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Huang J, Qiao X, Song K, Liu R, Huang S, He J, Zhu S, Reinhardt JD, He C. Effectiveness of Rehabilitation Interventions in Individuals With Emerging Virtual Respiratory Tract Infectious Disease: A Systematic Review and Meta-Analysis. Clin Rehabil 2024; 38:857-883. [PMID: 38629433 DOI: 10.1177/02692155241239881] [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] [Indexed: 05/24/2024]
Abstract
OBJECTIVE Assessing rehabilitation effectiveness for persistent symptoms post-infection with emerging viral respiratory diseases. DATA SOURCES Systematic review of seven databases (MEDLINE, EMBASE, Cochrane Library, PEDro, MedRxiv, CNKI, Wanfang) until 30 December 2023. REVIEW METHODS Evaluated 101 studies (9593 participants) on respiratory function, exercise capacity, and quality of life. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for observational studies and non-RCTs, and the NIH Quality Assessment Tools for before-after studies. RESULTS The most common rehabilitation program combined breathing exercises with aerobic exercise or strength training. Rehabilitation interventions significantly enhanced respiratory function, as evidenced by improvements on the Borg Scale (MD, -1.85; 95% CI, -3.00 to -0.70, low certainty), the mMRC Dyspnea Scale (MD, -0.45; 95% CI, -0.72 to -0.18, low certainty), and the Multidimensional Dyspnoea-12 Scale (MD, -4.64; 95% CI, -6.54 to -2.74, moderate certainty). Exercise capacity also improved, demonstrated by results from the Six-Minute Walk Test (MD, 38.18; 95% CI, 25.33-51.03, moderate certainty) and the Sit-to-Stand Test (MD, 3.04; 95% CI, 1.07-5.01, low certainty). CONCLUSION Rehabilitation interventions are promising for survivors of viral respiratory diseases, yet gaps in research remain. Future investigations should focus on personalizing rehabilitation efforts, utilizing remote technology-assisted programs, improving research quality, and identifying specific subgroups for customized rehabilitation strategies to achieve the best outcomes for survivors.
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Affiliation(s)
- Jinming Huang
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xu Qiao
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Kangping Song
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rong Liu
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shuangshuang Huang
- Rehabilitation Medicine Department, The Fifth People's Hospital of Sichuan Province, Chengdu, China
| | - Jing He
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Siyi Zhu
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jan D Reinhardt
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Center for Rehabilitation Research, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Jiangsu, China
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Chengqi He
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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de Paula Silva-Lalucci MP, Marques DCDS, Valdés-Badilla P, Andreato LV, Magnani Branco BH. Obesity as a Risk Factor for Complications and Mortality in Individuals with SARS-CoV-2: A Systematic Review. Nutrients 2024; 16:543. [PMID: 38398867 PMCID: PMC10892776 DOI: 10.3390/nu16040543] [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: 01/22/2024] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
This systematic review aimed to analyze the available studies that identified overweight and/or obesity as a risk factor for mortality, use of respiratory support, and changes in biochemical markers in adults hospitalized with SARS-CoV-2. The PubMed, Web of Science, and Scopus databases were searched using PRISMA guidelines until January 2024. The protocol was registered with PROSPERO (code: CRD42024501551). Of the 473 articles, only 8 met the inclusion criteria (e.g., adult individuals aged 18 or over diagnosed with COVID-19 individuals with overweight and/or obesity). In addition, the Downs and Black tool was used to assess the quality of the studies. The studies analyzed totaled 9782 adults hospitalized for COVID-19, indicating that overweight and obesity are present in more than half of adults. Diseases such as diabetes mellitus and hypertension are more prevalent in adults with obesity. The systematic review also highlighted that a higher incidence of respiratory support is related to a higher incidence of hospitalization in intensive care units and that adults with overweight and obesity have a higher risk of mortality from COVID-19. Biochemical markers such as procalcitinin, C-reactive protein, and interleukin-6 are associated with the severity of COVID-19 infection. This systematic review exposed overweight and/or obesity as a risk factor for worse COVID-19 disease, as well as for the need for intensive care, respiratory support, mortality, and changes in essential blood markers.
