Capacidad y perfil funcional de personas post-COVID-19: seguimiento a un año
DOI:
https://doi.org/10.1590/Palabras clave:
Pandemia, Rehabilitación, SARS-CoV-2Resumen
Pacientes que se recuperaron de la infección
por COVID-19 presentan características resultantes de las
manifestaciones clínicas de la propia enfermedad. La evolución
de la pandemia resalta la importancia de analizar el impacto de
estas manifestaciones en la calidad de vida de los pacientes post-
COVID-19. Este estudio tuvo el objetivo de analizar el perfil de
pacientes post-COVID-19 infectados en 2020 y 2021. Se realizó un
estudio transversal con pacientes remitidos para rehabilitación post-
COVID-19. Se utilizaron como instrumentos de medida la Escala
Modificada de Borg, la Escala de Disnea Medical Research Council
(MRC), los instrumentos de calidad de vida EQ-5D-3L y EQ-VAS,
además de la Escala Funcional Post-COVID (PCFS). Se realizaron
pruebas de espirometría, manovacuometría, dinamometría
manual, prueba de caminata de 6 minutos (TC6) y prueba
sentado-de pie. Participaron 286 pacientes (49.01±16.86 años),
subdivididos en los años 2020 (n=118) y 2021 (n=168). Los resultados
mostraron un empeoramiento de los síntomas en 2021, con un
aumento en los números de internaciones, días de admisión en
la enfermería y en la UCI. Hubo un deterioro en la calidad de vida
relacionada con la salud, y los dominios movilidad (p=0.02), dolor/
malestar (p=0.001) y actividades habituales (p=0.004) tuvieron
una mayor significación. La persistencia de los síntomas y la
consiguiente reducción de la funcionalidad indicaron el aumento
de la gravedad de la enfermedad en 2021. La segunda ola de
COVID-19 aumentó la gravedad de la enfermedad y provocó un
mayor número de disfunciones funcionales y sistémicas, lo que
impactó la calidad de vida y resaltó la necesidad de rehabilitación
Descargas
Referencias
World Health Organization. WHO COVID-19 Dashboard.
Number of COVID-19 cases reported to WHO. [2021] [cited
10 14]. Available from: https://covid19.who.int/
Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, et al. COVID-19
patients’ clinical characteristics, discharge rate, and fatality
rate of meta-analysis. J Med Virol. 2020;92(6):577-83.
doi: 10.1002/jmv.25757
Liu C, Ginn HM, Dejnirattisai W, Supasa P, Wang B, et al.
Reduced neutralization of SARS-CoV-2 B.1.617 by vaccine
and convalescent serum. Cell. 2021;184(16):4220-36.
doi: https://doi.org/10.1016/j.cell.2021.06.020
Bhatta S, Sharma S, Sharma D, Maharjan L, Bhattachan S,
et al. Study of Hearing Status in COVID-19 Patients:
A Multicentered Review. Indian J Otolaryngol Head Neck Surg.
;74(Suppl 2):3036-42. doi: 10.1007/s12070-021-02710-w
Sun P, Qie S, Liu Z, Ren J, Li K, et al. Clinical characteristics
of hospitalized patients with SARS-CoV-2 infection: A single
arm meta-analysis. J Med Virol. 2020;92(6):612-7. doi: 10.1002/
jmv.25735
Li X, Zhong X, Wang Y, Zeng X, Luo T, et al.. Clinical determinants
of the severity of COVID-19: A systematic review and metaanalysis.
PLoS One. 2021;3;16(5):e0250602. doi: 10.1371/journal.
pone.0250602
Zhao Y-M, Shang Y-M, Song W-B, Li QQ, Xie H, et al. Follow-
Up study of the pulmonary function and related physiological
characteristics of COVID-19 survivors three months after
recovery. EClinicalMedicine. 2020;25:100463. doi: 10.1016/
j.eclinm.2020.100463
Shah AS, Wong AW, Hague CJ, Murphy DT, Johnston JC, et al. A
prospective study of 12-week respiratory outcomes in COVID-
-related hospitalisations. BMJ Journals. 2021;76:402-4.
doi: 10.1136/thoraxjnl-2020-216226
Silva ADF, Perovano LS, Barboza LI, Nascimento WM, Silva FM,
et al. Perfil sociodemográfico dos pacientes confirmados
para Covid-19 residentes no Espírito Santo, Brasil. AtoZ.
