Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Division of the Institute of Lumezzane, Via G Mazzini 129, 25065 Lumezzane (Brescia), Italy.
Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Division of the Institute of Montescano, Pavia, Italy.
Pulmonology. 2021 Nov-Dec;27(6):518-528. doi: 10.1016/j.pulmoe.2021.06.005. Epub 2021 Jun 24.
There is evidence of short- and long-term impairment of physical performance in patients with COVID-19 infection, but a verification of measures of physical impairment in this condition is lacking. We reviewed the measures used to assess physical performance in these patients. Secondary targets were measures of exercise or daily life activities induced symptoms.
Medline, CINAHL, and Pedro databases were searched from January 2020 to February 2021 for articles in the English language. Two investigators independently conducted the search, screened all titles and/or abstracts based on the inclusion criteria and independently scored the studies. The quality of the studies was evaluated by two reviewers according to the NIH quality assessment tool for observational cohort and cross-sectional studies. Discrepancies were resolved through consensus.
Out of 156 potentially relevant articles, 31 observational studies (8 cross-sectional), 1 randomized controlled trial, and 1 protocol were included. The quality of most of the 31 evaluable studies was judged as low (11 studies) or fair (14 studies). Sample sizes of the studies ranged from 14 to 20,889 patients. among the 28 reported measures, Barthel Index (42.4% of studies), Six-Minute Walking Distance Test (36.4%), Short Physical Performance Battery (21.2%) and 1-Minute Sit-to-Stand (12.1%) were the most used. Fifteen% and 36% of studies reported exercise induced desaturation and dyspnoea when performing the assessments, respectively. Other exercise induced symptoms were fatigue and pain. Studies reported wide ranges of impairment in physical performance as compared to "reference" values (range of mean or median reported values vs "reference values": 11-77 vs 100 points for Barthel Index; 11-22 vs 22-37 repetitions/min for 1m-STS; 0.5-7.9 vs 11.4 ± 1.3 points for SPPB; and 45-223 vs 380-782 m for 6MWT respectively).
This review found that a wide variety of functional status tests have been used, making comparisons difficult between studies. These measures show impairment in physical performance in COVID-19 patients. However, the quality of most of the studies was judged as low or fair.
有证据表明，COVID-19 感染患者的身体机能会出现短期和长期的损害，但目前缺乏对此类疾病身体损害评估手段的验证。我们回顾了用于评估这些患者身体机能的方法。次要目标是评估运动或日常生活活动引起的症状的方法。
2020 年 1 月至 2021 年 2 月，我们在 Medline、CINAHL 和 Pedro 数据库中以英文检索了相关文献。两名调查员独立进行了检索，根据纳入标准筛选所有标题和/或摘要，并独立对研究进行评分。两名审查员根据 NIH 观察性队列和横断面研究质量评估工具评估研究质量。通过协商解决分歧。
在 156 篇可能相关的文章中，纳入了 31 项观察性研究（8 项为横断面研究）、1 项随机对照试验和 1 项方案。在 31 项可评估研究中，大多数研究的质量被评为低（11 项）或一般（14 项）。研究样本量从 14 到 20889 名患者不等。在所报告的 28 项措施中，最常用的是 Barthel 指数（42.4%的研究）、6 分钟步行试验（36.4%）、简短体能测试（21.2%）和 1 分钟坐站测试（12.1%）。分别有 15%和 36%的研究报告在进行评估时运动引起的低氧血症和呼吸困难，其他运动引起的症状有疲劳和疼痛。与“参考值”相比，研究报告的身体机能障碍程度差异很大（报告的平均或中位数与“参考值”的范围：Barthel 指数为 11-77 与 100 分；1 分钟坐站测试为 11-22 与 22-37 次/分钟；SPPB 为 0.5-7.9 与 11.4±1.3 分；6MWT 为 45-223 与 380-782 米）。
本综述发现，已经使用了多种不同的功能状态测试，这使得研究之间的比较变得困难。这些方法表明 COVID-19 患者的身体机能受损。然而，大多数研究的质量被评为低或一般。
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