Knowledge on the sequelae of Coronavirus Disease 2019 (COVID-19) remains limited due to the relatively recent onset of this pathology. However, the literature on other types of coronavirus infections prior to COVID-19 reports that patients may experience persistent symptoms after discharge. To determine the prevalence of respiratory symptoms in survivors of hospital admission after COVID-19 infection. A living systematic review of five databases was performed in order to identify studies which reported the persistence of respiratory symptoms in COVID-19 patients after discharge. Two independent researchers reviewed and analysed the available literature, and then extracted and assessed the quality of those articles. Of the 1,154 reports returned by the initial search nine articles were found, in which 1,816 patients were included in the data synthesis. In the pooled analysis, we found a prevalence of 0.52 (CI 0.38–0.66, p < 0.01, I 2 = 97%), 0.37 (CI 0.28–0.48, p < 0.01, I 2 = 93%), 0.16 (CI 0.10–0.23, p < 0.01, I 2 = 90%) and 0.14 (CI 0.06–0.24, p < 0.01, I 2 = 96%) for fatigue, dyspnoea, chest pain, and cough, respectively. Fatigue, dyspnoea, chest pain, and cough were the most prevalent respiratory symptoms found in 52%, 37%, 16% and 14% of patients between 3 weeks and 3 months, after discharge in survivors of hospital admission by COVID-19, respectively.

Background Coronavirus disease has provoked much discussion since its first appearance. Despite it being widely studied all over the world, little is known about the impact of the disease on functional ability related to performing activities of daily living (ADL) in patients post COVID-19 infection. Objectives To understand the impact of COVID-19 on ADL performance of adult patients and to describe the common scales used to assess performance of ADL on patients post-COVID-19. Methods A systematic review was conducted. We included studies that applied a physical capacity test in COVID-19 patients, post-infection. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of the evidence. Results A total of 1,228 studies were included, after removing duplicates, 1,005 abstracts were screened and of those 983 were excluded. A final number of nine studies which met the eligibility criteria were included. The findings revealed worsening of physical function and ADL performance in all patients post COVID-19 infection. Conclusion All included studies found a reduction of ADL beyond the test or scale used, revealing a vital worsening of functional ability in ADL performance and consequently loss of independence in COVID-19 patients after the acute phase of infection. Functional ability status previous to COVID-19 is crucial for predicting the severity of the disease and mortality. Barthel Index and ADL score were the most used assessment tools across subjects with different intrinsic capacity and context levels.

The Guillain-Barré syndrome (GBS) incidence rate (IR) varies between 0.16 and 3.00 cases per 100,000 inhabitants. Little data exist on the epidemiology of GBS in Latin American countries. Our objective was to describe GBS epidemiology based on a national database in a Latin American country and to contribute to the global map of GBS epidemiology. This was a retrospective study that included all reported GBS cases in Chile between 2001 and 2012. Gender, age, seasonal occurrence, and geographical distribution were analyzed. A total of 4,158 GBS cases were identified from 19,513,655 registries. The mean age was 37 ± 24 years, and 59% of patients were male (male to female ratio of 1.5 : 1). Gender IR was 2.53/100,000 for males and 1.68/100,000 for females. The overall standardized IR was 2.1/100,000, although this varied between 1.61/100,000 (2001) and 2.35/100,000 (2010). The seasonal distribution was as follows: autumn 22%; winter 25%; spring 27%; and summer 26%. The geographical IR were as follows: far North 1.49/100,000; North 1.94/100,000; Central 1.97/100,000; South 3.18/100,000; and far South 2.78/100,000. The reported IR of GBS in Chile was similar to other studies based on national databases. In Chile, IR was greater in men and in the south.

