SYSTEMATIC REVIEW article
Front. Physiol.
Sec. Exercise Physiology
Clinical efficacy of exercise in the treatment of post-COVID-19 syndrome: a systematic review and network meta-analysis
Provisionally accepted
- 1Longhua Hospital, Shanghai, China
- 2Shanghai University of Traditional Chinese Medicine Shanghai Geriatric Institute of Chinese Medicine, Shanghai, China
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Post-COVID-19 syndrome (PCS) describes a constellation of persistent or new symptoms lasting beyond the acute phase of SARS-CoV-2 infection. Emerging evidence suggests that exercise is a cost-effective and accessible intervention that may enhance pulmonary function, improve cardiopulmonary circulation, regulate emotional status, and alleviate symptoms of PCS. However, robust evidence supporting the efficacy of exercise therapy in PCS remains limited. This systematic review and meta-analysis aimed to elucidate the therapeutic potential of exercise therapy in PCS. A search of the PubMed, Embase, Web of Science, and Ovid databases up to March 25, 2025 yielded 33 randomized controlled trials (with 2,895 participants) for meta-analysis. The results showed that exercise therapy significantly improved the multi-dimensional outcomes of patients with PCS. Bayesian network meta-analysis indicated that the combination of aerobic exercise and respiratory muscle training had the best effect on lung function. Multimodal exercise significantly improved the results of the six-minute walk test, the dyspnea score, and peak oxygen uptake. Mental Health and Mental Component Summary scores improved significantly in the group that received exercise therapy (P<0.01). The results of this meta-analysis confirm that exercise can significantly improve quality of life and the emotional state of patients with PCS. They also provide evidence for a treatment strategy in patients with post-COVID-19 sequelae.
Keywords: post-COVID syndrome, Exercise Therapy, clinical trials, netword meta-analysis, PCS
Received: 02 Jul 2025; Accepted: 20 Nov 2025.
Copyright: © 2025 Ye, Du, Cui, Xu and LIU. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jie Ye, yejie1977@126.com
Xiangqian Xu, doctorxutcm@126.com
TE LIU, liute1979@shutcm.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.