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Affiliation(s)
- Marielle Priscila de Paula Silva-Lalucci
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology, and Innovation, Maringá 87050-390, Paraná, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Paraná, Brazil
| | - Déborah Cristina de Souza Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology, and Innovation, Maringá 87050-390, Paraná, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Paraná, Brazil
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | - Leonardo Vidal Andreato
- Higher School of Health Sciences, State University of Amazonas, Manaus 69065-001, Amazonas, Brazil;
| | - Braulio Henrique Magnani Branco
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology, and Innovation, Maringá 87050-390, Paraná, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Paraná, Brazil
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Díaz-Cano Carmona I, López Lozano AM, Pérez Rastrollo FJ, Moreno Moreno AM, Barrera Chacón JM. [Functional evaluation in patient with critical SARS-CoV-2 disease: Cohort study in a third level hospital rehabilitation unit]. Rehabilitacion (Madr) 2023; 57:100779. [PMID: 36738656 PMCID: PMC9790869 DOI: 10.1016/j.rh.2022.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION SARS-COV-2 pneumonia is a highly contagious respiratory disease that causes respiratory, physical and psychological dysfunctions. We present the results of patient assessment when they were discharged from the ICU. MATERIAL AND METHOD Cohort study of patients affected by SARS-COV-2 pneumonia admitted to the intensive care unit from 01/10/2020 to 31/07/2021. We collect sociodemographic data, personal history, ICU and hospital stay, Barthel, FAC and mMRC (pre-admission/initial assessment/discharge), development of osteomuscular and/or neurological pathology and need for rehabilitation treatment. RESULTS A total of 341 patients were evaluated, of which 224 met criteria. The average age was 63 years (68.75% men). Mean ICU/hospital stay were 27/44 days. They were assessed by physiatry, after that, we provide a guide developed by physiatry, solving doubts about the disease and setting exercises of intensity and progressive difficulty, to be carried out during the admission and at home. Neurological pathology was present at 42.86% patients, of whom a 83.33% were peripheral nervous system disease. The total of the sample needed respiratory physiotherapy and a 72.32% motor physiotherapy. CONCLUSIONS In our study, a high number of patients have needed rehabilitation treatment in order to get functional recovery, highlighting the development of post-COVID neurological pathology. SARS-COV-2 generates other complications, not only respiratory, subsidiary to be assessed and treated by rehabilitation services for a comprehensive recovery that minimizes sequelae.
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Affiliation(s)
- I Díaz-Cano Carmona
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - A M López Lozano
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F J Pérez Rastrollo
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
| | - A M Moreno Moreno
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J M Barrera Chacón
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
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Yilmaz Gokmen G, Durmaz D, Demir C, Yilmaz FN. Determining Post-COVID-19 Symptoms and Rehabilitation Needs in Hospitalized and Nonhospitalized COVID-19 Survivors with Tele-Assessment Methods. Telemed J E Health 2023; 29:1312-1323. [PMID: 36757300 DOI: 10.1089/tmj.2022.0349] [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] [Indexed: 02/10/2023] Open
Abstract
Objectives: This study aimed to evaluate the post-COVID-19 symptoms, the severity of symptoms, and functional capacities seen in hospitalized and nonhospitalized COVID-19 survivors according to time periods (total 6, 1-3, and 3-6 months) by tele-assessment methods and to predict the need for periodic rehabilitation of COVID-19 survivors. Methods: Three hundred ninety-four COVID-19 survivors (50.18 ± 15.14 years) who were between 1 and 6 months after PCR(+) were included in the study, and their ongoing symptoms and the severity of these symptoms (0-10 points) were assessed with COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) Tool, and the 30-s Chair Stand Test (CST) was applied by tele-assessment methods. Results: In hospitalized and nonhospitalized survivors of COVID-19, 87% experienced at least one symptom within the first 6 months. The most prevalent symptoms were anxiety (47.7%), fatigue (46.7%), and muscle pain (45.7%). The most common symptom in the nonhospitalized group was fatigue (52.6%), whereas anxiety was 46.8% in the hospitalized group. The 30-s CST score of the nonhospitalized group was significantly higher than the hospitalized group (p < 0.001). Conclusions: In the first 6 months post-COVID-19, musculoskeletal problems, anxiety, fatigue, and muscle pain were observed to be the most prevalent symptoms, regardless of time, in hospitalized and nonhospitalized survivors. There was a serious decrease in their functional capacity. Priority should be given to psychiatric, cardiopulmonary, and musculoskeletal rehabilitation in post-COVID-19. Inclusion of hospitalized/nonhospitalized COVID-19 survivors in a comprehensive rehabilitation program tailored to their needs by following a comprehensive tele-assessment by a multidisciplinary team will reduce the "long COVID-19 syndrome." ClinicalTrials.gov Registration Number: NCT04900441.
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Affiliation(s)
- Gulhan Yilmaz Gokmen
- Department of Cardiopulmonary Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
| | - Dilber Durmaz
- Department of Chest Diseases, Faculty of Medicine, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
| | - Canan Demir
- Department of Cardiopulmonary Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
| | - Fatma Nur Yilmaz
- Department of Neurologic Physiotherapy and Rehabilitation, Faculty of Medicine, Bandırma Onyedi Eylul University, Bandirma/Balikesir, Turkey
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Qorolli M, Beqaj S, Ibrahimi‐Kaçuri D, Murtezani A, Krasniqi V, Mačak Hadžiomerović A. Functional status and quality of life in post-COVID-19 patients two to three weeks after hospitalization: A cross-sectional study. Health Sci Rep 2023; 6:e1510. [PMID: 37621387 PMCID: PMC10444983 DOI: 10.1002/hsr2.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Background and Aims Extended hospitalization due to coronavirus disease 2019 (COVID-19) is associated with residual musculoskeletal and functional deficits lasting even 6 months after discharge; therefore, it is crucial that post-hospitalized patients are promptly assessed. The aim of this study was to identify post-COVID-19 patients' functional status and quality of life, as well as to investigate their inter-relatedness 2-3 weeks after hospital discharge. Methods The study included 39 post-COVID-19 patients previously hospitalized in the Clinic for Infectious Diseases at the University Clinical Center of Kosovo (UCCK) from August to December 2021. Physiotherapeutic assessment encompassed socio-demographic and clinical data including Short Physical Performance Battery (SPPB) for physical functional performance, hand grip strength, 6-min Walk Test (6MWT) for aerobic capacity and endurance, EuroQol 5-Dimension 5-Level (EQ-5D-5L) for quality of life, Visual Analogue Scale (VAS) for pain, Borg CR10 for dyspnea, peripheral oxygen saturation and heart rate. Descriptive statistics, Pearson correlation, and multiple linear regression analysis were utilized for data processing. Results The median (interquartile range [IQR]) for Borg CR10, VAS pain scale, total SPPB, grip strength, and 6MWT were 1 (0-3), 3 (1-6), 9 (8-10), 30.5 (23.2-43.5) kg, 344.5 (312.7-381.7) m respectively, while the mean (SD) for EQ-5D-5L index value was 0.7 (0.2). The strongest and most significant correlation was depicted between SPPB total score and its subscales, followed by correlation with EQ-5D-5L (r = 0.719, p < 0.001), grip strength (r = 0.612 p < 0.001), Borg CR10 (r = -0.515, p = 0.001), 6MWT (r = 0.416, p = 0.02), and VAS scale (r = -0.343, p = 0.03). Using the multiple regression analysis, the grip strength, Borg-CR10, and 6MWT were found to be strongly predictive of SPPB total score. Conclusion In post-COVID-19 patients' functional status and quality of life were impaired 2-3 weeks following hospitalization. SPPB showed the most frequent and significant correlation with other variables, hence it should be considered as one of the primary screening tools.
