Fatores correlacionados a intolerância ao exercício na alta de pacientes hospitalizados por COVID-19
DOI:
https://doi.org/10.11606/issn.2317-0190.v30i3a214174Palavras-chave:
Tolerância ao Exercício, Força Muscular, Estado Funcional, Hospitalização, COVID-19Resumo
Objetivo: Verificar a prevalência da intolerância ao exercício e a correlação com o perfil sociodemográfico, clínico, de hospitalização e função física na alta de pacientes hospitalizados pela COVID-19. Métodos: Estudo transversal com 52 pacientes internados por COVID-19 no Hospital Santa Casa de Misericórdia de Vitória, Espírito Santo. Coletou-se informações no momento da alta quanto ao perfil sociodemográfico, clínico, de hospitalização e função física, através de questionário semiestruturado, prontuário eletrônico, escalas e testes. Utilizou-se o Medical Research Council Modificado (mMRC) para graduar a dispneia, o Medical Research Council (MRC) para avaliar força muscular periférica, a manovacuometria, através das pressões inspiratória e expiratória máximas, para mensurar força muscular respiratória e a Medida de Independência Funcional (MIF) para funcionalidade. A variável desfecho, tolerância ao exercício, foi medida pelo Teste de Sentar e Levantar de 1 minuto. Resultados: Todos participantes apresentaram intolerância ao exercício no momento da alta hospitalar. O desempenho no teste de sentar e levantar foi inversamente correlacionado com o grau de dispneia e diretamente com a força muscular inspiratória, pontuação total da Medida de Independência Funcional, domínios de autocuidado, locomoção, mobilidade (p 0,019), e controle de esfíncter Conclusão: A prevalência da intolerância ao exercício na alta por COVID-19 foi de 100%, e estava correlacionada com o grau de dispneia, força muscular inspiratória e funcionalidade para autocuidado, locomoção, mobilidade e controle de esfíncter. Destaca-se a avaliação da tolerância ao exercício como importante preditor de sequelas pós-COVID-19, capaz de avaliar a interação entre diversos sistemas orgânicos.
Downloads
Referências
Brasil. Ministério da Saúde. Boletim Epidemiológico Especial: Doença pelo novo coronavírus - COVID-19. Brasília: Ministério da Saúde/Secretaria de Vigilância em Saúde e Ambiente; 2023. [Boletim Epidemiológico n.152].
Fillmore NR, La J, Zheng C, Doron S, Do NV, Monach PA, et al. The COVID-19 hospitalization metric in the pre- and post-vaccination eras as a measure of pandemic severity: A retrospective, nationwide cohort study. Infect Control Hosp Epidemiol. 2022;43(12):1767-1772. Doi: https://doi.org/10.1017/ice.2022.13
Montani D, Savale L, Noel N, Meyrignac O, Colle R, Gasnier M, et al. Post-acute COVID-19 syndrome. Eur Respir Rev. 2022;31(163):210185. Doi: https://doi.org/10.1183/16000617.0185-2021
Miranda DAP, Gomes SVC, Filgueiras PS, Corsini CA, Almeida NBF, Silva RA, et al. Long COVID-19 syndrome: a 14-months longitudinal study during the two first epidemic peaks in Southeast Brazil. Trans R Soc Trop Med Hyg. 2022;116(11):1007-14. Doi: https://doi.org/10.1093/trstmh/trac030
Raman B, Cassar MP, Tunnicliffe EM, Filippini N, Griffanti L, Alfaro-Almagro F, et al. Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge. EClinicalMedicine. 2021;31:100683. Doi: https://doi.org/10.1016/j.eclinm.2020.100683
Larsson AC, Palstam A, Persson HC. Physical Function, Cognitive Function, and Daily Activities in Patients Hospitalized Due to COVID-19: A Descriptive Cross-Sectional Study in Sweden. Int J Environ Res Public Health. 2021;18(21):11600. Doi: https://doi.org/10.3390/ijerph182111600
Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603-5. Doi: https://doi.org/10.1001/jama.2020.12603
Salmon Ceron D, Bartier S, Hautefort C, Nguyen Y, Nevoux J, Hamel AL, et al. Self-reported loss of smell without nasal obstruction to identify COVID-19. The multicenter Coranosmia cohort study. J Infect. 2020;81(4):614-620. Doi: https://doi.org/10.1016/j.jinf.2020.07.005
