Italian suggestions for pulmonary rehabilitation in COVID-19 patients recovering from acute respiratory failure: results of a Delphi process

Michele Vitacca, Marta Lazzeri, Enrico Guffanti, Pamela Frigerio, Francesco D'Abrosca, Silvia Gianola, Mauro Carone, Mara Paneroni, Piero Ceriana, Franco Pasqua, Paolo Banfi, Francesco Gigliotti, Carla Simonelli, Serena Cirio, Veronica Rossi, Chiara G Beccaluva, Mariangela Retucci, Martina Santambrogio, Andrea Lanza, Francesca GalloAlessia Fumagalli, Marco Mantero, Greta Castellini, Mariaconsiglia Calabrese, Giorgio Castellana, Eleonora Volpato, Marina Ciriello, Marina Garofano, Enrico Clini, Nicolino Ambrosino, On Behalf Of Aipo Associazione Italiana Pneumologi Ospedalieri Arir Associazione Riabilitatori dell'Insufficienza Respiratoria Sip Società Italiana di Pneumologia Aifi Associazione Italiana Fisioterapisti And Sifir Società Italiana di Fisioterapia E Riabilitazione

Research output: Contribution to journalArticlepeer-review


There is a need of consensus about the pulmonary rehabilitation (PR) in patients with COVID-19 after discharge from acute care. To facilitate the knowledge of the evidence and its translation into practice, we developed suggestions based on experts' opinion. A steering committee identified areas and questions sent to experts. Other international experts participated to a RAND Delphi method in reaching consensus and proposing further suggestions. Strong agreement in suggestions was defined when the mean agreement was >7 (1 = no agreement and 9 = maximal agreement). Panelists response rate was >95%. Twenty-three questions from 4 areas: Personnel protection equipment, phenotypes, assessments, interventions, were identified and experts answered with 121 suggestions, 119 of which received high level of concordance. The evidence-based suggestions provide the clinicians with current evidence and clinical experts opinion. This framework can be used to facilitate clinical decision making within the context of the individual patient. Further studies will evaluate the clinical usefulness of these suggestions.

Original languageEnglish
JournalMonaldi Arch. Chest Dis.
Issue number2
Publication statusPublished - Jun 23 2020


  • Ambulatory Care
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections/complications
  • Delphi Technique
  • Exercise Test
  • Humans
  • Intensive Care Units
  • Italy
  • Nutritional Status
  • Pandemics
  • Personal Protective Equipment
  • Physical Therapy Modalities
  • Pneumonia, Viral/complications
  • Quality of Life
  • Respiratory Function Tests
  • Respiratory Insufficiency/etiology
  • Respiratory Therapy/methods
  • SARS-CoV-2
  • Stress Disorders, Post-Traumatic

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