Blokland Ilse J, Ilbrink Shanna, Houdijk Han, Dijkstra Jan-Willem, van Bennekom Coen A M, Fickert Richard, de Lijster René, Groot Floor P
Heliomare, afd. Research & Development, Wijk aan Zee.
Contact: Ilse J. Blokland (
Ned Tijdschr Geneeskd. 2020 Oct 29;164:D5253.
To safely and effectively train the exercise capacity of post-COVID-19 patients it is important to test for cardiopulmonary risk factors and to assess exercise limitations. The goal of this study was to describe the exercise capacity and underlying exercise limitations of mechanically ventilated post-COVID-19 patients in clinical rehabilitation.
A retrospective cohort study.
Twenty-four post-COVID-19patients that were mechanically ventilated at ICU and thereafter admitted for clinical rehabilitation performed a symptom-limited cardiopulmonary exercise test (CPET) with breath-by-breath gas-exchange monitoring, ECG-registration, blood pressure- and saturation monitoring. In absence of a primary cardiac or ventilatory exercise limitation patients were considered to be limited primarily by decreased peripheral muscle mass.
Twenty-three patients could perform a maximal exercise test and no adverse events occurred. Cardiorespiratory fitness was very poor with a median peak oxygen uptake of 15.0 [10.1-21.4] mlO2/kg/min (57% of predicted values). However, we observed large differences within the group in both exercise capacity and exercise limitations. While 7/23 patients were primarily limited by ventilatory function, the majority (70%) was limited primarily by the decreased peripheral muscle mass.
Cardiorespiratory fitness of post-COVID-19 patients in clinical rehabilitation is strongly deteriorated. The majority of patients seemed primarily limited for exercise by the decreased peripheral muscle mass.
为安全有效地训练新冠病毒感染康复患者的运动能力，检测心肺危险因素并评估运动受限情况至关重要。本研究的目的是描述临床康复中接受机械通气的新冠病毒感染康复患者的运动能力及潜在运动受限情况。
一项回顾性队列研究。
24例在重症监护病房接受机械通气并随后入院进行临床康复的新冠病毒感染康复患者进行了症状限制心肺运动试验（CPET），同时进行逐次呼吸气体交换监测、心电图记录、血压和饱和度监测。若不存在原发性心脏或通气运动受限，则认为患者主要受外周肌肉量减少的限制。
23例患者能够进行最大运动试验，且未发生不良事件。心肺适能非常差，峰值摄氧量中位数为15.0[10.1 - 21.4]mlO₂/kg/min（为预测值的57%）。然而，我们观察到该组患者在运动能力和运动受限方面存在很大差异。虽然23例患者中有7例主要受通气功能限制，但大多数（70%）主要受外周肌肉量减少的限制。
临床康复中的新冠病毒感染康复患者心肺适能严重恶化。大多数患者似乎主要因外周肌肉量减少而限制运动。
