University Cesumar, Maringa, Parana, Brazil.
Graduate Program in Health Promotion, University Cesumar, Maringa, Paraná, Brazil.
Sci Rep. 2023 Oct 17;13(1):17615. doi: 10.1038/s41598-023-44738-8.
COVID-19 sequelae are varied, and whether they are temporary or permanent is still unknown. Identifying these sequelae may guide therapeutic strategies to improve these individuals' recovery. This prospective cohort aimed to assess body composition, cardiopulmonary fitness, and long-term symptoms of overweight individuals affected by COVID-19. Participants (n = 90) were divided into three groups according to the severity of acute COVID-19: mild (no hospitalization), moderate (hospitalization, without oxygen support), and severe/critical cases (hospitalized in Intensive Care Unit). We assessed body composition with a tetrapolar multifrequency bioimpedance, hemodynamic variables (heart rate, blood pressure, and peripheral oxygen saturation-SpO) at rest, and the Bruce test with direct gas exchange. Two assessments with a one-year interval were performed. The most prevalent long-term symptoms were memory deficit (66.7%), lack of concentration (51.7%), fatigue (65.6%), and dyspnea (40%). Bruce test presented a time effect with an increase in the distance walked after 1 year just for severe/critical group (p < 0.05). SpO was significantly lower in the severe/critical group up to 5 min after the Bruce test when compared to the mild group, and diastolic blood pressure at the end of the Bruce test was significantly higher in the severe/critical group when compared to mild group (p < 0.05; for all comparisons). A time effect was observed for body composition, with increased lean mass, skeletal muscle mass, fat-free mass, and lean mass just for the severe/critical group after 1 year (p < 0.05). Cardiopulmonary fitness parameters did not differ among the groups, except for respiratory quotient with higher values for the severe/critical group when compared to itself after 1 year. All COVID-19 patients might present long-term sequelae, regardless of the acute disease severity. Reassessing and identifying the most prevalent long-term sequelae are essential to perform more precise health promotion interventions.
新冠后遗症表现多样,其是否为永久性仍未知。明确这些后遗症有助于指导治疗策略,从而改善患者的康复情况。本前瞻性队列研究旨在评估超重新冠患者的身体成分、心肺功能和长期症状。根据新冠急性感染的严重程度,将 90 名参与者分为三组:轻症(未住院)、中症(住院,无需吸氧支持)和重症/危重症(入住重症监护病房)。我们使用四极多频生物阻抗仪评估身体成分,在休息时测量血流动力学变量(心率、血压和外周血氧饱和度-SpO),并进行 Bruce 测试和直接气体交换。在一年的时间间隔内进行两次评估。最常见的长期症状是记忆障碍(66.7%)、注意力不集中(51.7%)、疲劳(65.6%)和呼吸困难(40%)。Bruce 测试存在时间效应,即重症/危重症组在 1 年后行走距离增加(p<0.05)。与轻症组相比,重症/危重症组在 Bruce 测试后 5 分钟内的 SpO 显著降低,重症/危重症组在 Bruce 测试结束时的舒张压显著高于轻症组(p<0.05;所有比较)。身体成分存在时间效应,即重症/危重症组在 1 年后的瘦体重、骨骼肌质量、去脂体重和瘦体重增加(p<0.05)。各组心肺功能参数无差异,除重症/危重症组在 1 年后的呼吸商较高外。所有新冠患者都可能出现长期后遗症,无论急性疾病的严重程度如何。重新评估和确定最常见的长期后遗症对于实施更精确的健康促进干预至关重要。