Nascimento Emilia Raposo, Parazzi Paloma Lopes Francisco, Marson Fernando Augusto Lima, Ribeiro Maria Ângela Gonçalves Oliveira, Gomez Carla Cristina Sousa, Conti Patrícia Blau Margosian, Siqueira Bianca Aparecida, Silva Edvane Aparecida Braz Araújo, Ribeiro José Dirceu
Center for Research in Pediatrics, University of Campinas, Campinas 13083-871, SP, Brazil.
Laboratory of Molecular Biology and Genetics, Laboratory of Clinical and Molecular Microbiology, LunGuardian Research Group-Epidemiology of Respiratory and Infectious Diseases, Postgraduate Program in Health Science, São Francisco University, Bragança Paulista 12916-900, SP, Brazil.
Clin Pract. 2025 Apr 2;15(4):73. doi: 10.3390/clinpract15040073.
The coronavirus disease (COVID-19) pandemic was associated with an intense impact on health worldwide. Among the sequelae, it became necessary to clarify respiratory impairment related to lung function and aerobic capacity, as well as the treatment of curative and preventive measures of pulmonary involvement. In this context, this study aimed to compare vital signs, the sensation of dyspnea (Borg scale), lung function, and exercise tolerance before and after the use of non-invasive mechanical ventilation (NIV) in adults of both sexes after acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A cross-sectional analytical clinical study was performed with the inclusion of individuals who had been diagnosed with COVID-19 at least three months before data collection. Individuals were evaluated for vital signs (heart rate and peripheral oxygen saturation), Borg scale, spirometry, and submaximal exercise protocol of two minutes of the step test before and after receiving NIV in ventilation mode by continuous positive airway pressure of 6 cm HO for 30 min. A total of 50 participants were enrolled and grouped as a mild (N = 25) or severe (N = 25) clinical phenotype during SARS-CoV-2 infection according to the criteria of the World Health Organization. In our data, the forced vital capacity ( < 0.001), the ratio between the forced expiratory volume in the first one second to the forced vital capacity and the forced vital capacity ( = 0.020), and the two-minute submaximal step exercise protocol (number of steps- = 0.001) showed a statistical improvement in the severe clinical phenotype group after NIV. In addition, forced expiratory volume in the first one second to the forced vital capacity ( = 0.032) and the two-minute submaximal step exercise protocol (number of steps- < 0.001) showed a statistical improvement in the mild clinical phenotype group after NIV. No changes were described for vital signs and the Borg scale. This study allowed us to identify that NIV is a tool that promotes better exercise capacity by increasing the number of steps achieved in both clinical phenotype groups and improving lung function observed in the spirometry markers.
冠状病毒病（COVID-19）大流行对全球健康产生了巨大影响。在后遗症中，有必要阐明与肺功能和有氧运动能力相关的呼吸功能损害，以及肺部受累的治疗和预防措施。在此背景下，本研究旨在比较严重急性呼吸综合征冠状病毒2（SARS-CoV-2）急性感染后成年男女使用无创机械通气（NIV）前后的生命体征、呼吸困难感觉（Borg量表）、肺功能和运动耐量。进行了一项横断面分析临床研究，纳入在数据收集前至少三个月被诊断为COVID-19的个体。在接受气道持续正压6 cm HO通气模式的NIV 30分钟前后，对个体进行生命体征（心率和外周血氧饱和度）、Borg量表、肺量计和两分钟次极量运动方案（台阶试验）评估。根据世界卫生组织标准，共招募了50名参与者，并在SARS-CoV-2感染期间分为轻度（N = 25）或重度（N = 25）临床表型组。在我们的数据中，重度临床表型组在NIV后，用力肺活量（<0.001）、第一秒用力呼气量与用力肺活量之比及用力肺活量（=0.020）和两分钟次极量台阶运动方案（步数- = 0.001）显示出统计学改善。此外，轻度临床表型组在NIV后，第一秒用力呼气量与用力肺活量之比（=0.032）和两分钟次极量台阶运动方案（步数- < 0.001）显示出统计学改善。生命体征和Borg量表未发现变化。本研究使我们能够确定，NIV是一种通过增加两个临床表型组达到的步数和改善肺量计指标中观察到的肺功能来促进更好运动能力的工具。
