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Dusart C, Smet J, Chirumberro A, André S, Roman A, Claus M, Bruyneel AV, Menez O, Alard S, De Vos N, Bruyneel M. Pulmonary Functional Outcomes at 3 Months in Critical COVID-19 Survivors Hospitalized during the First, Second, and Third Pandemic Waves. J Clin Med 2023; 12:jcm12113712. [PMID: 37297906 DOI: 10.3390/jcm12113712] [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: 05/05/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION Despite improved management of patients with COVID-19, we still ignore whether pharmacologic treatments and improved respiratory support have modified outcomes for intensive care unit (ICU) surviving patients of the three first consecutive waves (w) of the pandemic. The aim of this study was to evaluate whether developments in the management of ICU COVID-19 patients have positively impacted respiratory functional outcomes, quality of life (QoL), and chest CT scan patterns in ICU COVID-19 surviving patients at 3 months, according to pandemic waves. METHODS We prospectively included all patients admitted to the ICU of two university hospitals with acute respiratory distress syndrome (ARDS) related to COVID-19. Data related to hospitalization (disease severity, complications), demographics, and medical history were collected. Patients were assessed 3 months post-ICU discharge using a 6 min walking distance test (6MWT), a pulmonary function test (PFT), a respiratory muscle strength (RMS) test, a chest CT scan, and a Short Form 36 (SF-36) questionnaire. RESULTS We included 84 ARDS COVID-19 surviving patients. Disease severity, complications, demographics, and comorbidities were similar between groups, but there were more women in wave 3 (w3). Length of stay at the hospital was shorter during w3 vs. during wave 1 (w1) (23.4 ± 14.2 days vs. 34.7 ± 20.8 days, p = 0.0304). Fewer patients required mechanical ventilation (MV) during the second wave (w2) vs. during w1 (33.3% vs. 63.9%, p = 0.0038). Assessment at 3 months after ICU discharge revealed that PFTs and 6MWTs scores were worse for w3 > w2 > w1. QoL (SF-36) deteriorated (vitality and mental health) more for patients in w1 vs. in w3 (64.7 ± 16.3 vs. 49.2 ± 23.2, p = 0.0169). Mechanical ventilation was associated with reduced forced expiratory volume (FEV1), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO), and respiratory muscle strength (RMS) (w1,2,3, p < 0.0500) on linear/logistic regression analysis. The use of glucocorticoids, as well as tocilizumab, was associated with improvements in the number of affected segments in chest CT, FEV1, TLC, and DLCO (p < 0.01). CONCLUSIONS With better understanding and management of COVID-19, there was an improvement in PFT, 6MWT, and RMS in ICU survivors 3 months after ICU discharge, regardless of the pandemic wave during which they were hospitalized. However, immunomodulation and improved best practices for the management of COVID-19 do not appear to be sufficient to prevent significant morbidity in critically ill patients.