;9(2):216-23. doi:10.5380/atoz.v9i2.76179
Chen N, Zhou M, Dong X, Qu J, Gong F, et al. Epidemiological
and clinical characteristics of 99 cases of 2019 novel coronavirus
pneumonia in Wuhan, China: a descriptive study. Lancet.
;395(10223):507-13. doi: 10.1016/S0140-6736(20)30211-7
Townsend L, Dyer AH, Jones K, Dunne J, Mooney A, et al.
Persistent fatigue following SARS-CoV-2 infection is common
and independent of severity of initial infection. PLoS ONE.
;15(11):e0240784. doi: 10.1371/journal.pone.0240784
Burneto AF. Comparação entre a escala modificada de Borg
e a escala de Borg modificada análogo visual aplicadas em
pacientes com dispnéia. Rev Bras Cienc Mov. 1989;3(1):34-40.
Kovelis D, Segretti NO, Probst VS, Lareau SC, Brunetto AF,
et al. Validação do modified pulmonary functional status and
dyspnea questionnaire e da escala do Medical Research Council
para o uso em pacientes com doença pulmonar obstrutiva
crônica no Brasil. J Bras Pneumol. 2008;34(12):1008-18.
doi: 10.1590/S1806-37132008001200005
Szend A, Janssen B, Cabasés J, ed. Self-Reported Population
Health: an international perspective based on EQ-5D-3L.
Dordrecht (NL): Springer; 2014. doi: 10.1007/978-94-007-7596-1
Ferreira PL, Ferreira LN, Pereira LN. Contribution for the
validation of the Portuguese version of EQ-5D. Acta Med
Port. 2013;26(6):664-75.
Machado FVC, Meys R, Delbressine JM, Vaes AW, Goërtz YMJ,
et al. Construct validity of the Post COVID-19 Functional
Status Scale in adult subjects with COVID-19. Health Qual
Life Outcomes. 2021;3;19(1):40. doi: 10.1186/s12955-021-01691-2.
Silva LCC, Rubin AS, Silva LMC, Fernandes JC. Espirometria
na prática médica. AMRIGS. 2005;49(3):183-94.
Pereira CAC, Rodrigues SC, Sato T. Novos valores de referência
para espirometria forçada em brasileiros adultos de raça branca.
J Bras Pneumol. 2007;33(4):397-406.
Souza RB. Pressões respiratórias estáticas máximas. J Pneumol.
;28(Suppl 3):S155-65.
Pereira CAC, Sato T, Rodrigues SC. Novos valores de referência
para espirometria forçada em brasileiros adultos de raça branca.
J Bras Pneumol. 2007;33(4):397-406.
Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values
for lung function tests: maximal respiratory pressures and
voluntary ventilation, 2. Braz J Med Biol Res. 1999;32(6):719-27.
Lima CA, Siqueira TB, Travassos EF, Macedo CMG, Bezerra AL,
et al. Influência da força da musculatura no sucesso da
decanulação. Rev Bras Ter Intens. 2002;23(1):56-61.
Dias JA, Ovando AC, Külkamp W, Junior NGB. Força de Preensão
Palmar: métodos de avaliação e fatores que influenciam a medida.
Rev Bras Cineantropom Desemp Hum. 2010;12(3):209-16.
ATS Committee on Profi ciency Standards for Clinical Pulmonary
Function Laboratories. ATS statement: guidelines for the sixminute
walk test. Am J Respir Crit Care Med. 2002;166(1):111-7.
doi: org/10.1164/ajrccm.166.1.at1102
Enright PL, Sherril DL. Reference equations for the six-minute
walk in healthy adults. J Respir Crit Care Med. 1998;158:1384-87.
Núñez-Cortés R, Ruvera-Lillo G, Arias-Campoverde, Soto-
Garcia D, Garcia-Palomera R, et al. 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: 10.1177/1479973121999205
Victora C, Castro MC, Gurzenda S, Medeiros AC, Giovanny
França, et al. Estimating the early impact of vaccination against
COVID-19 on deaths among elderly people in Brazil: analyses
of routinely-collected data on vaccine coverage and mortality.
Lancet. 2021;38:256187. doi: 10.1016/j.eclinm.2021.101036
Ministério da Saúde (BR). Secretaria de Vigilância em Saúde.
