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严重和危重新冠肺炎患者肺康复的疗效:一项对照研究。

Effectiveness of Pulmonary Rehabilitation in Severe and Critically Ill COVID-19 Patients: A Controlled Study.

机构信息

Barmelweid Academy, Klinik Barmelweid AG, 5017 Barmelweid, Switzerland.

Department of Therapeutics, Klinik Barmelweid AG, 5017 Barmelweid, Switzerland.

出版信息

Int J Environ Res Public Health. 2021 Aug 25;18(17):8956. doi: 10.3390/ijerph18178956.

Abstract

BACKGROUND

Severe and critically ill COVID-19 patients frequently need pulmonary rehabilitation (PR) after hospitalization. However, little is known about the effectiveness of PR in COVID-19 patients.

METHODS

We compared the performances in the six-min walk test (6MWT), chronic respiratory questionnaire (CRQ), and Functional Independence Measure (FIM) from inpatient PR between 51 COVID-19 patients and 51 other patients with common pneumonia. We used multivariate linear regression controlled for baseline values at entrance, age, sex, and cumulative illness rating scale. The odds ratios (ORs) of non-improvement/improvement in 6MWT (>30-m) and CRQ (>10-point) at discharge were compared between the two groups (Fisher's exact test).

RESULTS

The two groups had similar improvements in 6MWT and CRQ, but the COVID-19 group achieved a 4-point higher FIM (-value = 0.004). The OR of non-improvement/improvement in 6MWT was 0.30 (-value = 0.13) between COVID-19 and controls; however, the odds of non-improvement in CRQ tended to be 3.02 times higher (-value = 0.075) in COVID-19 patients. Severe and critical COVID-19 patients had similar rehabilitation outcomes.

CONCLUSIONS

Inpatient PR can effectively improve physical functions and life quality in COVID-19 patients, irrespective of disease severity. Whether the relatively low gains in CRQ is an indicator of chronic disease development in COVID-19 patients needs further studies.

摘要

背景

严重和危重症 COVID-19 患者住院后经常需要进行肺康复(PR)。然而,对于 COVID-19 患者 PR 的有效性知之甚少。

方法

我们比较了 51 例 COVID-19 患者和 51 例普通肺炎患者住院 PR 时的 6 分钟步行试验(6MWT)、慢性呼吸系统问卷(CRQ)和功能独立性测量(FIM)的表现。我们使用多元线性回归控制了入院时的基线值、年龄、性别和累积疾病评分量表。比较了两组患者出院时 6MWT(>30m)和 CRQ(>10 分)改善/无改善的比值比(OR)(Fisher 精确检验)。

结果

两组患者的 6MWT 和 CRQ 均有相似的改善,但 COVID-19 组的 FIM 提高了 4 分(-值=0.004)。COVID-19 与对照组相比,6MWT 改善/无改善的 OR 为 0.30(-值=0.13);然而,COVID-19 患者的 CRQ 无改善的可能性高出 3.02 倍(-值=0.075)。严重和危重症 COVID-19 患者的康复结果相似。

结论

住院 PR 可有效改善 COVID-19 患者的身体功能和生活质量,无论疾病严重程度如何。CRQ 相对较低的改善是否是 COVID-19 患者慢性疾病发展的指标,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bc7/8430691/5a5c90511daf/ijerph-18-08956-g001.jpg

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