Factors correlated to exercise intolerance upon discharge in patients hospitalized for COVID-19

Authors

  • Lara Bourguignon Lopes Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória
  • Gabriele Teixeira Braz de Souza Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória
  • Mariane Colares da Silva Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória
  • Roberta Ribeiro Batista Barbosa Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória

DOI:

https://doi.org/10.11606/issn.2317-0190.v30i3a214174

Keywords:

Exercise Tolerance, Muscle Strength, Functional Status, Hospitalization, COVID-19

Abstract

Objective: To verify the prevalence of exercise intolerance and the correlation with the sociodemographic, clinical, hospitalization and physical function profile at discharge of patients hospitalized for COVID-19. Methods: Cross-sectional study with 52 patients hospitalized for COVID-19 at Hospital Santa Casa de Misericórdia in Vitória, Espírito Santo. Information was collected at discharge regarding the sociodemographic, clinical, hospitalization and physical function profile, through a semi-structured questionnaire, electronic medical record, scales and tests. The Modified Medical Research Council (mMRC) was used to grade dyspnea, the Medical Research Council (MRC) was used to assess peripheral muscle strength, manovacuometry, through maximal inspiratory and expiratory pressures, to measure respiratory muscle strength and the Independence Measure Functional (MIF) for functionality. The outcome variable, exercise tolerance, was measured by the 1-minute Sit and Stand Test. Results: All participants presented exercise intolerance at discharge. Performance in the 1-minute Sit and Stand Test was inversely correlated with the degree of dyspnea and directly with inspiratory muscle strength, total score on the Independence Measure Functional, self-care domains, locomotion, mobility and sphincter control. Conclusion: The prevalence of exercise intolerance at discharge due to COVID-19 was 100%, and was correlated with the degree of dyspnea, inspiratory muscle strength and functionality for self-care, locomotion, mobility and sphincter control. The assessment of exercise tolerance stands out as an important predictor of sequelae after COVID-19, capable of assessing the interaction between different organ systems.

Downloads

Download data is not yet available.

References

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

Published

2023-09-30

Issue

Section

Original Article

How to Cite

1.
Lopes LB, Souza GTB de, Silva MC da, Barbosa RRB. Factors correlated to exercise intolerance upon discharge in patients hospitalized for COVID-19. Acta Fisiátr. [Internet]. 2023 Sep. 30 [cited 2024 Jul. 18];30(3):194-200. Available from: https://periodicos.usp.br/actafisiatrica/article/view/214174