Wang EY, Mao T, Klein J, Dai Y, Huck JD, Liu F, et al. Diverse Functional Autoantibodies in Patients with COVID-19. medRxiv. 2021:2020.12.10.20247205. Doi: https://doi.org/10.1101/2020.12.10.20247205
Dani M, Dirksen A, Taraborrelli P, Torocastro M, Panagopou-los D, Sutton R, et al. Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies. Clin Med (Lond). 2021;21(1):e63-e67. Doi: https://doi.org/10.7861/clinmed.2020-0896
Agarwala P, Salzman SH. Six-Minute walk test: clinical role, technique, coding, and reimbursement. Chest. 2020;157(3):603-11. Doi: https://doi.org/10.1016/j.chest.2019.10.014
Leite VF, Rampim DB, Jorge VC, Lima MDCC, Cezarino LG, Rocha CN, et al. Persistent symptoms and disability after COVID-19 hospitalization: data from a comprehensive telerehabilitation program. Arch Phys Med Rehabil. 2021;102(7):1308-1316. Doi: https://doi.org/10.1016/j.apmr.2021.03.001
Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A, Gouze H, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;81(6):e4-e6. Doi: https://doi.org/10.1016/j.jinf.2020.08.029
De Jonghe B, Sharshar T, Lefaucheur JP, Authier FJ, Durand-Zaleski I, Boussarsar M, et al. Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA. 2002;288(22):2859-67. Doi: https://doi.org/10.1001/jama.288.22.2859
Costa D, Gonçalves HA, Lima LP, Ike D, Cancelliero KM, Montebelo MIL. Novos valores de referência para pressões respiratórias máximas na população brasileira J Bras Pneumol. 2010; 36(5):306-12. Doi: https://doi.org/10.1590/S1806-37132010000300007
Riberto M, Miyazaki MH, Jucá SSH, Sakamoto H, Pinto PPN, Battistella LR. Validação da versão brasileira da Medida de Independência Funcional. Acta Fisiátr. 2004;11(2):72-6. Doi: https://doi.org/10.5935/0104-7795.20040003
Núñez-Cortés R, Rivera-Lillo G, Arias-Campoverde M, Soto-García D, García-Palomera R, Torres-Castro R. Use of sit-to-stand test to assess the physical capacity and exertional desaturation in patients post COVID-19. Chron Respir Dis. 2021;18:1479973121999205. Doi: https://doi.org/10.1177/1479973121999205
Strassmann A, Steurer-Stey C, Lana KD, Zoller M, Turk AJ, Suter P, et al. Population-based reference values for the 1-min sit-to-stand test. Int J Public Health. 2013;58(6):949-53. Doi: https://doi.org/10.1007/s00038-013-0504-z
Figueiredo Filho DB, Rocha EC, Silva Júnior JA, Paranhos R, Neves JAB, Santos MLWD. Desvendando os mistérios do coeficiente de correlação de Pearson: o retorno. Leviathan. 2014;19(8):66-95. Doi: https://doi.org/10.11606/issn.2237-4485.lev.2014.132346
Huang L, Yao Q, Gu X, Wang Q, Ren L, Wang Y, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398(10302):747-58. Doi: https://doi.org/10.1016/S0140-6736(21)01755-4
Fernández-Lázaro D, Santamaría G, Sánchez-Serrano N, Lantarón Caeiro E, Seco-Calvo J. Efficacy of therapeutic exercise in reversing decreased strength, impaired respiratory function, decreased physical fitness, and decreased quality of life caused by the Post-COVID-19 syndrome. Viruses. 2022;14(12):2797. Doi: https://doi.org/10.3390/v14122797
Rooney S, Webster A, Paul L. Systematic review of changes and recovery in physical function and fitness after severe acute respiratory syndrome-related coronavirus infection: implications for COVID-19 rehabilitation. Phys Ther. 2020;100(10):1717-1729. Doi: https://doi.org/10.1093/ptj/pzaa129
Baricich A, Borg MB, Cuneo D, Cadario E, Azzolina D, Balbo PE, et al. Midterm functional sequelae and implications in rehabilitation after COVID-19: a cross-sectional study. Eur J Phys Rehabil Med. 2021;57(2):199-207. Doi: https://doi.org/10.23736/S1973-9087.21.06699-5
Thomas M, Price OJ, Hull JH. Pulmonary function and COVID-19. Curr Opin Physiol. 2021;21:29-35. Doi: https://doi.org/10.1016/j.cophys.2021.03.005
