BENEFITS OF BALNEO AND MUD TREATMENT FOR LATE SEQUENCES OF COVID-19
Authors:   Department of Medical Rehabilitation and Ergotherapy, Physical Medicine and Sports, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria, Мratskova Galina 
Published: September 2023

Balneotherapy is one of the most used therapies, where natural factors are applied for treatment and prevention. It is used in various pathological conditions, with evidence of a good effect in rheumatic and neurological diseases, and in recent years also in patients recovering from COVID-19. The therapeutic factors that are used include: natural mineral or thermal waters, natural peloids (mud) and other environmental therapeutic factors. The pandemic of COVID-19 turned out to be a significant factor that led to changes in lifestyle and habits and, accordingly, the use of balneotherapy procedures for prevention and treatment. Balneotherapy (SPA-therapy) is recommended by the European SPA association after COVID-19, for better recovery of health and limitation of long-term symptoms in patients with post-COVID-19 syndrome (PCS). It is suggested that balneo-climate-treatment can improve lung function, increase the physical activity capacity and the performance of therapeutic exercises as well as the quality of life of patients in the recovery phase after COVID-19. The purpose of the present review is to investigate the benefits and effectiveness of both balneo and mud therapy in patients with long-term post-COVID-19 sequelae. Materials and methods: For the purpose of the present study, a review was made of the known scientific articles published in the world databases (Google Scholar, Pubmed, Science Direct Web of Science, Scopus, and literary sources in Cyrillic). The results were searched for the following keywords: post-COVID-19 condition, long-term effects of COVID-19, post-COVID-19 syndrome (PCS), rehabilitation, balneotherapy, SPA therapy, peloidotherapy, mud treatment, lye therapy, treatment with Rapa (highly concentrated solution of salts (most often NaCl)). Results: The review of the scientific literature published in specific medical journals found evidence for the therapeutic effectiveness and benefits of balneo and mud therapy in patients with long-term consequences of COVID-19. The described application methods are characterized by variety in the application methodology, both for external (baths, bathtubs, showers, therapeutic SPA applications) and for internal application (mainly through inhalations). On the other hand, different recommendations were found regarding the type and chemical characteristics of mineral (thermal) water and therapeutic mud that are preferred for therapy. Overwhelmingly, studies recommend combining balneo (SPA) and mud therapy with resort and climate treatment, moderate physical activity and a dietary regimen tailored to the individual characteristics of patients. Conclusion: Balneo (SPA) treatment, therapies with natural and preformed physical factors could have a preventive role, in order to improve the body’s reactivity to the adverse factors of the external environment and pathogenic microorganisms and to increase insusceptibility to infectious diseases.