Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de la Salud, Universidad de Antofagasta, Antofagasta, Chile.
Programa de Magister en Fisiología Clínica del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago, Chile.
J Appl Physiol (1985). 2023 Mar 1;134(3):678-684. doi: 10.1152/japplphysiol.00544.2022. Epub 2023 Feb 2.
Among the people most affected by coronavirus disease 2019 (COVID-19) are those suffering from hypertension (HTN). However, pharmacological therapies for HTN are ineffective against COVID-19 progression and severity. It has been proposed that exercise training (EX) could be used as post-COVID treatment, which does not rule out the possible effects during hospitalization for COVID-19. Therefore, we aimed to determine the impact of supervised EX on HTN patients with COVID-19 during hospitalization. Among a total of 1,508 hospitalized patients with COVID-19 (confirmed by PCR), 439 subjects were classified as having HTN and were divided into two groups: EX ( = 201) and control ( = 238) groups. EX (3-4 times/wk during all hospitalizations) consisted of aerobic exercises (15-45 min; i.e., walking); breathing exercises (10-15 min) (i.e., diaphragmatic breathing, pursed-lip breathing, active abdominal contraction); and musculoskeletal exercises (8-10 sets of 12-15 repetitions/wk; lifting dumbbells, standing up and sitting, lumbar stabilization). Our data revealed that the EX (clinician: patient, 1:1 ratio) intervention was able to improve survival rates among controlled HTN patients with COVID-19 during their hospitalization when compared with the control group (chi-squared: 4.83; hazard ratio: 1.8; 95% CI: 1.117 to 2.899; = 0.027). Multivariate logistic regression analysis revealed that EX was a prognostic marker (odds ratio: 0.449; 95% CI: 0.230-0.874; = 0.018) along with sex and invasive and noninvasive mechanical ventilation. Our data showed that an intrahospital supervised EX program reduced the mortality rate among patients with HTN suffering from COVID-19 during their hospitalization. In the present study, we found that exercise training improves the survival rate in hypertensive patients with COVID-19 during their hospitalization period. Our results provide strong evidence for the therapeutic efficacy of exercise training as a feasible approach to improving the outcomes of patients with COVID-19 who suffer from hypertension during their hospitalization.
在 2019 年冠状病毒病（COVID-19）中受影响最大的人群中，有高血压（HTN）患者。然而，针对 HTN 的药物治疗对 COVID-19 的进展和严重程度无效。有人提出，运动训练（EX）可作为 COVID-19 后的治疗方法，这并不排除在 COVID-19 住院期间可能产生的影响。因此，我们旨在确定住院期间监督下的 EX 对 COVID-19 合并 HTN 患者的影响。在总共 1508 名住院 COVID-19 患者（通过 PCR 确诊）中，有 439 名患者被归类为患有 HTN，并分为两组：EX（n=201）和对照组（n=238）。EX（在所有住院期间每周 3-4 次）包括有氧运动（15-45 分钟；即散步）；呼吸练习（10-15 分钟）（即膈肌呼吸、缩唇呼吸、主动腹部收缩）；和肌肉骨骼练习（每周 8-10 组，每组 12-15 次重复；举重哑铃、站立和坐下、腰椎稳定）。我们的数据显示，与对照组相比，EX（临床医生：患者，1:1 比例）干预能够提高 COVID-19 合并 HTN 患者住院期间的生存率（卡方检验：4.83；风险比：1.8；95%置信区间：1.117 至 2.899；p=0.027）。多变量逻辑回归分析显示，EX 是一个预后标志物（比值比：0.449；95%置信区间：0.230-0.874；p=0.018），与性别以及有创和无创机械通气有关。我们的数据表明，住院期间监督下的 EX 计划降低了 COVID-19 合并 HTN 患者的死亡率。在本研究中，我们发现运动训练可提高住院期间 COVID-19 合并 HTN 患者的生存率。我们的结果为运动训练的治疗效果提供了有力证据，表明这是一种可行的方法，可以改善住院期间患有高血压的 COVID-19 患者的结局。
