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Arêas GPT, Goulart CDL, Sant’Anna T, Fernandes TG, Alvim RDO, Borges FFDR, do Amaral CMSSB, Rodrigues SCF, Valente J, Ferreira JMBB, Rezende AG, de Oliveira Júnior EF, de Lacerda MVG, de Almeida-Val FF. Pulmonary Rehabilitation Associated with Noninvasive Ventilation on Physical Capacity and Quality of Life in Post-COVID-19: A Randomized Controlled Double-Blinded Clinical Trial Protocol. J Multidiscip Healthc 2024; 17:1483-1490. [PMID: 38596000 PMCID: PMC11003467 DOI: 10.2147/jmdh.s438120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/29/2024] [Indexed: 04/11/2024] Open
Abstract
Background The coronavirus disease-2019 (COVID-19) pulmonary rehabilitation (PR) seems to be a better choice to improve physical and functional capacity after acute infection. However, there is a lack of evidence regarding the effects of different strategies to optimize post-acute phase rehabilitation and reduce long COVID-19 physical deteriorations. Objective To compare the use of a noninvasive ventilation (NIV) plus aerobic exercise strategy during PR program with to a standard PR (without NIV) on physical capacity and quality of life outcomes in post-COVID-19. Methods Double-blinded randomized controlled clinical trial. A total of 100 individuals discharged from hospital in a post-acute phase of severe COVID-19 will be randomized into two groups: PR + NIV (Group 1) and PR (Group 2). Inclusion criteria include participants who present symptomatic dyspnea II and III by the modified Medical Research Council, aged 18 years or older. Both groups will receive aerobic and resistance exercise, and inspiratory muscle training. However, group 1 will perform aerobic training with bilevel NIV. Cardiopulmonary exercise test will assess the O2 peak uptake, 6-minute walk test will assess the walking distance and short-form 36 will assess the quality of life before and after 8 weeks (after 24 PR sessions). Moreover, patients will be contacted by telephone every 3 months for one year to record possible adverse events, hospitalizations, and death. All data will be registered in RedCap, and analyses will be performed in the STATA v13 software. Clinical Trial Registration RBR-3t9pkzt.
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Affiliation(s)
- Guilherme Peixoto Tinoco Arêas
- Department of Physiological Sciences, Exercise Physiology Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
- Cardiopulmonary Laboratory, Getúlio Vargas University Hospital, UFAM, Manaus, AM, Brasil
| | | | - Thaís Sant’Anna
- Faculty of Physical Education and Physiotherapy, Respiratory and Cardiovascular Physiotherapy Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
| | - Tiótrefis Gomes Fernandes
- Faculty of Physical Education and Physiotherapy, Respiratory and Cardiovascular Physiotherapy Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
| | - Rafael de Oliveira Alvim
- Department of Physiological Sciences, Exercise Physiology Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
| | | | | | - Suzy Cristina França Rodrigues
- Department of Physiological Sciences, Exercise Physiology Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
| | - Jefferson Valente
- Dr Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM, Brasil
| | | | - Anna Gabriela Rezende
- Department of Physiological Sciences, Exercise Physiology Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
- Dr Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM, Brasil
| | | | - Marcus Vinícius Guimarães de Lacerda
- Dr Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM, Brasil
- Leônidas and Maria Deane Institute, Fiocruz Amazonas, Manaus, AM, Brasil
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Fernando Fonseca de Almeida-Val
- Department of Physiological Sciences, Exercise Physiology Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
- Cardiopulmonary Laboratory, Getúlio Vargas University Hospital, UFAM, Manaus, AM, Brasil
- Dr Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM, Brasil
- Faculty of Physical Education and Physiotherapy, Respiratory and Cardiovascular Physiotherapy Laboratory, Federal University of Amazonas, Manaus, AM, Brasil
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da Silva ALG, Vieira LDP, Dias LS, Prestes CV, Back GD, Goulart CDL, Arena R, Borghi-Silva A, Trimer R. Impact of long COVID on the heart rate variability at rest and during deep breathing maneuver. Sci Rep 2023; 13:22695. [PMID: 38123689 PMCID: PMC10733257 DOI: 10.1038/s41598-023-50276-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
While the majority of individuals with coronavirus disease 2019 (COVID-19) recover completely, a significant percentage experience persistent symptom, which has been characterized as Long COVID and may be associated with cardiac and autonomic dysfunction. We evaluated heart rate variability (HRV) at rest and during deep-breathing (M-RSA) in patients with Long COVID. Case-control design involved 21 patients with Long COVID and 20 controls; the HRV was evaluated (POLAR system) at rest in the supine position and during M-RSA and expressed in time domain and non-linear analysis. In the supine position we found a reduction HRV measures in Long COVID' patients compared to controls for: Mean_iRR (p < 0.001), STD_iRR (p < 0.001); STD_HR (p < 0.001); SD1 (p < 0.001); SD2 (p < 0.001); alpha2 (p < 0.001). In the M-RSA we found reduction Mean_iRR (p < 0.001), STD_iRR (p < 0.001), STD_HR (p < 0.001), rMSSD (p < 0.001), RR_tri-index (p < 0.001) in Long COVID' patients except for highest Mean_HR p < 0.001. In conclusion, Long COVID reduced HRV at rest and during deep breathing. These findings may imply impairment of cardiac autonomic control when symptoms of COVID-19 persist following initial recovery.