Study design: Cross-sectional. Objective: To assess cough using air stacking (AS) to assist inspiratory volume with abdominal compression (AC) during expiration in patients with American Spinal Injury Association Impairment Scale (AIS) A. Setting: Large tertiary hospital in Chile. Methods: Peak cough flow (PCF) was measured during four different interventions: spontaneous maximal expiratory effort (MEE); MEE while receiving AC (MEE-AC); MEE after AS with a manual resuscitation bag (AS-MEE); and MEE with AS and AC (AS-MEE-AC). Results: Fifteen in-patients with complete tetraplegia (C4-C6) were included. Median age was 33 years . PCF during the different interventions was PCF for MEE was 183 ± 90 l min À1 ; PCF for MEE-AC was 273 ± 119 l min À1 ; PCF for AS-MEE was 278 ± 106 l min À1 and PCF for AS-MEE-AC was 368 ± 129 l min À1 . We observed significant differences in PCF while applying MEE-AC and AS-MEE compared with MEE (P ¼ 0.0001). However, the difference in PCF value was greater using the AS-MEE-AC technique (P ¼ 0.00001). Conclusion: Patients with spinal cord injury (SCI) presented an ineffective cough that constitutes a risk factor for developing respiratory complications. The application of combined techniques (AS-MEE-AC) can reach near normal PCF values. This is a lowcost, simple and easily applied intervention that could be introduced to all patients with tetraplegia.

The prevalence and mortality of chronic obstructive pulmonary disease (COPD) is increasing in Chile, constituting a public health problem. Pulmonary and systemic consequences of COPD affect physical activity, as the disease progresses. There are multiple means for physical activity assessment, from low cost and easily applicable questionnaires to sophisticated laboratory tests. Physical inactivity is a modifiable risk factor for morbidity and mortality in patients with COPD. Physical activity interventions not only contribute to decrease the likelihood of mortality, but also protect from comorbidities, especially cardiovascular ones. It also plays a major role avoiding functional limitations of these subjects. Dyspnea and fatigue render exercise as an unpleasant activity for most patients with COPD. If psychological alterations such as anxiety and depression are summed, these patients drift towards an inactive lifestyle. This article analyzes several tools available to assess physical activity is patients with COPD, useful in clinical practice.

Measurement of respiratory muscles strength such as maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) are used to detect, diagnose and treat respiratory weakness. However, devices used for these measurements are not widely available and are costly. Currently, the use of a digital manometer is recommended. In industry, several inexpensive devices are available, but these have not been validated for clinical use. Our objective was to determine the agreement between maximal respiratory pressures obtained with a clinical digital manometer and that with a non-clinical digital manometer in healthy volunteers. We assessed the height, weight, lung function, MIP, and MEP of healthy volunteers. To compare pressures obtained by each type of digital manometer, a parallel approach configuration was used. The agreement was measured with the Intraclass Coefficient Correlation (ICC) and the Bland-Altman plot. Twenty-seven participants (14 men) were recruited with a median age of 22 (range: 21–23) years. Each participant underwent three measurements to give a total of 81 measurements. The mean MIPs were 90.8 ± 26.4 (SEM 2.9) and 91.1 ± 26.4 (SEM 2.9) cmH2O for the clinical and non-clinical digital manometers, respectively. The mean MEPs were 113.8 ± 40.4 (SEM 4.5) and 114.5 ± 40.5 (SEM 4.5) cmH2O for the clinical and non-clinical digital manometers, respectively. We obtained an ICC of 0.998 (IC 0.997–0.999) for MIP and 0.999 (IC 0.998–0.999) for MEP. There is a high agreement in the values obtained for MIP and MEP between clinical and non-clinical digital manometers in healthy volunteers. Further validation at lower pressures and safety profiling among human subjects is needed.

No abstract

Background: The literature is unclear as to whether children and adolescents with chronic respiratory diseases (CRDs) differ from their healthy peers in physical activity (PA). Objective: To determine the PA levels measured through accelerometers in children and adolescents with CRDs. Methods: The authors conducted a systematic review using five databases. The authors included studies that assessed the PA measured by accelerometers in children and adolescents with CRDs. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. Results: From 11,497 reports returned by the initial search, 29 articles reporting on 4381 patients were included. In the sensitivity analysis, the authors found that children and adolescents with CRDs had a moderate-to-vigorous PA (MVPA) of −0.08 hours per day (95% confidence interval [CI], −0.12 to −0.03 h/d; P = .001), which was lower than the healthy controls; the values for sedentary time (mean difference −0.47 h/d; 95% CI, −1.29 to 0.36 h/d; P = .27) and steps/d (mean difference 361 steps/d; 95% CI −385 to 1707 steps/d; P = .45) were similar for both. Conclusion: Children and adolescents with CRDs have a slight reduction in MVPA in comparison with healthy controls, but sedentary time and steps/d were similar for both.