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Pleguezuelos E, Del Carmen A, Moreno E, Ortega P, Robles A, Serra-Prat M, Miravitlles M, Yebenes JC, Garnacho-Castaño MV. Impaired pulmonary and muscle function during moderate exercise in female patients recovered from SARS-CoV-2. Sci Rep 2022; 12:20943. [PMID: 36464697 PMCID: PMC9719894 DOI: 10.1038/s41598-022-24941-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
This study aimed to assess pulmonary and muscle dysfunction by analyzing the slow component of oxygen uptake (VO2SC), and mechanical and ventilatory efficiency in adult women recovered from the severe acute respiratory syndrome coronavirus type II (SARS-CoV-2) during a constant load test. 32 women (N = 17 patients with SARS-CoV-2; N = 15 control group) performed two cardiopulmonary exercise tests (CPX) on a cycle ergometer. In the first test, the participants performed incremental CPX until extenuation. In the second test the participants performed a 10-min CPX at a constant load intensity (watts) corresponding to the first ventilatory threshold. There was a 48-72 h rest period between the two tests. There was a significant increase in the VO2SC in the patients recovered from SARS-CoV-2 (160.4 ± 60 mL min-1) in comparison with the healthy participants (59.6 ± 65 mL min-1) (P < 0.001). Mechanical efficiency significantly decreased in patients recovered from SARS-CoV-2 compared to the control group (P = 0.04). Ventilatory inefficiency significantly increased in the patients recovered from SARS-CoV-2 compared with the control group (P < 0.001). Adult women recovered from SARS-CoV-2 infection have important pulmonary and muscular dysfunction and fatigue which contributes to increasing the VO2SC and reducing mechanical and ventilatory efficiency during mild-moderate exercise at a constant load.
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Affiliation(s)
- Eulogio Pleguezuelos
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Barcelona, Spain
- Department of Experimental Science and Healthcare, Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Amin Del Carmen
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Barcelona, Spain
| | - Eva Moreno
- Physical Medicine and Rehabilitation Department, Hospitalet General Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Pilar Ortega
- Pneumology Department, Hospital de Mataró, Barcelona, Spain
| | | | - Mateo Serra-Prat
- Research Unit, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain
| | - Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | | | - Manuel V Garnacho-Castaño
- Campus Docent Sant Joan de Déu, Fundación Privada, Universitat de Barcelona, Carrer de Miret i Sans, 10, 08034, Barcelona, Spain.
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Pleguezuelos E, Del Carmen A, Llorensi G, Carcole J, Casarramona P, Moreno E, Ortega P, Serra-Prat M, Palomera E, Miravitlles MM, Yebenes JC, Boixeda R, Campins L, Villelabeitia-Jaureguizar K, Garnacho-Castaño MV. Severe loss of mechanical efficiency in COVID-19 patients. J Cachexia Sarcopenia Muscle 2021; 12:1056-1063. [PMID: 34102017 PMCID: PMC8242734 DOI: 10.1002/jcsm.12739] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/30/2021] [Accepted: 05/21/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There is limited information about the impact of coronavirus disease (COVID-19) on the muscular dysfunction, despite the generalized weakness and fatigue that patients report after overcoming the acute phase of the infection. This study aimed to detect impaired muscle efficiency by evaluating delta efficiency (DE) in patients with COVID-19 compared with subjects with chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), and control group (CG). METHODS A total of 60 participants were assigned to four experimental groups: COVID-19, COPD, IHD, and CG (n = 15 each group). Incremental exercise tests in a cycle ergometer were performed to obtain peak oxygen uptake (VO2 peak). DE was obtained from the end of the first workload to the power output where the respiratory exchange ratio was 1. RESULTS A lower DE was detected in patients with COVID-19 and COPD compared with those in CG (P ≤ 0.033). However, no significant differences were observed among the experimental groups with diseases (P > 0.05). Lower VO2 peak, peak ventilation, peak power output, and total exercise time were observed in the groups with diseases than in the CG (P < 0.05). A higher VO2 , ventilation, and power output were detected in the CG compared with those in the groups with diseases at the first and second ventilatory threshold (P < 0.05). A higher power output was detected in the IHD group compared with those in the COVID-19 and COPD groups (P < 0.05) at the first and second ventilatory thresholds and when the respiratory exchange ratio was 1. A significant correlation (P < 0.001) was found between the VO2 peak and DE and between the peak power output and DE (P < 0.001). CONCLUSIONS Patients with COVID-19 showed marked mechanical inefficiency similar to that observed in COPD and IHD patients. Patients with COVID-19 and COPD showed a significant decrease in power output compared to IHD during pedalling despite having similar response in VO2 at each intensity. Resistance training should be considered during the early phase of rehabilitation.