Plano Nacional de Operacionalização da Vacinação Contra a
COVID-19. Brasília (DF): Ministério da Saúde; 2021.
Naveca F, Nascimento V, Souza VC, Corado AL, Nascimento F,
et al. COVID-19 in Amazonas, Brazil, was driven by the persistence
of endemic lineages and P.1 emergence. Nat Med. 2021;27,
-8. doi: https://doi.org/10.1038/s41591-021-01378-7
Faria NR, Mellan TA, Whittaker C, Claro IM, Candido DS, et al.
Genomics and epidemiology of the P.1 SARS-CoV-2 lineage
in Manaus, Brazil. Science. 2021;372(6544):815-21. doi: 10.1126/
science.abh2644
Challen R, Brooks-Pollock E, Read JM, Dyson L, Tsaneva-
Atanasova K, et al. Risk of mortality in patients infected with
SARS-CoV-2 variant of concern 202012/1: matched cohort study.
BMJ. 2021;372:n579. doi: 10.1136/bmj.n579. doi: 10.1136/bmj.n579
Niquini RP, Lana RM, Pacheco AG, Cruz OG, Coelho FC, et al. SRAG
por COVID-19 no Brasil: descrição e comparação de características
demográficas e comorbidades com SRAG por influenza e com
a população geral. Cad Saude Publica. 2020;36(7):e00149420.
doi: https://doi.org/10.1590/0102-311X00149420
Silva GM, Pesce GB, Martins DC, Carreira L, Fernandes CAM,
et al. Obesidade como fator agravante da COVID-19 em
adultos hospitalizados: revisão integrativa. Acta Paul Enferm.
;34:eAPE02321. doi: 10.37689/acta-ape/2021AR02321
Centers for Diseade Control and Prevention. People with Certain
Medical Conditions and COVID-19 Risk Factors. [2022] [cited
10 14]. Available from: https://www.cdc.gov/covid/riskfactors/
index.html
Cai H. Sex difference and smoking predisposition in patients
with COVID-19. Lancet Respir Med. 2020;8(4):e20. doi: 10.1016/
S2213-2600(20)30117-X. Erratum in: Lancet Respir Med.
;8(4):e26. doi: 10.1016/S2213-2600(20)30130-2.
Organização Pan-Americana da Saúde. Hospitalizações e mortes
entre jovens por COVID-19 disparam, afirma diretora da OPAS
[Internet]. Paho.org. [2021] [cited 2021 06 10]. Available from:
https://www.paho.org/pt/noticias/5-5-2021-hospitalizacoes-emortes-
entre-jovens-por-covid-19-disparam-afirma-diretora-da
Freitas ARR, Beckedorff OA, Cavalcanti LPG, Siqueira AM,
Castro DB, et al. A emergência da nova variante P.1 do SARSCoV-
no Amazonas (Brasil) foi temporalmente associada a
uma mudança no perfil da mortalidade devido a COVID-19,
segundo sexo e idade. Lancet Reg Health Am. 2021;1:100064.
doi: 10.1016/j.lana.2021.100021
Karagiannidis C, Windisch W, McAuley DF, Welte T, Busse R.
Major differences in ICU admissions during the first and second
COVID-19 ave in Germany. Lancet Respir Med. 2021;9(5):e47-8.
Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott
HC. Pathophysiology, Transmission, Diagnosis, and Treatment
of Coronavirus Disease 2019 (COVID-19): A Review. JAMA.
;324(8):782-93. doi:10.1001/jama.2020.12839
Kurtz P, Bastos LSL, Dantas LF, Zampieri FG, Soares M, et al.
Evolving changes in mortality of 13 301 critically ill adult
patients with COVID-19 over 8 months. Intensive Care Med.
;47:538-48. doi: 10.1007/s00134-021-06388-0
Martinez BP, Andrade FMD, Roncalli A, Martins JA, Ribeiro DC,
et al. Indicação e uso da ventilação não-invasiva e da cânula
nasal de alto fluxo, e orientações sobre manejo da ventilação
mecânica invasiva no tratamento da insuficiência respiratória
aguda na COVID-19*. ASSOBRAFIR Cien. 2020;11(1):101-10.
doi: 10.47066/2177-9333.AC20.covid19.010
Grieco DL, Menga LS, Cesarano M, Rosà T, Spadaro S, et al.
