Baratto Claudia, Dewachter Céline, Caravita Sergio, Zambon Antonella, Bondue Antoine, Parati Gianfranco, Vachiéry Jean-Luc
Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano IRCCS Ospedale San Luca Milano Italy.
Department of Cardiology, Hôpital Académique Erasme Cliniques Universitaires de Bruxelles Bruxelles Belgium.
Pulm Circ. 2022 Jul 1;12(3):e12089. doi: 10.1002/pul2.12089. eCollection 2022 Jul.
The outbreak of novel coronavirus-19 disease (COVID-19) was classified as a global pandemic thanks to the rapid viral spread, and restrictive policy measures of infection containment, including "lockdown" periods and self-isolation, were first instituted in Belgium from March to June 2020. The consequent reduction in physical activity could have a negative impact on exercise capacity, especially in frail patients with pre-existing chronic diseases, such as pulmonary arterial hypertension (PAH). With the aim to define the impact of COVID-19 lockdown on functional status, we included in our observational analysis clinically stable PAH patients, who had performed at least four consecutive 6-min walking tests (6MWT) during 2019-2020, to compare their exercise performance before and after the lockdown. In the 63 patients included, a comparison between the distance covered at 6MWT after the lockdown period and the pooled mean of the previous three 6MWTs showed a mean reduction of 14 m after the lockdown (= 0.004). Moreover, the mean distance covered at 6MWT went from 447 m in March 2020 to 434 m in June 2020, with a significant average loss of 13 m (= 0.024). Our results showed that PAH patients were less performing at 6MWT after 3 months of reduced physical activity, despite constant clinical stability and the absence of signs of disease progression, suggesting that this confounding factor should be kept in mind when evaluating changes in 6MWT during or after COVID-19 pandemic.
新型冠状病毒19疾病（COVID-19）的爆发因其病毒的迅速传播而被列为全球大流行，2020年3月至6月，比利时率先采取了包括“封锁”期和自我隔离在内的限制感染控制政策措施。随之而来的身体活动减少可能会对运动能力产生负面影响，尤其是对于患有肺动脉高压（PAH）等慢性疾病的体弱患者。为了确定COVID-19封锁对功能状态的影响，我们在观察性分析中纳入了临床稳定的PAH患者，这些患者在2019 - 2020年期间至少连续进行了四次6分钟步行试验（6MWT），以比较封锁前后他们的运动表现。在纳入的63例患者中，封锁期后6MWT所走距离与前三次6MWT的合并平均值相比，封锁后平均减少了14米（= 0.004）。此外，6MWT的平均行走距离从2020年3月的447米降至2020年6月的434米，平均显著减少了13米（= 0.024）。我们的结果表明，尽管临床保持稳定且没有疾病进展迹象，但PAH患者在身体活动减少3个月后，6MWT的表现较差，这表明在评估COVID-19大流行期间或之后6MWT的变化时，应考虑到这一混杂因素。
