This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
The goal of the present study was to compare pulmonary function test (PFT) and
cardiopulmonary exercise test (CPET) performance in COVID-19 survivors with a
control group (CG). This was a cross-sectional study. Patients diagnosed with
COVID-19, without severe signs and symptoms, were evaluated one month after the
infection. Healthy volunteers matched for sex and age constituted the control
group. All volunteers underwent the following assessments: i) clinical
evaluation, ii) PTF; and iii) CPET on a cycle ergometer. Metabolic variables
were measured by the CareFusion Oxycon Mobile device. In addition, heart rate
responses, peak systolic and diastolic blood pressure, and perceived exertion
were recorded. Twenty-nine patients with COVID-19 and 18 healthy control
subjects were evaluated. Surviving patients of COVID-19 had a mean age of 40
years and had higher body mass index and persistent symptoms compared to the CG
(P<0.05), but patients with COVID-19 had more comorbidities, number of
medications, and greater impairment of lung function (P<0.05). Regarding
CPET, patients surviving COVID-19 had reduced peak workload, oxygen uptake
(
V̇
O
2
), carbon dioxide output
(
V̇
CO
2
), circulatory power (CP), and end-tidal
pressure for carbon dioxide (
P
ET
CO
2
) (P<0.05). Additionally, survivors had depressed
chronotropic and ventilatory responses, low peak oxygen saturation, and greater
muscle fatigue (P<0.05) compared to CG
.
Despite not showing signs
and symptoms of severe disease during infection, adult survivors had losses of
lung function and cardiorespiratory capacity one month after recovery from
COVID-19. In addition, cardiovascular, ventilatory, and lower limb fatigue
responses were the main exercise limitations.
Among the most prevalent multimorbidities that accompany the aging process, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) stand out, representing the main causes of hospital admissions in the world. The prevalence of COPD coexistence in patients with CHF is higher than in control subjects, given the common risk factors associated with a complex process of chronic diseases developing in the aging process. COPD-CHF coexistence confers a marked negative impact on mechanical-ventilatory, cardiocirculatory, autonomic, gas exchange, muscular, ventilatory, and cerebral blood flow, further impairing the reduced exercise capacity and health status of either condition alone. In this context, integrated approach to the cardiopulmonary based on pharmacological optimization and non-pharmacological treatment (i.e., exercise-based cardiopulmonary and metabolic rehabilitation) can be emphatically encouraged by health professionals as they are safe and well-tolerated, reducing hospital readmissions, morbidity, and mortality. This review aims to explore aerobic exercise, the cornerstone of cardiopulmonary and metabolic rehabilitation, resistance and inspiratory muscle training and exercise-based rehabilitation delivery models in patients with COPD-CHF multimorbidities across the continuum of the disease. In addition, the review address the importance of adjuncts to enhance exercise capacity in these patients, which may be used to optimize the gains obtained in these programs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.