Effect of Helmet Noninvasive Ventilation vs High-Flow Nasal
Oxygen on Days Free of Respiratory Support in Patients With
COVID-19 and Moderate to Severe Hypoxemic Respiratory
Failure: The HENIVOT Randomized Clinical Trial. JAMA.
;4;325(17):1731-43. doi: 10.1001/jama.2021.4682
Wang, JG. Cardiovascular Disease and Severe Hypoxemia Are
Associated With Higher Rates of Noninvasive Respiratory
Support Failure in Coronavirus Disease 2019 Pneumonia. Crit Care
Explor. 2021;3(3):e0355. doi: 10.1097/CCE.0000000000000355
Ministério da Saúde. Orientações sobre a otimização do uso
de oxigênio e suporte ventilatório em pacientes graves com
COVID-19. [2021]. [cited 2024 10 14]. Available from: https://www.
gov.br/saude/pt-br/assuntos/covid-19/publicacoes-tecnicas/
recomendacoes/orientacoes-sobre-otimizacao-do-uso-deoxigenio-
e-suporte-ventilatorio-em-pacientes-graves-comcovid-
Augustin MMD, Schoomers P, Stecher M, Dewald F, Gieselmann L,
et al. Post-COVID syndrome in non-hospitalised patients with
COVID-19: a longitudinal prospective cohort study. Lancet Reg
Health Eur. 2021;6:100122. doi: 10.1016/j.lanepe.2021.100122
Sudre CH, Murray B, Varvasky T, Graham MS, Penfold RS,
et al. Attributes and predictors of Long-COVID. Nat Med.
;27(4):626-31. doi: 10.1038/s41591-021-01292-y
Greenhalgh T, Knight MA, Buxton, M, Husain L. Management
of post-acute covid-19 in primary care. BMJ. 2020;370:m3026.
doi: 10.1136/bmj.m3026
Polese J, Sant`Ana L, Moulas IR, Lara IC, Bernardi JM, et al.
Pulmonary function evaluation after hospital discharge of
patients with severe COVID-19. Clinics. 2021;28;76:e2848.
doi: 10.6061/clinics/2021/e2848
Gautam AP, Arena R, Dixit S, Borghi-Silva A. Pulmonary
rehabilitation in COVID-19 pandemic era: The need for a revised
approach. Respirology. 2020;25(12):1320-2.
Borghi-Silva A, Krishna AG, Garcia-Araujo AS. Importance of
functional capacity assessment and physical exercise during
and after hospitalization in COVID-19 patients: revisiting
pulmonary rehabilitation. J Bras Pneumol. 2021;47(4):e20210277.
doi: 10.36416/1806-3756/e20210277
Sayler SJ, Maeda J, Sembuche S, Kebede Y, Tshangela A, et al.
The first second waves of the COVID-19 pandemic in Africa:
a cross-sectional study. Lancet. 2021;397(10281):1265-75.
doi: 10.1016/S0140-6736(21)00632-2
Portela MC, Grabois V, Travassos C. Matriz Linha de Cuidado
Covid-19 na Rede de Atenção à Saúde. Fiocruz. 2020;15.
Barker-Davies RM, O’Sullivan O, Senaratne KPP, Backer P,
Cranley M, et al. The Stanford Hall consensus statement for post-
COVID-19 rehabilitation. Br J Sports Med. 2020;54(16):949-59.
doi: 10.1136/bjsports-2020-102596
Khoo TC, Jesudason E, FitzGerald A. Catching our breath:
reshaping rehabilitation services for COVID-19. Disabil Rehabil.
;43(1):112-7. doi: 10.1080/09638288.2020.1808905
Siyi Zhu, Zhang L, Xie S, He H, Wei Q, et al. Reconfigure
rehabilitation services during the Covid-19 pandemic: best
practices from Southwest China. Disabil Rehabil. 2020;43(1):126-32.
doi: 10.1080/09638288.2020.1808905
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2024 Maria Julia Batista Moreira, Christiane Riedi Daniel, Andersom Ricardo Fréz, Marina Pegoraro Baroni, Sibele Andrade de Mello Knout, João Afonso Ruaro
Esta obra está bajo una licencia internacional Creative Commons Atribución-CompartirIgual 4.0.