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Affiliation(s)
- Cecile Dusart
- Department of Pneumology, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Jelle Smet
- Department of Pneumology, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Audrey Chirumberro
- Department of Pneumology, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Stephanie André
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Pneumology, CHU Brugmann, 1020 Brussels, Belgium
| | - Alain Roman
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
- GDepartment of Intensive Care Medicine, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Marc Claus
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
- GDepartment of Intensive Care Medicine, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Ophelie Menez
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Radiology, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Stephane Alard
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Radiology, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Nathalie De Vos
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Clinical Chemistry, LHUB-ULB, CHU Saint-Pierre, 1000 Brussels, Belgium
| | - Marie Bruyneel
- Department of Pneumology, CHU Saint-Pierre, 1000 Brussels, Belgium
- Department of Pneumology, Université Libre de Bruxelles, CHU Saint-Pierre, 1000 Brussels, Belgium
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De Luca V, Femminella GD, Patalano R, Formosa V, Lorusso G, Rivetta C, Di Lullo F, Mercurio L, Rea T, Salvatore E, Korkmaz Yaylagul N, Apostolo J, Silva RC, Dantas C, van Staalduinen WH, Liotta G, Iaccarino G, Triassi M, Illario M. Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16050. [PMID: 36498125 PMCID: PMC9739796 DOI: 10.3390/ijerph192316050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Frailty is a complex interplay between several factors, including physiological changes in ageing, multimorbidities, malnutrition, living environment, genetics, and lifestyle. Early screening for frailty risk factors in community-dwelling older people allows for preventive interventions on the clinical and social determinants of frailty, which allows adverse events to be avoided. By conducting a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aimed to develop an updated framework for the main measurement tools to assess frailty risks in older adults, paying attention to use in the community and primary care settings. This search focused on the biopsychosocial domains of frailty that are covered in the SUNFRAIL tool. The study selected 178 reviews (polypharmacy: 20; nutrition: 13; physical activity: 74; medical visits: 0; falls: 39; cognitive decline: 12; loneliness: 15; social support: 5; economic constraints: 0) published between January 2010 and December 2021. Within the selected reviews, 123 assessment tools were identified (polypharmacy: 15; nutrition: 15; physical activity: 25; medical visits: 0; falls: 26; cognitive decline: 18; loneliness: 9; social support: 15; economic constraints: 0). The narrative review allowed us to evaluate assessment tools of frailty domains to be adopted for multidimensional health promotion and prevention interventions in community and primary care.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Roberta Patalano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Valeria Formosa
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Grazia Lorusso
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Cristiano Rivetta
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Federica Di Lullo
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Teresa Rea
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Joao Apostolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - Rosa Carla Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | | | | | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
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Reference equations for the six-minute walking distance in obese Chinese subjects more than 40 years old. Eat Weight Disord 2022; 27:2561-2568. [PMID: 35459986 PMCID: PMC9556423 DOI: 10.1007/s40519-022-01404-8] [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: 01/04/2022] [Accepted: 04/05/2022] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND Studies have shown that the reference equations for the six-minute walking distance (6MWD), which were mainly derived from healthy, normal-weight people, are not suitable for individuals with obesity. The main purpose of this study was to establish reference equations for the 6MWD in obese Chinese subjects. METHODS In our study, a total of 214 individuals with obesity performed the six-minute walking tests (6MWTs) according to the American thoracic society (ATS) guidelines, and the longer 6MWD was used for further analysis. The reference equations for the 6MWD were developed using stepwise multiple regression analysis. The newly established equations for the 6MWD were compared to the existing prediction equations. RESULTS The mean 6MWD for the cohort was 523 ± 56 m. We found that the reliability of two 6MWTs was good. Age and BMI were identified as independent factors, and explained 31% and 27% of the variance in the 6MWD for the male and female participants, respectively. Thus, the reference equations reported in the previous studies did not accurately predict the 6MWD in our subjects. CONCLUSION Our study was the first to describe the 6MWD in obese Chinese subjects and to propose new predictive equations. These established equations can improve the assessment of the health of obese Chinese patients whose exercise capacity is affected by the disease. LEVEL OF EVIDENCE III, Cohort study.
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Zhang J, Zou Y, Wang Z, Chen X, Pan J, Yu H, Li E, Zou H. Two-minute walk distance reference equations for middle-aged and elderly Chinese individuals with obesity. PLoS One 2022; 17:e0273550. [PMID: 36001629 PMCID: PMC9401169 DOI: 10.1371/journal.pone.0273550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 08/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective While the six-minute walk test (6MWT) is often used to assess exercise capacity, the less well-known two-minute walk test (2MWT) is more feasible for some patients. In previous studies, we developed reference equations for the two-minute walk distance (2MWD) for healthy Chinese adults. However, our study did not recruit people with obesity, and the reference equations did not apply to participants with a body mass index (BMI) > 30 kg/m2. The main objective of this study was to establish reference equations for the 2MWD among middle-aged and elderly Chinese individuals with obesity. Methods A total of 295 individuals were recruited. The participants underwent two 2MWTs, with the longer of the two 2MWDs used for further analyses. The reference equations for the 2MWD were developed using stepwise multiple regression analysis. The newly established equations for the 2MWD were then compared with the existing equations. Results The mean 2MWD of the participants was 176±20 m. Age and BMI were identified as independent factors that influenced the 2MWD and explained 28% and 32% of the variance in walking distance for the male and female groups, respectively. The reference equations for the 2MWD were as follows: Conclusion This study resulted in the development of reference equations for predicting 2MWD among middle-aged and elderly Chinese people with obesity. These equations will be a clinically valuable tool for evaluating functional capacity, determining prognoses and monitoring treatment in middle-aged and elderly Chinese people with obesity.
