O'Sullivan Oliver, Holdsworth David A, Ladlow Peter, Barker-Davies Robert M, Chamley Rebecca, Houston Andrew, May Samantha, Dewson Dominic, Mills Daniel, Pierce Kayleigh, Mitchell James, Xie Cheng, Sellon Edward, Naylor Jon, Mulae Joseph, Cranley Mark, Talbot Nick P, Rider Oliver J, Nicol Edward D, Bennett Alexander N
Academic Department of Military Rehabilitation (ADMR), Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, LE12 5QW, UK.
Academic Unit of Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UK.
Sports Med Open. 2023 Feb 2;9(1):7. doi: 10.1186/s40798-023-00552-0.
The COVID-19 pandemic has led to significant morbidity and mortality, with the former impacting and limiting individuals requiring high physical fitness, including sportspeople and emergency services.
Observational cohort study of 4 groups: hospitalised, community illness with on-going symptoms (community-symptomatic), community illness now recovered (community-recovered) and comparison. A total of 113 participants (aged 39 ± 9, 86% male) were recruited: hospitalised (n = 35), community-symptomatic (n = 34), community-recovered (n = 18) and comparison (n = 26), approximately five months following acute illness. Participant outcome measures included cardiopulmonary imaging, submaximal and maximal exercise testing, pulmonary function, cognitive assessment, blood tests and questionnaires on mental health and function.
Hospitalised and community-symptomatic groups were older (43 ± 9 and 37 ± 10, P = 0.003), with a higher body mass index (31 ± 4 and 29 ± 4, P < 0.001), and had worse mental health (anxiety, depression and post-traumatic stress), fatigue and quality of life scores. Hospitalised and community-symptomatic participants performed less well on sub-maximal and maximal exercise testing. Hospitalised individuals had impaired ventilatory efficiency (higher VE/V̇CO slope, 29.6 ± 5.1, P < 0.001), achieved less work at anaerobic threshold (70 ± 15, P < 0.001) and peak (231 ± 35, P < 0.001), and had a reduced forced vital capacity (4.7 ± 0.9, P = 0.004). Clinically significant abnormal cardiopulmonary imaging findings were present in 6% of hospitalised participants. Community-recovered individuals had no significant differences in outcomes to the comparison group.
Symptomatically recovered individuals who suffered mild-moderate acute COVID-19 do not differ from an age-, sex- and job-role-matched comparison population five months post-illness. Individuals who were hospitalised or continue to suffer symptoms may require a specific comprehensive assessment prior to return to full physical activity.
新冠疫情导致了严重的发病率和死亡率，前者对包括运动员和应急服务人员在内的需要高身体素质的个体产生影响并造成限制。
对四组进行观察性队列研究：住院患者、有持续症状的社区患病者（社区有症状者）、现已康复的社区患病者（社区康复者）以及对照组。共招募了113名参与者（年龄39±9岁，86%为男性）：住院患者（n = 35）、社区有症状者（n = 34）、社区康复者（n = 18）和对照组（n = 26），在急性病发作约五个月后进行研究。参与者的结局指标包括心肺成像、次最大和最大运动测试、肺功能、认知评估、血液检查以及关于心理健康和功能的问卷调查。
住院患者组和社区有症状者组年龄更大（分别为43±9岁和37±10岁，P = 0.003），体重指数更高（分别为31±4和29±4，P < 0.001），心理健康状况（焦虑、抑郁和创伤后应激）、疲劳和生活质量评分更差。住院患者和社区有症状者在次最大和最大运动测试中的表现较差。住院患者的通气效率受损（VE/V̇CO斜率更高，29.6±5.1，P < 0.001），在无氧阈值时完成的功更少（70±15，P < 0.001），在峰值时完成的功也更少（231±35，P < 0.001），且用力肺活量降低（4.7±0.9，P = 0.004）。6%的住院患者存在具有临床意义的心肺成像异常发现。社区康复者与对照组在结局方面无显著差异。
患有轻中度急性新冠的症状性康复个体在患病五个月后与年龄、性别和工作角色匹配的对照组人群没有差异。住院或仍有症状的个体在恢复全面身体活动之前可能需要进行特定的综合评估。