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Affiliation(s)
- Merita Qorolli
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Samire Beqaj
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
| | | | - Ardiana Murtezani
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Valon Krasniqi
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
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Weldon EJ, Hong B, Hayashi J, Goo C, Carrazana E, Viereck J, Liow K. Mechanisms and Severity of Exercise Intolerance Following COVID-19 and Similar Viral Infections: A Comparative Review. Cureus 2023; 15:e39722. [PMID: 37398713 PMCID: PMC10310058 DOI: 10.7759/cureus.39722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Approximately 19% of the population is suffering from "Long COVID", also known as post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC), which often results in exercise intolerance. As COVID infections continue to be common, studying the long-term consequences of coronavirus disease (COVID) on physical function has become increasingly important. This narrative review will aim to summarize the current literature surrounding exercise intolerance following COVID infection in terms of mechanism, current management approaches, and comparison with similar conditions and will aim to define limitations in the current literature. Multiple organ systems have been implicated in the onset of long-lasting exercise intolerance post-COVID, including cardiac impairment, endothelial dysfunction, decreased VO2 max and oxygen extraction, deconditioning due to bed rest, and fatigue. Treatment modalities for severe COVID have also been shown to cause myopathy and/or worsen deconditioning. Besides COVID-specific pathophysiology, general febrile illness as commonly experienced during infection will cause hypermetabolic muscle catabolism, impaired cooling, and dehydration, which acutely cause exercise intolerance. The mechanisms of exercise intolerance seen with PASC also appear similar to post-infectious fatigue syndrome and infectious mononucleosis. However, the severity and duration of the exercise intolerance seen with PASC is greater than that of any of the isolated mechanisms described above and thus is likely a combination of the proposed mechanisms. Physicians should consider post-infectious fatigue syndrome (PIFS), especially if fatigue persists after six months following COVID recovery. It is important for physicians, patients, and social systems to anticipate exercise intolerance lasting for weeks to months in patients with long COVID. These findings underscore the importance of long-term management of patients with COVID and the need for ongoing research to identify effective treatments for exercise intolerance in this population. By recognizing and addressing exercise intolerance in patients with long COVID, clinicians can provide proper supportive interventions, such as exercise programs, physical therapy, and mental health counseling, to improve patient outcomes.
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Affiliation(s)
- Edward J Weldon
- Department of Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Brain Research, Innovation, & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Bradon Hong
- Department of Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Brain Research, Innovation, & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Jeffrey Hayashi
- Department of Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Brain Research, Innovation, & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Connor Goo
- Department of Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Brain Research, Innovation, & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Enrique Carrazana
- Brain Research, Innovation, & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Department of Neurology, Hawaii Neuro COVID Clinic, Honolulu, USA
| | - Jason Viereck
- Brain Research, Innovation, & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Department of Neurology, Hawaii Neuro COVID Clinic, Honolulu, USA
| | - Kore Liow
- Brain Research, Innovation, & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Department of Neurology, Hawaii Neuro COVID Clinic, Honolulu, USA
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Begazo Flores P, Supervía M, Gimeno González M, Morata Crespo AB. [Pandemic COVID-19 impact in Rehabilitation Services in Spain]. Rehabilitacion (Madr) 2023; 57:100736. [PMID: 35545483 PMCID: PMC8898680 DOI: 10.1016/j.rh.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/22/2021] [Accepted: 02/22/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients. MATERIAL AND METHODS Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22nd, 2020 to February the 12th, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS. OBJECTIVE To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments. RESULTS 38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average. 59.1% (n = 23) of the included hospitals had already implemented a specific post-covid follow-up rehab-consultation, whereas 9.1% (n = 4) of them were planning on implementing it. 64.3% (n = 24) of the surveyed centers implemented specific protocols for COVID-19 patients, while another 7.1% (n = 3) were in development progress. 48.5% (n = 18) of the surveyed centers did not owe its own specific training program within its ICUs and respiratory rehab-areas for the internal medical residents. CONCLUSIONS The pandemic situation has resulted in a substantial increase on the workload in the Spanish Rehabilitation Services. Most of the hospitals included in the present study had already implemented outpatient follow-up consultations. Rehabilitation in critical patients is an exponentially recurrent topic for this medical specialty that needs to be furtherly addressed in the nearby future.