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Affiliation(s)
- Andréa Lúcia Gonçalves da Silva
- Department of Health Sciences, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil.
- Nucleus of Research in Surveillance, Prevention and Rehabilitation in Cardiorespiratory Diseases, Rio Grande do Sul, Brazil.
| | - Luana Dos Passos Vieira
- Scientific Initiation Scholarship at Laboratory of Cardiorespiratory Rehabilitation, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Luiza Scheffer Dias
- Scientific Initiation Scholarship at Laboratory of Cardiorespiratory Rehabilitation, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Cecília Vieira Prestes
- Scientific Initiation Scholarship at Laboratory of Cardiorespiratory Rehabilitation, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Guilherme Dionir Back
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Cassia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Renata Trimer
- Department of Health Sciences, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
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Monteiro-Alfredo T, Macedo MLR, de Picoli Souza K, Matafome P. New Therapeutic Strategies for Obesity and Its Metabolic Sequelae: Brazilian Cerrado as a Unique Biome. Int J Mol Sci 2023; 24:15588. [PMID: 37958572 PMCID: PMC10648839 DOI: 10.3390/ijms242115588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Brazil has several important biomes holding impressive fauna and flora biodiversity. Cerrado being one of the richest ones and a significant area in the search for new plant-based products, such as foods, cosmetics, and medicines. The therapeutic potential of Cerrado plants has been described by several studies associating ethnopharmacological knowledge with phytochemical compounds and therapeutic effects. Based on this wide range of options, the Brazilian population has been using these medicinal plants (MP) for centuries for the treatment of various health conditions. Among these, we highlight metabolic diseases, namely obesity and its metabolic alterations from metabolic syndrome to later stages such as type 2 diabetes (T2D). Several studies have shown that adipose tissue (AT) dysfunction leads to proinflammatory cytokine secretion and impaired free fatty acid (FFA) oxidation and oxidative status, creating the basis for insulin resistance and glucose dysmetabolism. In this scenario, the great Brazilian biodiversity and a wide variety of phytochemical compounds make it an important candidate for the identification of pharmacological strategies for the treatment of these conditions. This review aimed to analyze and summarize the current literature on plants from the Brazilian Cerrado that have therapeutic activity against obesity and its metabolic conditions, reducing inflammation and oxidative stress.
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Affiliation(s)
- Tamaeh Monteiro-Alfredo
- Coimbra Institute of Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra, 3000-075 Coimbra, Portugal
- Research Group on Biotechnology and Bioprospection Applied to Metabolism and Cancer (GEBBAM), Federal University of Grande Dourados, Dourados 79804-970, MS, Brazil;
- Laboratório de Purificação de Proteínas e Suas Funções Biológicas (LPPFB), Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil;
| | - Maria Lígia Rodrigues Macedo
- Laboratório de Purificação de Proteínas e Suas Funções Biológicas (LPPFB), Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil;
| | - Kely de Picoli Souza
- Research Group on Biotechnology and Bioprospection Applied to Metabolism and Cancer (GEBBAM), Federal University of Grande Dourados, Dourados 79804-970, MS, Brazil;
| | - Paulo Matafome
- Coimbra Institute of Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra, 3000-075 Coimbra, Portugal
- Coimbra Health School (ESTeSC), Polytechnic University of Coimbra, Rua 5 de Outubro, 3046-854 Coimbra, Portugal
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Faghy MA, Yates J, Hills AP, Jayasinghe S, da Luz Goulart C, Arena R, Laddu D, Gururaj R, Veluswamy SK, Dixit S, Ashton REM. Cardiovascular disease prevention and management in the COVID-19 era and beyond: An international perspective. Prog Cardiovasc Dis 2023; 76:102-111. [PMID: 36693488 PMCID: PMC9862672 DOI: 10.1016/j.pcad.2023.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
Despite some indicators of a localized curtailing of cardiovascular disease (CVD) prevalence, CVD remains one of the largest contributors to global morbidity and mortality. While the magnitude and impact of the coronavirus disease 2019 (COVID-19) pandemic have yet to be realized in its entirety, an unquestionable impact on global health and well-being is already clear. At a time when the global state of CVD is perilous, we provide a continental overview of prevalence data and initiatives that have positively influenced CVD outcomes. What is clear is that despite attempts to address the global burden of CVD, there remains a lack of collective thinking and approaches. Moving forward, a coordinated global infrastructure that, if developed with appropriate and relevant key stakeholders, could provide significant and longstanding benefits to public health and yield prominent and consistent policy resulting in impactful change. To achieve global impact, research priorities that address multi-disciplinary social, environmental, and clinical perspectives must be underpinned by unified approaches that maximize public health.
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Affiliation(s)
- Mark A Faghy
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK; Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - James Yates
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Andrew P Hills
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America; School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ross Arena
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK; Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Rachita Gururaj
- Department of Physiotherapy, Ramaiah Medical College, Bengaluru, India
| | - Sundar Kumar Veluswamy
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America; Department of Physiotherapy, Ramaiah Medical College, Bengaluru, India
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, King Khalid University, Saudi Arabia
| | - Ruth E M Ashton
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
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