IMR Press / FBL / Volume 26 / Issue 7 / DOI: 10.52586/4938
Open Access Review
Key toolkits of non-pharmacological management in COPD: during and beyond COVID-19
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1 Department of Respiratory Care, Prince Sultan Military College of Health Sciences, 34313 Dammam, Saudi Arabia
2 UCL Respiratory, University College London, WC1E 6BT London, UK
3 National Heart and Lung Initiation, Imperial College London, SW7 2BX London, UK
4 Faculty of Applied Medical Sciences, Umm Al-Qura University, 21961 Makkah, Saudi Arabia
5 Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, 45142 Jazan, Saudi Arabia
6 Department of Respiratory Therapy, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
7 Institute for Liver and Digestive Health, Division of Medicine, University College London, NW3 2PF London, UK
*Correspondence: (Jaber S. Alqahtani)
Front. Biosci. (Landmark Ed) 2021, 26(7), 246–252;
Submitted: 29 April 2021 | Revised: 18 May 2021 | Accepted: 26 May 2021 | Published: 30 July 2021
Copyright: © 2021 The Author(s). Published by BRI.
This is an open access article under the CC BY 4.0 license (

Individuals with COPD are at higher risk of severe disease and mortality if they contract COVID-19. Shielding and social distancing have negatively impacted the delivery of routine care for COPD patients, which should be maintained to avoid further deterioration. We aimed to review the literature about the key toolkits of non-pharmacological treatments of COPD patients before and during the COVID-19 pandemic. In particular, we focused on smoking cessation, pulmonary rehabilitation, and telehealth delivery approaches during the COVID-19 crisis. Smoking cessation services are important to mitigate the spread of the virus, especially in people with chronic lung disease; the pandemic, in one way or another, has helped to enhance people’s motivation to quit smoking. Also, tele-rehabilitation is considered as effective as conventional pulmonary rehabilitation in controlling symptoms of disease, promoting physical activity, and enhancing self-management of COPD. Tele-rehabilitation offers flexibility and it could be the dominant mode for providing a pulmonary rehabilitation programme. Finally, the use of telehealth (TH) modes has trended during the pandemic. Consensus about the effectiveness of TH in reducing exacerbation events is still inconclusive. In the context of COPD, further clinical research must concentrate on understanding attitudes, behaviours, and motivations towards smoking cessation. Further recommendations include gauging the feasibility of a long-term tele-rehabilitation programme in large COPD populations, designing more COPD-related mobile apps, and evaluating the feasibility of tele-rehabilitation in clinical practice.

Smoking cessation
Pulmonary rehabilitation
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