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Affiliation(s)
- P Begazo Flores
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - M Supervía
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España; Mayo Clinic, Rochester, Minnesota, EE. UU
| | - M Gimeno González
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España
| | - A B Morata Crespo
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España
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e Silva Malzone JR, Ribeiro AP, de Souza TS, Wilbert DD, Novo NF, Juliano Y. Clinical and Epidemiological Characteristics of Patients with COVID-19 Admitted to the Intensive Care Unit: A Two-Year Retrospective Analysis. Life (Basel) 2023; 13:life13030741. [PMID: 36983896 PMCID: PMC10059043 DOI: 10.3390/life13030741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/05/2023] [Accepted: 02/18/2023] [Indexed: 03/12/2023] Open
Abstract
In March 2020, COVID-19 was characterized as a pandemic by the World Health Organization. Hospitalized patients affected by COVID-19 presented with severe respiratory and motor impairment, especially those who required intensive treatment and invasive mechanical ventilation, with sequelae that extended after the period of hospitalization. Thus, the aim of the current study was to verify the clinical and epidemiological characteristics of patients with COVID-19 admitted to the Intensive Care Unit in 2020 and 2021, according to age group. Methods: A retrospective cohort study. Data were collected through the “ICUs Brasileiras” between March 2020 and November 2021 for severe acute respiratory syndrome (SARS) due to COVID-19. The following were analyzed: the number of hospital admissions, days in the ICU and hospital, clinical aspects (non-invasive or invasive ventilatory support, comorbidities, frailty, SAPS 3 and SOFA severity scales, use of amines and renal support), and ICU and hospital mortality rate. Results: A total of 166,966 ICU hospital admissions were evaluated over the evaluated quarters. The main results showed a peak in the number of hospitalizations between March and May 2021, with a higher percentage of males. The peak of ICU admissions for 7 days was between March and May 2021 and 21 days between March and May 2020. In addition, higher deaths were observed in the age groups between 40 and 80 years between 2020 and 2021, with the group above 81 being the age group with the highest mortality. Mortality in the ICU of ventilated patients was higher in the age group above 70 years. Another observation was the predominance of SAPS 3 and the peak of mechanical ventilation for more than 7 days between June and August 2021. Conclusion: The clinical and epidemiological characteristics of patients with COVID-19 were influenced by age group, showing higher mortality over 81 years and over 70 years in the ICU supported by mechanical ventilation, maintained for 7 days from June to August 2021. The years 2020 and 2021 also showed differences for patients with COVID-19, with greater hospitalization between March and May 2021, especially in the ICU for 7 days, and between March and May 2020 for the 21-day period.
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Affiliation(s)
| | - Ana Paula Ribeiro
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
- Physical Therapy Department, School of Medicine, University of Sao Paulo, São Paulo 05360-160, Brazil
- Correspondence: or ; Tel.: +55-11-99139-2168
| | - Tatiane Silva de Souza
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
| | - Debora Driemeyer Wilbert
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
| | - Neil Ferreira Novo
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
| | - Yara Juliano
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
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Moraes FCAD, Santos RRDE, Campos JCD, Mota ACC, Pessoa FR, Sarges DC, Moraes DA, Souza DDSMD. Covid-19 and Heart Involvement: A Systematic Review of Literature. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2023. [DOI: 10.36660/ijcs.20220035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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Rahmati M, Molanouri Shamsi M, Woo W, Koyanagi A, Won Lee S, Keon Yon D, Shin JI, Smith L. Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital: A systematic review. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:149-158. [PMID: 36717302 PMCID: PMC9851951 DOI: 10.1016/j.joim.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/25/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hospitalized patients recovering from coronavirus disease 2019 (COVID-19) may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge. However, to date, no attempt has been made to collate and synthesize literature in this area. OBJECTIVE This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital. SEARCH STRATEGY A systematic search of MEDLINE/PubMed, CINAHL, Scopus and medRxiv was conducted to identify articles published up to March 2022. INCLUSION CRITERIA This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity, exercise, or breathing training to enhance or restore functional capacity, pulmonary function, quality of life, and mental health or function. DATA EXTRACTION AND ANALYSIS Selection of included articles, data extraction, and methodological quality assessments were conducted by two review authors respectively, and consensus was reached through discussion and consultation with a third reviewer. Finally, we review the outcomes of studies based on four categories including: (1) functional capacity, (2) pulmonary function, (3) quality of life, and (4) mental health status. RESULTS A total of 7534 titles and abstracts were screened; 10 cohort studies, 4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review. Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity, pulmonary function, quality of life and mental health status. CONCLUSION Physical rehabilitation interventions may be safe, feasible and effective in COVID-19 patients discharged from the hospital, and can improve a variety of clinically relevant outcomes. Further studies are warranted to determine the underlying mechanisms. Please cite this article as: Rahmati M, Shamsi MM, Woo W, Koyanagi A, Lee SW, Yon DK, Shin JI, Smith L. Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital: A systematic review. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, 6816785468 Khoramabad, Iran.
| | - Mahdieh Molanouri Shamsi
- Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, 1411713116 Tehran, Iran.
| | - Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Gangnam-gu, Seoul 06273, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona 08010, Spain
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Dong Keon Yon
- Medical Science Research Institute, Kyung Hee University, Seoul 02447, Republic of Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea.
