Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study

Xiong, Lijuan; Li, Qian; Cao, Xiongjing; Xiong, Huangguo; Huang, Ming; Yang, Fengwen; Meng, Daquan; Zhang, Yanzhao; Fan, Yunzhou; Tang, Liang; Jin, Yang; Xia, Jiahong; Hu, Yu

doi:10.1016/j.ijid.2022.06.052

Cited by 5 publications

(8 citation statements)

References 40 publications

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“…Patients with severe COVID-19 developed dyspnea 1 week after SARS-CoV-2 infection, and severe cases rapidly progressed to acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulation dysfunction, and multiple organ failure. Our (3,4) and other prior studies (5)(6)(7) have reported on the recovery of Chinese patients with COVID-19 after discharge. Some previous studies had found that age and lifestyle behaviors were correlated with the risk of severe infection/death (8,9) and outcome of COVID-19 infection (10,11).…”

Section: Introductionmentioning

confidence: 51%

“…Like patients infected with SARS-CoV (27), H5N1 (28) and H7N9 (29), patients with SARS-CoV-2 (30-32) have elevated levels of cytokines in the acute and convalescent phases, suggesting suffering cytokine storms. Our and other studies reported the cytokines of the patients with COVID-19 showed a trend of decrease (indications of gradual improvement) after discharge (3,4,31). As reported in our prior study, at 13 months after discharge, 11.6% of the HCWs with severe COVID-19 had elevated IL-6, and more than 98% had normal levels of the remaining five cytokines (IFN-γ, IL-10, IL-2, IL-4 and TNF-α) (4).…”

Section: Immunological Factorsmentioning

confidence: 61%

“…In our previous study, 70.4, 48.9, 29.6, and 28.5% of the HCWs with severe COVID-19 did not have their functional fitness recovered at 5, 8, 11, and 13 months after discharge (3,4). At 28 months after discharge, the proportion who did not recover dropped to 18.9%.…”

Section: Functional Fitnessmentioning

confidence: 83%

“…According to the recommendations by the National Health Commission (15), the severity of the COVID-19 in HCWs is categorized into 4 groups including mild, moderate, severe (meeting at least one of the following items: shortness of breath, RR ≥30 beats/min; the oxygen saturation ≤93%; PaO 2 /FiO 2 ≤300 mmHg in the resting state), and critical (meeting at least one of the following items: respiratory failure requiring mechanical ventilation, shock, combined with other organ failure requiring intensive care unit monitoring and treatment). The specific categorizing criteria for each group are described in detail in our previous article (4). The participants with severe/critical COVID-19 were categorized into the severe group, and the participants with mild/moderate COVID-19 (with clinical symptoms, with or without pneumonia manifestations in imaging examination) were categorized into the non-severe group.…”

Section: Study Design and Participantsmentioning

confidence: 99%

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Age at SARS-CoV-2 infection and psychological and physical recovery among Chinese health care workers with severe COVID-19 at 28 months after discharge: A cohort study

Xiong

Cao

et al. 2023

Front. Public Health

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BackgroundNo prior study had reported the psychological and physical recovery of patients with COVID-19 2~3 years after discharge from the hospital. Moreover, it is not clear whether there is any difference in the health status of the patients with COVID-19 of different ages after discharge from the hospital.MethodsEmbedding in the “Rehabilitation Care Project for Medical Staff Infected with COVID-19” in China, this study included 271 health care workers (HCWs) with severe COVID-19. Their status of health-related quality of life, persistent symptoms, functional fitness and immune function at 28 months after discharge were followed, and compared according to tertiles of age at SARS-CoV-2 infection (group of younger (≤ 33 years); medium (34-42 years); and older (≥43 years)). Multivariate linear regression and multivariable adjusted logistic regression models were applied in investigating the associations of age at SARS-CoV-2 infection and outcomes.ResultsAt 28 months after discharge, 76% of the HCWs with severe COVID-19 had symptom of fatigue/weakness; 18.7% of the HCWs with severe COVID-19 did not fully recover their functional fitness; the decrease of CD3+ T cells, CD8+ T cells and the increase of natural killer cells accounted for 6.6, 6.6, and 5.5%, respectively. Compared with the HCWs with severe COVID-19 in younger group, HCWs with severe COVID-19 in older group had lower scores regarding physical functioning, role physical, bodily pain and role emotional; HCWs with severe COVID-19 in older group had higher risk of cough, joint pain, hearing loss and sleep disorder; HCWs with severe COVID-19 in older group scored lower on flexibility test. The variance of relative numbers of CD3+ T cells, CD8+ T cells and natural killer cells among HCWs with severe COVID-19 of different age groups were significant.ConclusionsThis study demonstrated that older HCWs with severe COVID-19 recovered slower than those with younger age regarding health-related quality of life, persistent symptoms, functional fitness and immune function at 28 months after discharge. Effective exercise interventions regarding flexibility should be performed timely to speed their rehabilitation, especially among those with older age.

