Larrateguy Santiago, Vinagre Julian, Londero Federico, Dabin Johana, Ricciardi Evangelina, Jeanpaul Santiago, Torres-Castro Rodrigo, Núñez-Cortés Rodrigo, Sánchez-Ramírez Diana, Gimeno-Santos Elena, Blanco Isabel
Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada "Dra. Teresa Ratto", Paraná 3100, Argentina.
Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin 3103, Argentina.
Biomedicines. 2023 Jul 20;11(7):2051. doi: 10.3390/biomedicines11072051.
Impaired functional capacity is one of the most commonly reported consequences among post-COVID-19 patients. This study aimed to analyse the clinical variables related to functional capacity and exertional desaturation in post-COVID-19 patients at the time of hospital discharge. A cross-sectional study was conducted on patients recovering from COVID-19 pneumonia. The main outcomes measures were functional capacity, assessed using the 1 min sit-to-stand test (1 min STST), and exertional desaturation, defined as a drop of ≥4% in the arterial oxygen saturation. Factors used to characterise the participant outcomes included the use of a high-flow nasal cannula (HFNC), prolonged hospitalisation, occurrence of pulmonary embolism during hospitalisation, and underlying comorbidities. A total of 381 participants (mean age = 53.7 ± 13.2 years, 65.6% men) were included. Participants completed a mean of 16.9 ± 6.2 repetitions in the 1 min STST. Exertional desaturation was observed in 51% of the patients. Higher odds of exertional desaturation were found in the participants who used a HFNC (OR = 3.6; 95%CI: 1.6 to 7.8), were admitted in the hospital >10 days (OR = 4.2; 95%CI: 2.6 to 6.8), and had a pulmonary embolism (OR = 3.5; 95%CI: 2.2. to 5.3). Use of a HFNC (β = -3.4; 95%CI: -5.3 to -1.44), a hospital stay >10 days (β = -2.2; 95%CI: -3.4 to -0.9), and a history of pulmonary embolism (β = -1.4; 95%CI: -2.6 to -0.2) were also negatively associated with the 1 min STST. Most post-COVID-19 patients exhibited reduced functional capacity at the time of hospital discharge, and approximately half had exertional desaturation after the 1 min STST. The use of a HFNC, prolonged hospitalisation and pulmonary embolism were the main clinical variables associated with worse a 1 min STST performance and a higher likelihood of exertional desaturation.
功能能力受损是新冠病毒感染后患者中最常报告的后果之一。本研究旨在分析新冠病毒感染后患者出院时与功能能力和运动性低氧血症相关的临床变量。对从新冠病毒肺炎中康复的患者进行了一项横断面研究。主要结局指标为功能能力，采用1分钟坐立试验（1 min STST）进行评估，以及运动性低氧血症，定义为动脉血氧饱和度下降≥4%。用于描述参与者结局的因素包括使用高流量鼻导管（HFNC）、住院时间延长、住院期间发生肺栓塞以及基础合并症。共纳入381名参与者（平均年龄 = 53.7 ± 13.2岁，65.6%为男性）。参与者在1分钟坐立试验中平均完成16.9 ± 6.2次重复动作。51%的患者出现运动性低氧血症。在使用HFNC的参与者中发现运动性低氧血症的几率更高（OR = 3.6；95%CI：1.6至7.8），住院时间>10天的参与者（OR = 4.2；95%CI：2.6至6.8），以及发生肺栓塞的参与者（OR = 3.5；95%CI：2.2至5.3）。使用HFNC（β = -3.4；95%CI：-5.3至-1.44）、住院时间>10天（β = -2.2；95%CI：-3.4至-0.9）以及有肺栓塞病史（β = -1.4；95%CI：-2.6至-0.2）也与1分钟坐立试验呈负相关。大多数新冠病毒感染后患者出院时功能能力下降，约一半患者在1分钟坐立试验后出现运动性低氧血症。使用HFNC、住院时间延长和肺栓塞是与1分钟坐立试验表现较差和运动性低氧血症可能性较高相关的主要临床变量。