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Affiliation(s)
- Jia Zhang
- Department of Medical Inspection, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yingying Zou
- Digestive System Department, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, China
| | - Zibin Wang
- Obstetrics Department, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoshu Chen
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jingye Pan
- Department of General and Intensive Medical Care, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haizhu Yu
- Department of General Practice, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Enci Li
- Nursing Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - He Zou
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail:
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Donini LM, Rosano A, Di Lazzaro L, Poggiogalle E, Lubrano C, Migliaccio S, Carbonelli M, Pinto A, Lenzi A. Validation of the Italian version of the Laval questionnaire: health-related quality of life in subjects with obesity. Health Qual Life Outcomes 2017; 15:101. [PMID: 28506319 PMCID: PMC5432971 DOI: 10.1186/s12955-017-0671-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/28/2017] [Indexed: 01/22/2023] Open
Abstract
Background Obesity is associated to increased risk of metabolic comorbidity as well as increased mortality. Notably, obesity is also associated to the impairment of the psychological status and of quality of life. Only three questionnaires are available in the Italian language evaluating the health-related quality of life in subjects with obesity. The aim of the present study was to test the validity and reliability of the Italian version of the Laval Questionnaire. Methods The original French version was translated into Italian and back-translated by a French native speaker. 273 subjects with obesity (Body Mass Index ≥ 30 kg/m2) were enrolled; the Italian version of the Laval Questionnaire and the O.R.Well-97 questionnaire were administered in order to assess health- related quality of life. The Laval questionnaire consists of 44 items distributed in 6 domains (symptoms, activity/mobility, personal hygiene/clothing, emotions, social interaction, sexual life). Disability and overall psychopathology levels were assessed through the TSD-OC test (SIO test for obesity correlated disabilities) and the SCL-90 (Symptom Checklist-90) questionnaire, respectively. To verify the validity of the Italian version, the analysis of internal consistency, test-retest reliability, and construct validity were performed. Results The observed proportion of agreement concordance of results was 50.2% with Cohen’s K = 0.336 (CI 95%: 0.267–0.404), indicating a fair agreement between the two tests. Test-retest correlation was statistically significant (ρ = 0.82; p < 0.01); validity (standardized Chronbach’s alpha) was considered reliable (α > 0.70). The analysis of construct validity showed a statistically significant association in terms of both total score (ρ = −0.66) and scores at each single domain (p < 0.01). A high correlation (p < 0.01) was observed between Laval questionnaire total and single domain scores and other related measures (Body Mass Index, TSD-OC scores, SCL-90 global severity index), revealing a high construct validity of the test. Conclusions The Italian version of the Laval Questionnaire is a valid and reliable measure to assess the health-related quality of life in subjects with obesity.
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Affiliation(s)
- Lorenzo Maria Donini
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy. .,"Sapienza" University of Rome, Department of Experimental Medicine- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Research Unit, p.le Aldo Moro n.5, 00185, Rome, Italy.
| | | | - Luca Di Lazzaro
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Eleonora Poggiogalle
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Carla Lubrano
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | | | | | - Alessandro Pinto
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Lenzi
- High Specialization Centre for the Care of Obesity ("CASCO"), Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
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