No abstract

The multisystem impairment promoted by COVID-19 may be associated with a reduction in exercise capacity. Cardiopulmonary abnormalities can change across the acute disease severity spectrum. We aimed to verify exercise physiology differences between COVID-19 survivors and SARS-CoV-2-naïve controls and how illness severity influences exercise limitation. A singlecentre cross-sectional analysis of prospectively collected data from COVID-19 survivors who underwent cardiopulmonary exercise testing (CPET) in their recovery phase (x = 50[36;72] days). Patients with COVID-19 were stratified according to severity as mild [M-Cov (outpatient)] vs severe/critical [SC-Cov(inpatients)] and were compared with SARS-CoV-2-naïve controls (N-Cov). Collected information included demographics, anthropometrics, previous physical exercise, comorbidities, lung function test and CPET parameters. A multivariate logistic regression analysis was performed to identify low aerobic capacity (LAC) predictors post COVID-19. Of the 702 included patients, 310 (44.2%), 305 (43.4%) and 87 (12.4%) were N-Cov, M-Cov and SC-Cov, respectively. LAC was identified in 115 (37.1%), 102 (33.4%), and 66 (75.9%) of N-CoV, M-CoV and SC-CoV, respectively (p < 0.001). SC-Cov were older, heavier with higher body fat, more sedentary lifestyle, more hypertension and diabetes, lower forced vital capacity, higher prevalence of early anaerobiosis, ventilatory inefficiency and exercise-induced hypoxia than N-Cov. M-Cov had lower weight, fat mass, and coronary disease prevalence and did not demonstrate more CEPT abnormalities than N-Cov. After adjustment for covariates, SC-Cov was an independent predictor of LAC (OR = 2.7; 95% CI, 1.3-5.6). Almost two months after disease onset, SC-CoV presented several exercise abnormalities of oxygen uptake, ventilatory adaptation and gas exchange, including a high prevalence of LAC. Highlights. Weeks after the acute disease phase, one-third of mild and three-quarters of severe and critical patients with COVID-19 presented a reduced aerobic capacity. Previous studies including SARS-CoV-1 survivors observed much lower values. . A severe or critical COVID-19 case was an independent predictor for low aerobic capacity. . In our sample, pre-COVID-19 exercise significantly reduced the odds of post-COVID-19 low aerobic capacity. Even severe or critical patients who exercised regularly had a prevalence of low aerobic capacity 2.5 times lower than those who did not have this routine before sickening.

Background: In pandemic times, social isolation is of utmost importance to minimize the spread of the SARS-Cov-2 virus. At times like these, home fitness becomes extremely necessary to avoid sedentarism and decompensation in chronic disease patients.Objectives: Evaluate the engagement of rehabilitation patients to a tele-oriented exercise program at home (TOEP).Materials and Methods: 66 of 94 patients (63.8% males; 65.5±14 years old; 5.2±2.6 months in rehabilitation) agreed to take part. Subjects were grouped in three levels of functionality to guide the exercise prescription. Weekly Training Rates (WTR) were compared using the Friedman test and corrected by Dunn's test. A multivariate logistic model was designed to determine independent predictors in program engagement. Statistical significance was determined by a p<0.05.Results: TOEP provided WTR similar to the pre-quarantine values of 2.8/week (p>0.05), and 91.8% of patients took part until the end of those 5 weeks. The presence of diabetes was a predicted factor for low engagement to TOEP with relative risk of 0.41 (CI95%: 0.25 to 0.66). Conclusion:TOEP provided satisfactory engagement in rehabilitation patients. Most of them increased WTR during quarantine. Patients with diabetes displayed lower engagement to the minimum standard frequency.