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
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Gabriela Lima de Melo G, Crystal A, Renee K, Nicole S, Paul O. Developing a group-based virtual education curriculum for cardiac rehabilitation and the associated toolkit to support implementation in Canada and across the globe. Heart Lung 2023; 57:80-94. [PMID: 36084400 DOI: 10.1016/j.hrtlng.2022.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/11/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND To overcome the many barriers faced by the long-lasting pandemic, the development of new ways to deliver cardiac rehabilitation (CR)'s components was needed. OBJECTIVE This mixed-methods study describes the process to create a virtual education curriculum and assess the level of user engagement and acceptability in CR participants. METHODS A 4-phase approach was used to develop the new virtual education curriculum for CR and collect feedback regarding patients' engagement with and acceptability of the curriculum in a convenience sample of 80 CR participants. Data were analyzed using a reflexive thematic analysis approach and mapped to the evidence-based implementation strategies, followed by stakeholder engagement. Considering all information gathered and applying best practices in patient education and curriculum development, a 16-week virtual education curriculum was established. RESULTS Five themes were identified on how the current education could be improved: focus on self-management, emphasize emotional wellbeing, improve facilitation, incorporate existing resources, and improve content flow. The recommendations associated with each theme informed the new curriculum and a tailored implementation plan to support the use of virtual education as part of routine care within the program. A toolkit that included a screening tool for comfort with/access to technology, patient-centered manuals with weekly learning plans, and a facilitator's manual was created. Overall, all recommended weekly education was completed by more than 70% of the participants, with greater acceptability. CONCLUSIONS The present study offers an example of a collaborative approach to tailoring strategies for the development of a new group-based virtual education model of CR.
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Affiliation(s)
- Ghisi Gabriela Lima de Melo
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 1R7, Canada.
| | - Aultman Crystal
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 1R7, Canada
| | - Konidis Renee
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 1R7, Canada
| | - Sandison Nicole
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 1R7, Canada
| | - Oh Paul
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 1R7, Canada
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Llurda-Almuzara L, Rodríguez-Sanz J, López-de-Celis C, Aiguadé-Aiguadé R, Arán-Jové R, Labata-Lezaun N, Fernández-de-las-Peñas C, Bosch J, Pérez-Bellmunt A. Effects of Adding an Online Exercise Program on Physical Function in Individuals Hospitalized by COVID-19: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16619. [PMID: 36554510 PMCID: PMC9778879 DOI: 10.3390/ijerph192416619] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
The worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has impacted all healthcare systems. One potential sequela experienced by hospitalized coronavirus disease 2019 (COVID-19) survivors includes muscle weakness with a reduction in strength and, consequently, a possible increase in frailty. The aim of this clinical trial was to evaluate the efficacy of adding an online therapeutic exercise program for 8 weeks to the medical prescriptions on functional variables in patients hospitalized due to COVID-19. A randomized controlled trial including 70 previously hospitalized COVID-19 survivors was conducted. Patients were randomly allocated to an experimental (n = 35) or control (n = 35) group. Both groups received regular prescriptions provided by their medical doctors. The experimental group also received a live online therapeutic exercise program for 8 weeks (3 sessions/week). Handgrip strength, gait speed, lower-extremity strength, balance, and frailty were assessed at baseline, at the end of the program, and one month after the end of the intervention. The repeated measures analysis of variance revealed significant Group*Time interactions for all the outcomes: (handgrip dominant: F = 17.395, p < 0.001, η2 = 0.24; handgrip non-dominant: F = 33.197, p < 0.001, η2 = 0.33; 4 m walk test (4WT): F = 13.039, p = 0.001, η2 = 0.16; short physical performance battery (SPPB): F = 26.421, p < 0.001, η2 = 0.28; the five chair-raise test (5CRT): F = 5.628, p = 0.004, η2 = 0.08; FRAIL scale: F = 11.249, p = 0.001, η2 = 0.14): patients in the experimental group experienced greater improvements in all outcomes than those assigned to the control group. This study revealed that the addition of an online exercise program for 8 weeks obtained greater improvements in handgrip strength, gait speed, lower-extremity strength, balance, and frailty in a sample of previously hospitalized COVID-19 survivors than application of just usual medical prescription.
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Affiliation(s)
- Luis Llurda-Almuzara
- Physiotherapy Department, Faculty of Health Sciences, European University of Gasteiz—EUNEIZ, La Biosfera Ibilbidea, 6, 01013 Vitoria-Gasteiz, Spain
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
| | - Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
| | - Carlos López-de-Celis
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain
| | | | - Raúl Arán-Jové
- Oxigena Fisioterapia, Calle N, 51, 50170 Mequinenza, Spain
- Hospital Universitari Santa Maria, Av. Alcalde Rovira Roure, 44, 25198 Lleida, Spain
| | - Noé Labata-Lezaun
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Alcorcon, Spain
| | - Joan Bosch
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
| | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, 08017 Barcelona, Spain
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de Almeida LV, Santos-de-Araújo AD, Cutrim RC, Tavarez RRDJ, Borghi-Silva A, Pereira FHF, Pontes-Silva A, Rêgo AS, Rocha DS, Marinho RS, Dibai-Filho AV, Bassi-Dibai D. Intra- and Interrater Reliability of Short-Term Measurement of Heart Rate Variability on Rest in Individuals Post-COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13587. [PMID: 36294172 PMCID: PMC9602575 DOI: 10.3390/ijerph192013587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.