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Affiliation(s)
- Eulogio Pleguezuelos
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain.,Department of Experimental Science and Healthcare, Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Amin Del Carmen
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Gemma Llorensi
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Jessica Carcole
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Paula Casarramona
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Eva Moreno
- Physical Medicine and Rehabilitation Department, Hospitalet General Hospital, L'Hospitalet de Llobregat, Spain
| | - Pilar Ortega
- Pneumology Department, Hospital de Mataró, Mataró, Spain
| | | | | | - Marc M Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | | | - Ramón Boixeda
- Department of Internal Medicine, Hospital de Mataró, CSDM, Mataró, Spain.,Grup d'Estudi al Maresme de la Pneumònia Adquirida en la Comunitat i la MPOC (GEMP@C), Mataró, Spain
| | - Lluis Campins
- Department of Pharmacy, Hospital de Mataró, CSdM, Mataró, Spain
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Canadell L, Martín-Loeches I, Díaz E, Trefler S, Grau S, Yebenes JC, Almirall J, Olona M, Sureda F, Blanquer J, Rodriguez A. Degree of adherence to recommended antiviral treatment during the pandemic and post-pandemic periods of influenza A(H1N1)pdm09 in 148 intensive care units in Spain. Med Intensiva 2014; 39:222-33. [PMID: 25107582 DOI: 10.1016/j.medin.2014.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/26/2014] [Accepted: 06/04/2014] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine the degree of antiviral treatment recommendations adherence and its impact to critical ill patients affected by influenza A(H1N1)pdm09 mortality. DESIGN Secondary analysis of prospective study. SETTING Intensive care (UCI). PATIENTS Patients with influenza A(H1N1)pdm09 in the 2009 pandemic and 2010-11 post-Pandemic periods. VARIABLES Adherence to recommendations was classified as: Total (AT); partial in doses (PD); partial in time (PT), and non-adherence (NA). Viral pneumonia, obesity and mechanical ventilation were considered severity criteria for the administration of high antiviral dose. The analysis was performed using t-test or «chi» square. Survival analysis was performed and adjusted by Cox regression analysis. RESULTS A total of 1,058 patients, 661 (62.5%) included in the pandemic and 397 (37.5%) in post-pandemic period respectively. Global adherence was achieved in 41.6% (43.9% and 38.0%; P=.07 respectively). Severity criteria were similar in both periods (68.5% vs. 62.8%; P=.06). The AT was 54.7% in pandemic and 36.4% in post-pandemic period respectively (P<.01). The NA (19.7% vs. 11.3%; P<.05) and PT (20.8% vs. 9.9%, P<.01) was more frequent in the post-pandemic period. The mortality rate was higher in the post-pandemic period (30% vs. 21.8%, P<.001). APACHE II (HR=1.09) and hematologic disease (HR=2.2) were associated with a higher mortality and adherence (HR=0.47) was a protective factor. CONCLUSIONS A low degree of adherence to the antiviral treatment was observed in both periods. Adherence to antiviral treatment recommendations was associated with lower mortality rates and should be recommended in critically ill patients with suspected influenza A(H1N1)pdm09.
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Affiliation(s)
- L Canadell
- Servicio de Farmacia Hospitalaria, Hospital Universitario de Tarragona Joan XXIII, Universitat Rovira i Virgili, Institut d'Investigaciò Sanitaria Pere Virgili, Tarragona, España
| | - I Martín-Loeches
- Servicio de Medicina Intensiva, Corporación Sanitaria Parc Taulí, CIBERES, Sabadell, España
| | - E Díaz
- Servicio de Medicina Intensiva, Corporación Sanitaria Parc Taulí, CIBERES, Sabadell, España
| | - S Trefler
- Servicio de Medicina Intensiva, Hospital Universitario de Tarragona Joan XXIII, Universitat Rovira i Virgili, Institut d'Investigaciò Sanitaria Pere Virgili, Tarragona, España
| | - S Grau
- Servicio de Farmacia Hospitalaria, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España
| | - J C Yebenes
- Servicio de Medicina Intensiva, Hospital Universitario de Mataró, Mataró, España
| | - J Almirall
- Servicio de Medicina Intensiva, Hospital Universitario de Mataró, Mataró, España
| | - M Olona
- Servicio de Medicina Preventiva - Hospital Universitario de Tarragona Joan XXIII, Tarragona, España
| | - F Sureda
- Cátedra de Farmacología clínica - Universidad Rovira i Virgili, Tarragona, España
| | - J Blanquer
- Servicio de Medicina Intensiva, Hospital Clínico, Valencia, España
| | - A Rodriguez
- Servicio de Medicina Intensiva, Hospital Universitario de Tarragona Joan XXIII, Universitat Rovira i Virgili, Institut d'Investigaciò Sanitaria Pere Virgili, Tarragona, España; Centros de Investigación Biomédica en Red Enfermedades Respiratorias , Tarragona, España.
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