Developing Pulmonary Rehabilitation for COVID-19: Are We Linked with the Present Literature? A Lexical and Geographical Evaluation Study Based on the Graph Theory

Augusto Fusco; Luca Padua; Daniele Coraci; Claudia Loreti; Letizia Castelli; Cosimo Costantino; Antonio Frizziero; Elisabetta Serafini; Lorenzo Biscotti; Roberto Bernabei; Silvia Giovannini

doi:10.3390/jcm10245763

Developing Pulmonary Rehabilitation for COVID-19: Are We Linked with the Present Literature? A Lexical and Geographical Evaluation Study Based on the Graph Theory

J Clin Med. 2021 Dec 9;10(24):5763. doi: 10.3390/jcm10245763.

Authors

Augusto Fusco¹, Luca Padua^{1

2}, Daniele Coraci³, Claudia Loreti⁴, Letizia Castelli¹, Cosimo Costantino⁵, Antonio Frizziero⁵, Elisabetta Serafini⁴, Lorenzo Biscotti^{4

6}, Roberto Bernabei^{2

4}, Silvia Giovannini^{2

7}

Affiliations

¹ UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
² Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
³ Physical Medicine and Rehabilitation Unit, Department of Neurosciences, University of Padova, 35122 Padua, Italy.
⁴ Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
⁵ Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy.
⁶ Presiding Officer of Geriatric Care Promotion and Development Centre (C.E.P.S.A.G), Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
⁷ UOS Riabilitazione Post-Acuzie, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic is a severe ongoing global emergency. Despite high rates of asymptomatic patients, in many cases, the infection causes a rapid decline in pulmonary function due to an acute respiratory distress-like syndrome, leading to multi-organ failure and death. To date, recommendations about rehabilitation on COVID-19 are based on clinical data derived from other similar lung diseases. Rehabilitation literature lacks a standard taxonomy, limiting a proper evaluation of the most effective treatments for patients after COVID-19 infection. In this study, we assessed the clinical and rehabilitative associations and the geographical area involved in interstitial lung diseases (ILD) and in COVID-19, by a mathematical analysis based on graph theory. We performed a quantitative analysis of the literature in terms of lexical analysis and on how words are connected to each other. Despite a large difference in timeframe (throughout the last 23 years for ILD and in the last 1.5 years for COVID-19), the numbers of papers included in this study were similar. Our results show a clear discrepancy between rehabilitation proposed for COVID-19 and ILD. In ILD, the term "rehabilitation" and other related words such as "exercise" and "program" resulted in lower values of centrality and higher values of eccentricity, meaning relatively less importance of the training during the process of care in rehabilitation of patients with ILD. Conversely, "rehabilitation" was one of the most cited terms in COVID-19 literature, strongly associated with terms such as "exercise", "physical", and "program", entailing a multidimensional approach of the rehabilitation for these patients. This could also be due to the widespread studies conducted on rehabilitation on COVID-19, with Chinese and Italian researchers more involved. The assessment of the terms used for the description of the rehabilitation may help to program shared rehabilitation knowledge and avoid literature misunderstandings.

Keywords: COVID-19; SARS-CoV-2; graph theory; interstitial lung disease; personalized medicine; rehabilitation.

Publication types

Review