Research Program in Men's Health: Aging and Metabolism; Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Am Geriatr Soc. 2021 Jan;69(1):12-17. doi: 10.1111/jgs.16968. Epub 2020 Dec 19.
Physical performance measures, including cardiopulmonary exercise testing (CPXT), are widely used in geriatric practice and aging research. Theoretically, research participants and study personnel could get infected in the closed environment of the exercise laboratory by contact with respiratory droplets from an infected person, by breathing virus-laden aerosols, or by touching fomites. Older adults are at increased risk of developing more severe disease and of dying from SARS-CoV-2 infection. This special article offers guidance-informed by a synthesis of scientific data and recommendations of the CDC and WHO-on procedures that can be implemented in exercise laboratories to minimize risk of SARS-CoV-2 and other respiratory infections. Most tests of physical function (e.g., gait speed, Short Physical Performance Battery) are not aerosol-generating and are associated with only a small increase in minute ventilation; in contrast, CPXT markedly increases minute ventilation and is potentially aerosol-generating. Researchers should evaluate the benefit-to-risk ratio of information gained from the laboratory assessment versus the risk of SARS-CoV2 infection. Risk mitigation strategies described here fall into four categories: personal hygiene and the use of personal protective equipment; standardized screening; reconfiguration of laboratory space; and optimization of laboratory ventilation. The proposed safety measures are not intended to replace institutional policy, state, or federal guidelines; they may not apply to all settings and are expected to evolve as more definitive information becomes available. These practical measures to maximize protection against SARS-CoV2 infection can help maximize participant and staff safety, reduce anxiety, and facilitate protocol adherence, and study integrity.
体能测试指标，包括心肺运动测试（CPXT），在老年医学实践和衰老研究中得到广泛应用。从理论上讲，研究参与者和研究人员可能会在运动实验室的封闭环境中通过与感染者的呼吸道飞沫接触、吸入含病毒的气溶胶或接触污染物而感染。老年人感染 SARS-CoV-2 后出现更严重疾病和死亡的风险增加。本文提供了指导，综合了科学数据以及美国疾病控制与预防中心和世界卫生组织的建议，介绍了可以在运动实验室中实施的程序，以最大程度地降低 SARS-CoV-2 和其他呼吸道感染的风险。大多数身体功能测试（例如，步态速度、简短体能测试电池）不会产生气溶胶，并且仅增加少量分钟通气量；相比之下，CPXT 会明显增加分钟通气量，并且可能会产生气溶胶。研究人员应评估从实验室评估中获得的信息与 SARS-CoV2 感染风险的获益与风险比。这里描述的风险缓解策略分为四类：个人卫生和使用个人防护设备；标准化筛查；重新配置实验室空间；以及优化实验室通风。拟议的安全措施并非旨在替代机构政策、州或联邦准则；它们可能不适用于所有环境，并且预计会随着更明确的信息的出现而不断发展。这些最大程度减少 SARS-CoV2 感染风险的实用措施可以帮助最大程度地保护参与者和员工的安全、减轻焦虑并促进协议遵守和研究完整性。
