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重度新冠后心肺康复:关于患者特征及与锻炼强度相关的恢复动态的综合研究

Post-Severe-COVID-19 Cardiopulmonary Rehabilitation: A Comprehensive Study on Patient Features and Recovery Dynamics in Correlation with Workout Intensity.

作者信息

Dumitrescu Andreea, Doros Gabriela, Lazureanu Voichita Elena, Septimiu-Radu Susa, Bratosin Felix, Rosca Ovidiu, Patel Harshkumar, Porosnicu Tamara Mirela, Vitcu Gabriela Mut, Mirea Andrei, Oancea Cristian, Mihaicuta Stefan, Stoicescu Emil Robert, Barata Paula Irina

机构信息

Cardioprevent Foundation, Calea Dorobantilor 3, 300134 Timisoara, Romania.

Third Discipline of Pediatrics, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.

出版信息

J Clin Med. 2023 Jun 29;12(13):4390. doi: 10.3390/jcm12134390.

Abstract

The aftermath of severe COVID-19 frequently involves considerable cardiopulmonary damage, necessitating rehabilitation. This study aimed to evaluate the impact of COVID-19 on cardiopulmonary health and assess the effectiveness of various rehabilitative interventions. Conducted between September 2021 and September 2022, this prospective study included patients who had been diagnosed with severe COVID-19 and admitted at the "Victor Babes" Infectious Diseases and Pulmonology Hospital, Timisoara, Romania. The patients were stratified into low- and high-intensity rehabilitation groups. The rehabilitation protocols were individually tailored, and the patient recovery was closely monitored over a 3-month period. Our cohort comprised 84 patients, with a mean age of 56.3 years for the low-intensity group ( = 42) and 53.1 years for the high-intensity group ( = 42). Both groups showed significant improvements in the lung injury area, need for oxygen supplementation, ejection fraction, systolic pulmonary artery pressure, and forced vital capacity. Additionally, considerable enhancements were observed in maximal voluntary ventilation, FEV1, FEV1/FVC ratio, peak expiratory flow, and forced expiratory flow at 25-75%. The work intensity also demonstrated substantial improvements from the initial testing to the 3-month mark in both groups. This study provides evidence that personalized, targeted rehabilitation strategies can improve long-term cardiopulmonary health in patients recovering from severe COVID-19, proving both low-intensity and high-intensity training as sufficient to improve heart and lung function if performed correctly and over a relatively short duration of 3 months. The study findings underscore the importance of implementing comprehensive cardiopulmonary rehabilitation protocols in the care of post-COVID-19 patients and highlight the value of stratified rehabilitation intensity based on individual patient dynamics and recovery features.

摘要

重症新型冠状病毒肺炎(COVID-19)的后遗症常常涉及相当严重的心肺损伤,因此需要进行康复治疗。本研究旨在评估COVID-19对心肺健康的影响,并评估各种康复干预措施的有效性。这项前瞻性研究于2021年9月至2022年9月期间进行,纳入了在罗马尼亚蒂米什瓦拉的“维克托·巴比什”传染病与肺病医院确诊为重症COVID-19并入院治疗的患者。患者被分为低强度和高强度康复组。康复方案是根据个体情况量身定制的,并在3个月的时间内密切监测患者的恢复情况。我们的队列包括84名患者,低强度组(n = 42)的平均年龄为56.3岁,高强度组(n = 42)的平均年龄为53.岁。两组在肺损伤面积、吸氧需求、射血分数、收缩期肺动脉压和用力肺活量方面均有显著改善。此外,在最大自主通气量、第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)比值、呼气峰值流速以及25%-75%用力呼气流量方面也有相当大的提高。两组从初始测试到3个月时的工作强度也都有显著改善。本研究提供了证据,表明个性化、有针对性的康复策略可以改善重症COVID-19康复患者的长期心肺健康,证明如果正确实施且在相对较短的3个月时间内进行,低强度和高强度训练都足以改善心肺功能。研究结果强调了在COVID-19后患者护理中实施全面心肺康复方案的重要性,并突出了根据个体患者动态和恢复特征进行分层康复强度的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20eb/10342827/3dc92ee939e3/jcm-12-04390-g001.jpg

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