Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain.
Department of Experimental Science and Healthcare, Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
J Cachexia Sarcopenia Muscle. 2021 Aug;12(4):1056-1063. doi: 10.1002/jcsm.12739. Epub 2021 Jun 8.
There is limited information about the impact of coronavirus disease (COVID-19) on the muscular dysfunction, despite the generalized weakness and fatigue that patients report after overcoming the acute phase of the infection. This study aimed to detect impaired muscle efficiency by evaluating delta efficiency (DE) in patients with COVID-19 compared with subjects with chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), and control group (CG).
A total of 60 participants were assigned to four experimental groups: COVID-19, COPD, IHD, and CG (n = 15 each group). Incremental exercise tests in a cycle ergometer were performed to obtain peak oxygen uptake (VO peak). DE was obtained from the end of the first workload to the power output where the respiratory exchange ratio was 1.
A lower DE was detected in patients with COVID-19 and COPD compared with those in CG (P ≤ 0.033). However, no significant differences were observed among the experimental groups with diseases (P > 0.05). Lower VO peak, peak ventilation, peak power output, and total exercise time were observed in the groups with diseases than in the CG (P < 0.05). A higher VO , ventilation, and power output were detected in the CG compared with those in the groups with diseases at the first and second ventilatory threshold (P < 0.05). A higher power output was detected in the IHD group compared with those in the COVID-19 and COPD groups (P < 0.05) at the first and second ventilatory thresholds and when the respiratory exchange ratio was 1. A significant correlation (P < 0.001) was found between the VO peak and DE and between the peak power output and DE (P < 0.001).
Patients with COVID-19 showed marked mechanical inefficiency similar to that observed in COPD and IHD patients. Patients with COVID-19 and COPD showed a significant decrease in power output compared to IHD during pedalling despite having similar response in VO at each intensity. Resistance training should be considered during the early phase of rehabilitation.
尽管患者在克服感染的急性期后会报告普遍的虚弱和疲劳，但关于冠状病毒病 (COVID-19) 对肌肉功能障碍的影响的信息有限。本研究旨在通过评估 COVID-19 患者的德尔塔效率 (DE) 与慢性阻塞性肺疾病 (COPD)、缺血性心脏病 (IHD) 和对照组 (CG) 相比，检测肌肉效率受损的情况。
共有 60 名参与者被分配到四个实验组：COVID-19、COPD、IHD 和 CG（每组 15 人）。在循环测功仪上进行递增运动测试以获得峰值摄氧量 (VO peak)。DE 是从第一个工作负荷结束到呼吸交换比为 1 时的功率输出获得的。
与 CG 相比，COVID-19 和 COPD 患者的 DE 较低（P ≤ 0.033）。然而，实验组之间的疾病（P > 0.05）没有显著差异。与 CG 相比，患有疾病的组中的 VO peak、峰值通气量、峰值功率输出和总运动时间较低（P < 0.05）。在第一和第二通气阈值时，CG 中的 VO、通气和功率输出高于疾病组（P < 0.05）。在第一和第二通气阈值以及呼吸交换比为 1 时，IHD 组的功率输出高于 COVID-19 和 COPD 组（P < 0.05）。在 VO peak 和 DE 之间以及在峰值功率输出和 DE 之间发现了显著的相关性（P < 0.001）。
COVID-19 患者表现出明显的机械效率低下，类似于 COPD 和 IHD 患者。与 IHD 相比，COVID-19 和 COPD 患者在踩踏时的功率输出明显降低，尽管在每个强度下的 VO 反应相似。在康复的早期阶段应考虑进行抗阻训练。