Souto XM. COVID-19: aspectos gerais e implicações globais. Recital. 2020: 2(1)13-36. Doi: https://doi.org/10.46636/recital.v2i1.90
Araja D, Berkis U, Lunga A, Murovska M. Shadow burden of undiagnosed myalgic encephalomyelitis/chronic fatigue syndrome (me/cfs) on society: retrospective and prospective-in light of COVID-19. J Clin Med. 2021;10(14):3017. Doi: https://doi.org/10.3390/jcm10143017
Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Sánchez-Alcaraz Martínez BJ, et al. Post-COVID-19 syndrome and the potential benefits of exercise. Int J Environ Res Public Health. 2021;18(10):5329. Doi: https://doi.org/10.3390/ijerph18105329
Belli S, Balbi B, Prince I, Cattaneo D, Masocco F, Zaccaria S, et al. Low physical functioning and impaired performance of activities of daily life in COVID-19 patients who survived hospitalisation. Eur Respir J. 2020;56(4):2002096. Doi: https://doi.org/10.1183/13993003.02096-2020
Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020;215:108427. Doi: https://doi.org/10.1016/j.clim.2020.108427
Ghosn J, Piroth L, Epaulard O, Le Turnier P, Mentré F, Bachelet D, et al. Persistent COVID-19 symptoms are highly prevalent 6 months after hospitalization: results from a large prospective cohort. Clin Microbiol Infect. 2021;27(7):1041.e1-1041.e4. Doi: https://doi.org/10.1016/j.cmi.2021.03.012
Townsend L, Dyer AH, Jones K, Dunne J, Mooney A, Gaffney F, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS One. 2020;15(11):e0240784. Doi: https://doi.org/10.1371/journal.pone.0240784
Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Med. 2020;46(4):637-653. Doi: https://doi.org/10.1007/s00134-020-05944-4
Silva HBMM, Santos DMO, Soares LO, Cacau LAP, Costa ASM. Análise do perfil de pacientes pós-COVID-19: um estudo de correlação entre força muscular respiratória e força muscular periférica. ASSOBRAFIR Cienc. 2022;(13):e44656. Doi: https://doi.org/10.47066/2177-9333.AC.2020.0038
Paneroni M, Simonelli C, Saleri M, Bertacchini L, Venturelli M, Troosters T, et al. Muscle Strength and Physical Performance in Patients Without Previous Disabilities Recovering From COVID-19 Pneumonia. Am J Phys Med Rehabil. 2021;100(2):105-109. Doi: https://doi.org/10.1097/PHM.0000000000001641
Corrêa TD, Midega TD, Timenetsky KT, Cordioli RL, Barbas CSV, Silva Júnior M, et al. Clinical characteristics and outcomes of COVID-19 patients admitted to the intensive care unit during the first year of the pandemic in Brazil: a single center retrospective cohort study. Einstein (Sao Paulo). 2021;19:eAO6739. Doi: https://doi.org/10.31744/einstein_journal/2021AO6739
Souza MO, Silva ACS, Almeida JR, Santos JFM, Santana LF, Nascimento MBC, et al. Impactos da COVID-19 na aptidão cardiorrespiratória: exercícios funcionais e atividade física. Rev Bras Ativ Fís Saúde. 2020;25:(1):1-5. Doi: https://doi.org/10.12820/rbafs.25e0171
Poloni JAT, Jahnke VS, Rotta LN. Insuficiência renal aguda em pacientes com COVID-19. RBAC. 2020;52(2):160-7. Doi: https://doi.org/10.21877/2448-3877.20200017
Junqueira JB, Santos VLCG. Incontinência urinária em pacientes hospitalizados: prevalência e fatores associados. Rev Lat Am Enfermagem. 2018;25:e2970. Doi: https://doi.org/10.1590/1518-8345.2139.2970
Singh SJ, Barradell AC, Greening NJ, Bolton C, Jenkins G, Preston L, et al. British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population. BMJ Open. 2020;10(12):e040213. Doi: https://doi.org/10.1136/bmjopen-2020-040213
Postigo-Martin P, Cantarero-Villanueva I, Lista-Paz A, Castro-Martín E, Arroyo-Morales M, Seco-Calvo J. A COVID-19 rehabilitation prospective surveillance model for use by physiotherapists. J Clin Med. 2021;10(8):1691. Doi: https://doi.org/10.3390/jcm10081691
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2023 Acta Fisiátrica
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