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Affiliation(s)
- Lucivalda Viegas de Almeida
- Postgraduate Program in Programs Management and Health Services, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Grupo de Pesquisa em Avaliação e Reabilitação Cardiovascular, Respiratória e Metabólica, Universidade Ceuma, São Luís 65075-120, MA, Brazil
| | - Aldair Darlan Santos-de-Araújo
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil
- Cardiopulmonary Physiotherapy Laboratory—LACAP, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil
| | - Rodrigo Costa Cutrim
- Grupo de Pesquisa em Avaliação e Reabilitação Cardiovascular, Respiratória e Metabólica, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís 65075-120, MA, Brazil
| | | | - Audrey Borghi-Silva
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil
- Cardiopulmonary Physiotherapy Laboratory—LACAP, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil
| | - Fábio Henrique Ferreira Pereira
- Grupo de Pesquisa em Avaliação e Reabilitação Cardiovascular, Respiratória e Metabólica, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Postgraduate Program in Environment, Universidade Ceuma, São Luís 65075-120, MA, Brazil
| | - André Pontes-Silva
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil
| | - Adriana Sousa Rêgo
- Postgraduate Program in Programs Management and Health Services, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Grupo de Pesquisa em Avaliação e Reabilitação Cardiovascular, Respiratória e Metabólica, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Postgraduate Program in Environment, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Department of Physical Therapy, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Postgraduate Program in Adult Health, Universidade Federal do Maranhão, São Luís 65080-805, MA, Brazil
| | - Daniel Santos Rocha
- Grupo de Pesquisa em Avaliação e Reabilitação Cardiovascular, Respiratória e Metabólica, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Department of Physical Therapy, Universidade Ceuma, São Luís 65075-120, MA, Brazil
| | - Renan Shida Marinho
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil
- Cardiopulmonary Physiotherapy Laboratory—LACAP, Universidade Federal de São Carlos, São Carlos 13565-905, SP, Brazil
| | - Almir Vieira Dibai-Filho
- Postgraduate Program in Adult Health, Universidade Federal do Maranhão, São Luís 65080-805, MA, Brazil
- Grupo de Pesquisa em Reabilitação, Exercício e Movimento (REMOVI) Universidade Federal do Maranhão, São Luís 65080-805, MA, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Programs Management and Health Services, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Grupo de Pesquisa em Avaliação e Reabilitação Cardiovascular, Respiratória e Metabólica, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Postgraduate Program in Environment, Universidade Ceuma, São Luís 65075-120, MA, Brazil
- Department of Physical Therapy, Universidade Ceuma, São Luís 65075-120, MA, Brazil
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Bailly M, Pélissier L, Coudeyre E, Evrard B, Bingula R, Rochette C, Mériade L, Blavignac C, Fournier AC, Bignon YJ, Rannou F, Dutheil F, Thivel D, Duclos M. Systematic Review of COVID-19-Related Physical Activity-Based Rehabilitations: Benefits to Be Confirmed by More Robust Methodological Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159025. [PMID: 35897400 PMCID: PMC9331032 DOI: 10.3390/ijerph19159025] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
The first emergency was to receive and treat COVID-19 patients in their acute phase; today, there is a clear need to propose appropriate post-acute rehabilitation programs. The aim of this research was to systematically review the effects of physical activity programs in the recovery of post-COVID-19 patients. The literature search followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, was registered in the PROSPERO database (CRD42022289219), and was conducted between August and December 2021. A total of 35 studies out of the 1528 initially identified were finally included in the analysis. The systematic review clearly showed the health benefits of rehabilitation including physical activity in post-COVID-19 recovery, regardless of exercise modalities. These positive results were even observed using minor muscle re-mobilization for severe cases (i.e., postural changes, few steps—2 times/day) or using low volumes of exercise for mild-to-moderate cases (i.e., 120 min/week). A total of 97% of the 29 studies that performed statistical analyses demonstrated a significant increase in at least one parameter of functional capacity, and 96% of the 26 studies that statistically investigated the effects on the quality of life, mental health, and general state reported improvements. Yet, most of the studies were retrospective, uncontrolled, and enrolled aged people with comorbidities presented in severe forms of COVID-19. Physical activity programs, in addition to their high heterogeneity, remained poorly described in 83% of the studies and were part of a multidisciplinary program for 89% of the studies. Despite promising results, there is today a real need for prospective well-designed studies specifically assessing the effects of physical activity. In addition, it might appear relevant to propose standardized programs further considering the main characteristics of patients such as age, comorbidities, or the severity of COVID-19.
