Effects of a multi-professional intervention on body composition, physical fitness and biochemical markers in overweight COVID-19 survivors: a clinical trial

Abstract

Introduction: The sequelae post-COVID can affect different systems. In this sense, considering the multi-factorial etiology of COVID-19, multi-professional interventions could be a relevant strategy for recovery health indicators.Objective: This study aimed to investigate the effects of multi-professional intervention on body composition, physical fitness, and biomarkers in overweight COVID-19 survivors with different symptomatology.Methodology: A non-randomized parallel group intervention included 69 volunteers (BMI ≥25 kg/m2), divided into three groups according to SARS CoV-2 symptomatology, but only 35 finished the longitudinal protocol [control group (n = 11); moderate group (n = 17) and severe group (n = 7)]. The groups were submitted to a multi-professional program (nutritional intervention, psychoeducation, and physical exercise intervention) for 8 weeks, and the volunteers underwent body composition assessments (primary outcome) and physical and biochemical tests (secondary outcome) in pre- and post-intervention. This study was registered on the Clinical Trials Registration Platform number: RBR-4mxg57b and with the local research ethics committee protocol under number: 4,546,726/2021.Results: After the 8-week multi-professional intervention, the following results were observed for the moderate COVID-19 group: improved dynamic strength of lower- and (p = 0.003), upper-limbs (p = 0.008), maximal isometric lumbar-traction strength (p = 0.04), flexibility (p = 0.0006), and albumin (p = 0.0005), as well as a reduction in the C reactive protein (CRP) (p = 0.003) and fasting glucose (p = 0.001); for the severe COVID-19 group: an improvement in dynamic lower-body strength (p = 0.001), higher values of albumin (p = 0.005) and HDL-c (p = 0.002), and lower values of CRP (p = 0.05), and for the control group: an improvement in sit-up repetitions (p = 0.008), and a reduction of CRP (p = 0.01), fasting glucose (p = 0.001) and total cholesterol (p = 0.04) were identified. All experimental groups reduced triglycerides after intervention (p < 0.05).Conclusion: Finally, 8 weeks of multiprofessional intervention can be an efficient tool for reversing the inflammatory process and promoting improvements in daily activities and quality of life, although it is believed that the severe COVID-19 group needs longer interventions to improve different health indicators.Clinical Trial Registration:https://ensaiosclinicos.gov.br/, identifier: RBR-4mxg57b.

Obesity as a Risk Factor for Complications and Mortality in Individuals with SARS-CoV-2: A Systematic Review

“…Rehabilitation is a multidisciplinary intervention that aims to improve functional capacity, increase the quality of life, facilitate social reintegration after hospitalization, reduce persistent symptoms, and improve the ability to perform the activities of daily living [ 112 ]. Sordi et al [ 113 ] evaluated the effect of a multi-professional intervention (nutritional, psychoeducational, and physical exercise intervention) on body composition, physical fitness, and biochemical markers in overweight COVID-19 survivors (BMI ≥ 25 kg/m 2 ) with different symptoms. After the interventions, the authors reported that the moderate COVID-19 group showed improvement in the dynamic muscle strength of the lower and upper limbs, maximum lumbar isometry—traction force, flexibility, and markers such as albumin, CRP, fasting glycemia, and triglycerides; for the severe COVID-19 group, improvements were seen in the dynamic muscle strength of the lower limbs and lower CRP and triglyceride values; for the control group, improvements were seen in abdominal repetitions, CRP, fasting glucose, TC, and triglycerides.…”

Long-term impact of SARS-CoV-2 infection on cardiorespiratory fitness: a meta-analysis

“…Large epidemiology has also documented that physical activity was inversely associated with severe COVID-19 ( 46 ). Physical activity is accounted as an efficient intervention for reversing an inflammatory process ( 47 ) and cardioprotective effect in COVID-19 survivors ( 43 ). In the context of current review, sufficient physical activity (≥150 min a week of moderate intensity) can impede viral entry to the targeted cell by increase in plasma soluble angiotensin-converting enzyme 2 (sACE2), which can bind to SARS-CoV-2 ( 43 ).…”

Effects of a Multi-professional Intervention on Quality of Life of Women with Overweight or Obesity Post-Covid-19. A Pragmatic Trial

“…The study conducted by Lemos et al (2022) evaluated body composition and cardiorespiratory fitness in individuals with overweight or obesity after COVID-19 and found that excess fat deposition creates a chronic low-grade inflammatory environment. In turn, this environment can dysregulate the immune and endocrine systems (Manrique-Acevedo et al, 2020), contributing to various other comorbidities and affecting functional capacity and health-related quality of life (Sordi et al, 2023;Ryal et al, 2023;Perli et al, 2023).…”

“…These findings emphasize the importance of addressing the topic with greater attention, aiming to understand the effects of obesity after COVID-19 infection and implementing interventions to improve the health and well-being of these patients. Among the comorbidities, previous studies have reported that obesity is one of the risk factors for the worsening of COVID-19 (Kang et al, 2020;Stefan et al, 2021;Lemos et al, 2022;Perli et al, 2023;Sordi et al, 2023;Ryal et al, 2023) and that individuals with obesity infected with COVID-19 had a higher mortality rate compared to non-obese individuals (Kang et al, 2020). Indeed, the quarantine period, adopted as a control measure during the pandemic, is a predictive factor for symptoms of acute stress disorder, anxiety, depression, insomnia, exhaustion, and post-traumatic stress disorder (Brooks et al, 2020).…”

“…Moreover, daily experiences of depression, anxiety, and stress can increase the likelihood of weight gain associated with overweight and obesity (Sheu et al, 2017). Therefore, it is crucial to implement interventions considering the various aspects associated with obesity, aiming to prevent and treat it during the pandemic (Brooks et al, 2020;Stefan et al, 2021;Sordi et al, 2023;Ryal et al, 2023).…”