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Section: Introductionmentioning

confidence: 51%

Section: Immunological Factorsmentioning

confidence: 61%

Section: Functional Fitnessmentioning

confidence: 83%

Section: Study Design and Participantsmentioning

confidence: 99%

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Age at SARS-CoV-2 infection and psychological and physical recovery among Chinese health care workers with severe COVID-19 at 28 months after discharge: A cohort study

Xiong

Cao

et al. 2023

Front. Public Health

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“…Improvements in lung function are critical to improve an individual’s ability to utilize oxygen and remove carbon dioxide, in addition to improved pulmonary function’s role in an improved immune function ( Xiong et al, 2022 ). While long-term cardiorespiratory effects of RT are well studied and yield contradictory results, acute cardiorespiratory responses to RT modalities have only been described in a few studies ( Falz et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

German volume training for health promotion: Acute vasopressor, pulmonary and metabolic responses

et al. 2022

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Resistance training (RT) is increasingly recommended for incorporation into comprehensive fitness or “exercise as medicine” programs. However, the acute effects of RT, and especially its different sub-types, and how they impact health outcomes are not fully investigated. This study evaluated German Volume Training (GVT) (“10 set × 10 rep scheme”) for its efficacy for its use in health settings. This study utilized a randomized crossover design with subjects serving as their own controls to establish baseline values. Subjects were blinded to the study hypothesis. Subjects performed a single session of GVT or no exercise, in a randomised order separated by a 1-week washout period. Outcomes were assessed before and immediately post-exercise. GVT significantly (p < 0.05) decreased systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP), but increased heart rate (HR), rate pressure product (RPP) and rating of perceived exertion (RPE). No changes were found in the measured spirometry parameters. Increases were observed in carbon dioxide production (VCO2) and minute ventilation (VE), but not respiratory exchange ratio. Post hoc analysis demonstrated that post-GVT values were significantly lower for SBP (p = 0.017; d = 1.00), DBP (p = 0.013; d = 0.90), MAP (p = 0.024; d = 1.06), and VCO2 (p = 0.009; d = −1.32), and significantly higher for RPP (p = 0.001; d = −3.11), RPE (p = 0.001; d = −14.14), and HR (p = 0.001; d = −3.00). This study indicates that acute GVT promotes post-exercise hypotension and is of sufficient intensity to increase both objective HR and subjective RPE intensities appropriately for use in a variety of health promotion settings.

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Emerging severe acute respiratory syndrome coronavirus 2 variants and their impact on immune evasion and vaccine-induced immunity

Pandey,

Kumar,

Rao

et al. 2024

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants harboring mutations in the structural protein, especially in the receptor binding domain (RBD) of spike protein, have raised concern about potential immune escape. The spike protein of SARS-CoV-2 plays a vital role in infection and is an important target for neutralizing antibodies. The mutations that occur in the structural proteins, especially in the spike protein, lead to changes in the virus attributes of transmissibility, an increase in disease severity, a notable reduction in neutralizing antibodies generated and thus a decreased response to vaccines and therapy. The observed multiple mutations in the RBD of the spike protein showed immune escape because it increases the affinity of spike protein binding with the ACE-2 receptor of host cells and increases resistance to neutralizing antibodies. Cytotoxic T-cell responses are crucial in controlling SARS-CoV-2 infections from the infected tissues and clearing them from circulation. Cytotoxic T cells efficiently recognized the infected cells and killed them by releasing soluble mediator's perforin and granzymes. However, the overwhelming response of T cells and, subsequently, the overproduction of inflammatory mediators during severe infections with SARS-CoV-2 may lead to poor outcomes. This review article summarizes the impact of mutations in the spike protein of SARS-CoV-2, especially mutations of RBD, on immunogenicity, immune escape and vaccine-induced immunity, which could contribute to future studies focusing on vaccine design and immunotherapy.

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Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study

Cited by 5 publications

References 40 publications

Age at SARS-CoV-2 infection and psychological and physical recovery among Chinese health care workers with severe COVID-19 at 28 months after discharge: A cohort study

Age at SARS-CoV-2 infection and psychological and physical recovery among Chinese health care workers with severe COVID-19 at 28 months after discharge: A cohort study

German volume training for health promotion: Acute vasopressor, pulmonary and metabolic responses

Emerging severe acute respiratory syndrome coronavirus 2 variants and their impact on immune evasion and vaccine-induced immunity

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