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Affiliation(s)
- Mélina Bailly
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Léna Pélissier
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
- Correspondence:
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Bertrand Evrard
- Service d’Immunologie, Centre Hospitalier Universitaire (CHU) Gabriel-Montpied, 63000 Clermont-Ferrand, France;
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Rea Bingula
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Corinne Rochette
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Laurent Mériade
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Christelle Blavignac
- Centre Imagerie Cellulaire Santé, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Anne-Cécile Fournier
- Cluster Auvergne-Rhône-Alpes Innovation Innovatherm, 63000 Clermont-Ferrand, France;
| | - Yves-Jean Bignon
- U1240 Imagerie Moléculaire et Stratégies Théranostiques, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Clermont Auvergne, 63000 Clermont Ferrand, France;
- Département d’Oncogénétique, Centre Jean Perrin, 63011 Clermont-Ferrand, France
| | - Fabrice Rannou
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, LaPSCo, Physiological and Psychosocial Stress, Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Witty Fit, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - David Thivel
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Martine Duclos
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
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Nazir A, Hasri IP. Pathophysiology and rehabilitation management of exercise intolerance in COVID-19 patients. Ann Thorac Med 2022; 17:87-93. [PMID: 35651896 PMCID: PMC9150663 DOI: 10.4103/atm.atm_357_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This review aimed to explore the pathophysiology and rehabilitation management of exercise intolerance in COVID-19 patients. METHODS We reviewed articles published in 2019-2021 using PubMed, Google Scholar, and CINAHL databases as an electronic database. Data obtained were pathophysiology and rehabilitation management of exercise intolerance in COVID-19 survivors. Types of the article were original articles and systematic or narrative reviews, both published and preprint articles. Articles that were written in English and freely accessible in pdf or HTML format were included. RESULTS There were 28 articles eligible for this review. Pathophysiology, rehabilitation management, and both pathophysiology and rehabilitation management were explained in 7, 24, and 4 articles, consecutively. DISCUSSION Exercise intolerance is caused by some pathological processes in the respiratory, cardiovascular, and musculoskeletal systems as a result of systemic inflammation. Fatigue and shortness of breath during the activity were the most common symptom in the early phase of COVID-19 and persisted until the follow-up phase. Hospital admission, especially prolonged use of ventilators and immobilization worsen functional impairment resulting in persistent symptoms. Rehabilitation management begins with a functional assessment consisting of symptom assessment and physical examination of the body systems affected. The goals of rehabilitation management are to increase functional capacity, reduce symptoms, improve the ability to perform daily activities, facilitate social reintegration, and improve quality of life. Exercise is an effective intervention to reach these goals. Several studies recommend breathing, and aerobic exercises, as well as resistance exercises for peripheral and respiratory muscles, to improve symptoms and increase functional capacity.
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Affiliation(s)
- Arnengsih Nazir
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Indra Putera Hasri
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
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NAKAMURA K, MAZAKI L, HAYASHI Y, TSUJI T, FURUSAWA H. Predicting the Classification of Home Oxygen Therapy for Post-COVID-19 Rehabilitation Patients Using a Neural Network. Phys Ther Res 2022; 25:99-105. [PMID: 36819912 PMCID: PMC9910350 DOI: 10.1298/ptr.e10181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/16/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We evaluated the accuracy of a neural network to classify and predict the possibility of home oxygen therapy at the time of discharge from hospital based on patient information post-coronavirus disease (COVID-19) at admission. METHODS Patients who survived acute treatment with COVID-19 and were admitted to the Amagasaki Medical Co-operative Hospital during August 2020-December 2021 were included. However, only rehabilitation patients (n = 88) who were discharged after a rehabilitation period of at least 2 weeks and not via home or institution were included. The neural network model implemented in R for Windows (4.1.2) was trained using data on patient age, gender, and number of days between a positive polymerase chain reaction test and hospitalization, length of hospital stay, oxygen flow rate required at hospitalization, and ability to perform activities of daily living. The number of training trials was 100. We used the area under the curve (AUC), accuracy, sensitivity, and specificity as evaluation indicators for the classification model. RESULTS The model of states at rest had as AUC of 0.82, sensitivity of 75.0%, specificity of 88.9%, and model accuracy of 86.4%. The model of states on exertion had an ACU of 0.82, sensitivity of 83.3%, specificity of 81.3%, and model accuracy of 81.8%. CONCLUSION The accuracy of this study's neural network model is comparable to that of previous studies recommended by Japanese Guidelines for the Physical Therapy and is expected to be used in clinical practice. In future, it could be used as a more accurate clinical support tool by increasing the sample size and applying cross-validation.
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Affiliation(s)
- Kensuke NAKAMURA
- Department of Rehabilitation, Amagasaki Medical Co-operative Hospital, Japan
| | - Lisa MAZAKI
- Department of Rehabilitation, Amagasaki Medical Co-operative Hospital, Japan
| | - Yukiko HAYASHI
- Department of Rehabilitation, Amagasaki Medical Co-operative Hospital, Japan
| | - Taro TSUJI
- Department of Rehabilitation, Amagasaki Medical Co-operative Hospital, Japan
| | - Hiroki FURUSAWA
- Department of Rehabilitation, Amagasaki Medical Co-operative Hospital, Japan
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Surendran PJ, Jacob P, Carr CS, Omar AS, Sudarsanan S, Shiju S, Albadwan YHO, Matharsa SAA, Mathew G, Selvamani DK. Delivery of Acute Rehabilitation to a Postcoronary Artery Bypass Graft COVID-19 Patient in a Pandemic Environment. Heart Views 2022; 23:118-122. [PMID: 36213428 PMCID: PMC9542968 DOI: 10.4103/heartviews.heartviews_101_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 06/08/2022] [Indexed: 11/25/2022] Open
Abstract
During the first wave of the coronavirus disease (COVID-19) pandemic, a 57-year-old COVID-19 male patient was diagnosed with non-ST-elevation myocardial infarction and required urgent coronary artery bypass graft. In-patient cardiac rehabilitation following cardiac surgery was inevitable to limit or prevent various postoperative complications. A routine rehabilitation program was not feasible because of the strict COVID-19 isolation procedures, the high risk of cross infections, and the lack of various resources. Moreover, the detrimental effects of COVID-19 infection on multiple body systems reduced his exercise tolerance, limiting his engagement in physical activity. This case report highlights the various challenges encountered during the rehabilitation of these patients and strategies adopted to overcome them, illustrating the feasibility of a modified rehabilitation program to ensure early functional recovery.
