RMT for neuromuscular disease in adults and children, in comparison to sham training, no training, standard treatment, breathing exercises, or other intensities or types of RMT. Associated Cochrane Clinical Answer: For people with neuromuscular disease, what are the effects of respiratory muscle training?

Interventions for preventing critical illness polyneuropathy and critical illness myopathy

Critical illness polyneuropathy or myopathy (CIP/CIM) is a frequent complication in the intensive care unit (ICU) and can be associated with prolonged mechanical ventilation, longer ICU stay and increased mortality. This review aims to systematically review the evidence from RCTs concerning the ability of any intervention to reduce the incidence of CIP or CIM in critically ill individuals. Associated Cochrane Clinical Answer: What are the effects of interventions used to prevent critical illness polyneuropathy or myopathy in patients in intensive care units?

Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease

Patients with advanced progressive disease often experience muscle weakness, which can impact adversely on their ability to be independent and their quality of life. In those patients who are unable or unwilling to undertake whole‐body exercise, neuromuscular electrical stimulation (NMES) may be an alternative treatment to enhance lower limb muscle strength. Programmes of NMES appear to be acceptable to patients and have led to improvements in muscle function, exercise capacity, and quality of life. This review evaluates the effectiveness of NMES on quadriceps muscle strength in adults with advanced disease, as well as examining the safety and acceptability of NMES, and its effect on peripheral muscle function (strength or endurance), muscle mass, exercise capacity, breathlessness, and health‐related quality of life. Associated Cochrane Clinical Answer: Does neuromuscular electrical stimulation improve outcomes in adults with advanced disease who have muscle weakness?

Diaries for recovery from critical illness

During intensive care unit (ICU) admission, patients can experience extreme physical and psychological stressors, including the abnormal ICU environment. These experiences impact on a patient’s recovery from critical illness and their longer term mental and physical health. One strategy that has been developed and implemented by clinical staff to treat the psychological distress prevalent in ICU survivors is the use of patient diaries, which provide a background to the cause of the patient’s ICU admission and an ongoing narrative outlining day‐to‐day activities. This review assesses the effect of a diary versus no diary on patients, and their caregivers or families, during the patient’s recovery from admission to an ICU. Associated Cochrane Clinical Answer: For people recovering from admission to an intensive care unit (ICU), what are the benefits of patient diaries?

Present‐centered therapy (PCT) for post‐traumatic stress disorder (PTSD) in adults

PCT is a non‐trauma, manualized psychotherapy for adults with PTSD. PCT was originally designed as a treatment comparator in trials evaluating the effectiveness of trauma‐focused cognitive‐behavioral therapy (TF‐CBT). Recent trials have indicated that PCT may be an effective treatment option for PTSD and that patients may drop out of PCT at lower rates relative to TF‐CBT. This review assesses the effects of PCT for adults with PTSD. Associated Cochrane Clinical Answer: What are the effects of present‐centered therapy for adults with post‐traumatic stress disorder (PTSD)?

Internet‐based cognitive and behavioural therapies for post‐traumatic stress disorder (PTSD) in adults

Therapist‐delivered trauma‐focused psychological therapies are the accepted first‐line treatments for the disorder. However, many barriers limit treatment uptake, such as the limited number of qualified therapists to deliver the interventions, cost, and compliance issues, such as time off work, childcare, and transportation, associated with the need to attend weekly appointments. Delivering cognitive behavioural therapy (CBT) on the Internet is an effective and acceptable alternative to therapist‐delivered treatments for anxiety and depression. However, fewer Internet‐based therapies have been developed and evaluated for PTSD, and uncertainty surrounds the efficacy of Internet‐based cognitive and behavioural therapy (I‐C/BT) for PTSD. This review assesses the effects of I‐C/BT for PTSD in adults. Associated Cochrane Clinical Answer: How do internet‐based cognitive and behavioral therapies compare with usual care for adults with post‐traumatic stress disorder (PTSD)?

Therapist‐supported Internet cognitive behavioural therapy for anxiety disorders in adults

Cognitive behavioural therapy (CBT) is an evidence‐based treatment for anxiety disorders. Because many people have difficulty accessing treatment, due to a variety of obstacles, researchers have explored the possibility of using the Internet to deliver CBT. It is important to ensure the decision to promote such treatment is grounded in high quality evidence, and this review assesses the effects of therapist‐supported Internet CBT (ICBT) on remission of anxiety disorder diagnosis and reduction of anxiety symptoms in adults as compared to waiting list control, unguided CBT, or face‐to‐face CBT. Associated Cochrane Clinical Answer: What are the benefits of cognitive behavioral therapy (with a therapist's support) when delivered over the Internet?

Psychological therapies for the treatment of mental disorders in low‐ and middle‐income countries affected by humanitarian crises

People living in humanitarian settings (such as in the aftermath of a crisis triggered by natural hazards) in LMICs are exposed to stressors that make them vulnerable to developing mental disorders. Mental disorders with a higher prevalence in these settings include PTSD and major depressive, anxiety, and related disorders. This review aims to compare the effectiveness and acceptability of psychological therapies versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at treating people with mental disorders living in LMICs affected by humanitarian crises. Associated Cochrane Clinical Answers: What are the benefits and harms of psychological therapies for children in low‐ and middle‐income countries affected by humanitarian crises? and What are the benefits and harms of psychological therapies for adults in low‐ and middle‐income countries affected by humanitarian crises?