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因 COVID-19 导致的心肺和骨骼肌损伤:紧急呼吁康复治疗。

Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation.

机构信息

Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil.

Department of Physiotherapy, Postgraduate Program in Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Zip-code: Presidente Prudente, SP, Brazil.

出版信息

Expert Rev Respir Med. 2021 Sep;15(9):1107-1120. doi: 10.1080/17476348.2021.1893169. Epub 2021 Mar 4.

Abstract

INTRODUCTION

It has become increasingly evident that COVID-19 contributes to multiorgan pathophysiology. The systemic inflammatory response increases both pro-inflammatory cytokine and chemokine levels, leading to immune dysregulation and increasing the likelihood of incurring cardiac and pulmonary injuries.

AREAS COVERED

Longer periods of hospitalization (~20 days) increase susceptibility to ICU-acquired muscle weakness and deconditioning, which decreases muscle function and functional capacity. These conditions affect the quality of life in the post-COVID-19 period and require multi-disciplinary approaches to rehabilitate the cardiopulmonary and musculoskeletal systems of these patients. In this context, this narrative review, which included articles published in the Embase, PEDro and PubMed databases up to December 2020, is focused on discussing the essential role of exercise and rehabilitation health professionals in the COVID-19 recovery process, from hospitalization to hospital discharge, addressing strategies for professionals to mitigate the cardiac and pulmonary impairments associated with hospitalization to home or ambulatory rehabilitation, purposing ways to conduct rehabilitation programs to restore their functional status and quality of life after the infection.

EXPERT OPINION

In the current environment, these findings further point to the vital role of rehabilitation health professionals in the coming years and the urgent need to develop strategies to assist COVID-19 survivors.

摘要

简介

越来越明显的是,COVID-19 会导致多器官病理生理学改变。全身性炎症反应会增加促炎细胞因子和趋化因子的水平,导致免疫失调,并增加发生心脏和肺部损伤的可能性。

涵盖领域

住院时间延长(~20 天)会增加 ICU 获得性肌肉无力和失健的易感性,从而降低肌肉功能和功能能力。这些情况会影响 COVID-19 后患者的生活质量,需要多学科方法来康复这些患者的心肺和肌肉骨骼系统。在这种情况下,本综述性叙述纳入了截止到 2020 年 12 月发表在 Embase、PEDro 和 PubMed 数据库中的文章,重点讨论了运动和康复健康专业人员在 COVID-19 康复过程中的重要作用,从住院到出院,探讨了专业人员减轻与住院相关的心脏和肺部损伤的策略,以用于制定将患者从住院或门诊康复恢复其功能状态和生活质量的方法。

专家意见

在当前环境下,这些发现进一步表明,康复健康专业人员在未来几年将发挥至关重要的作用,迫切需要制定策略来帮助 COVID-19 幸存者。

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