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Affiliation(s)
- Praveen Jayaprabha Surendran
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar,Address for correspondence: Mr. Praveen Jayaprabha Surendran, Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar. E-mail:
| | - Prasobh Jacob
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Cornelia Sonia Carr
- Department of Cardiac Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Amr Salah Omar
- Department of Cardiac Anesthesia, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Suraj Sudarsanan
- Department of Cardiac Anesthesia, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Shiny Shiju
- Department of Nursing, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Gigi Mathew
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Dinesh Kumar Selvamani
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Figueiredo EAB, Silva WT, Tsopanoglou SP, Vitorino DFDM, Oliveira LFLD, Silva KLS, Luz HDH, Ávila MR, Oliveira LFFD, Lacerda ACR, Mendonça VA, Lima VP, Mediano MFF, Figueiredo PHS, Rocha MOC, Costa HS. The health-related quality of life in patients with post-COVID-19 after hospitalization: a systematic review. Rev Soc Bras Med Trop 2022; 55:e0741. [PMID: 35352761 PMCID: PMC9053755 DOI: 10.1590/0037-8682-0741-2021] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/22/2022] [Indexed: 01/16/2023] Open
Abstract
Symptoms in post-COVID-19 patients who require hospitalization can persist for months, significantly affecting their health-related quality of life (HRQoL). Thus, the present study aimed to discuss the main findings regarding HRQoL in post-COVID-19 patients who required hospitalization. An electronic search was performed in the MEDLINE, EMBASE, CINAHL, Web of Science, LILACS, and Scopus databases, without date and language restrictions, until July 2021. Twenty-four articles were included in the analysis. It seems that HRQoL partially improved soon after hospital discharge, although the negative impact on HRQoL may persist for months. The physical and mental aspects are affected because patients report pain, discomfort, anxiety, and depression. The HRQoL of COVID-19 infected patients was worse than that of uninfected patients. Additionally, HRQoL seemed worse in patients admitted to the intensive care unit than in those who remained in the ward. Improvements in HRQoL after hospital discharge are independent of imaging improvement, and there seems to be no association between HRQoL after hospital discharge and disease severity on hospital admission. Many factors have been identified as determinants of HRQoL, with women and advanced age being the most related to worse HRQOL, followed by the duration of invasive mechanical ventilation and the need for intensive care. Other factors included the presence and number of comorbidities, lower forced vital capacity, high body mass index, smoking history, undergraduate education, and unemployment. In conclusion, these findings may aid in clinical management and should be considered in the aftercare of patients.
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Affiliation(s)
| | | | - Sabrina Pinheiro Tsopanoglou
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil; Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil
| | | | | | | | | | | | | | - Ana Cristina Rodrigues Lacerda
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil; Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil
| | - Vanessa Amaral Mendonça
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil; Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil
| | - Vanessa Pereira Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil; Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil
| | | | | | | | - Henrique Silveira Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil; Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil; Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil
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19
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Alonso AC, Silva-Santos PR, Quintana MSL, da Silva VC, Brech GC, Barbosa LG, Pompeu JE, Silva ECGE, da Silva EM, de Godoy CG, Greve JMD. Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis. Clinics (Sao Paulo) 2021; 76:e3540. [PMID: 34852146 PMCID: PMC8595570 DOI: 10.6061/clinics/2021/e3540] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=-0.28, p=0.04), Short Physical Performance Battery score (r=-0.28, p=0.03), and forced vital capacity (r=-0.29, p=0.03). CONCLUSION Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.
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Affiliation(s)
- Angelica Castilho Alonso
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Programa de Graduacao em Ciencias do Envelhecimento, Universidade Sao Judas Tadeu (USJT), Sao Paulo, SP, BR
| | - Paulo Roberto Silva-Santos
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marília Simões Lopes Quintana
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Vanderlei Carneiro da Silva
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Guilherme Carlos Brech
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Programa de Graduacao em Ciencias do Envelhecimento, Universidade Sao Judas Tadeu (USJT), Sao Paulo, SP, BR
| | - Lorena Gonçalves Barbosa
- Programa de Graduacao em Ciencias do Envelhecimento, Universidade Sao Judas Tadeu (USJT), Sao Paulo, SP, BR
| | - José Eduardo Pompeu
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Erika Christina Gouveia e Silva
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Elizabeth Mendes da Silva
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Caroline Gil de Godoy
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Julia Maria D’Andréa Greve
- Laboratorio de Estudos do Movimento, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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