ECSS Paris 2023: OP-MH15
INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worldwide and caused a pandemic that is still ongoing. The virus can cause a disease named as COVID-19, which is composed of multi systemic manifestations with a pulmonary system predominance with often damage to numerous other cells and organs, leading to an array of symptoms. Many individuals have reported persistent symptoms and/or complications lasting beyond 4 weeks, which is now called post-COVID-19 syndrome. While the precise definition of Post-COVID may be lacking, the most common symptoms reported in many studies are fatigue and dyspnea that last for months after acute COVID-19. Other persistent symptoms such as cognitive and mental impairments, chest and joint pains, palpitations, myalgia, smell and taste dysfunctions, cough, headache, and gastrointestinal and cardiac issues were reported. The purpose of this integrative review is to summarize and evaluate post-COVID-19 syndrome from a biological perspective and also discuss about physical exercise interventions. It is thus imperative to study post-COVID (short-term) and long-COVID (long-term) effects, specifically as local and systemic pathophysiological outcomes of other coronavirus-related diseases with the exercise interventions. METHODS: Pubmed, CINAHL, Scopus, Web of Science and Google Scholar search engines were used to identify the definition, mechanism, pathophysiology of short and long post-COVID and to find long COVID-19 and exercise-intervention benefits. RESULTS: Medical treatments for COVID-19 (anticoagulants, corticosteroids, anti-inflammatory drugs, oxygenation therapy and ventilation) and vaccination have improved patient outcomes. The majority of patients will recover spontaneously or after acute-phase management, but clinicians are now faced with long-term complications of COVID-19 including a large variety of symptoms, defined as "post-acute COVID-19 syndrome". Since the lungs are the most involved organs and the post-COVID prolonged and persistent effects are mainly related to the pulmonary system, it is crucial to define and predict the outcome and to determine the individuals that can progress to fibrosis and loss of function of lungs. The findings from our review indicated that there were four pathophysiological categories involved: virus-specific pathophysiological variations, oxidative stress, immunologic abnormalities, and inflammatory damage. CONCLUSION: Although studies examining the pathophysiology of post-COVID-19 syndrome are still relatively few, there is growing evidence that this is a complex and multifactorial syndrome involving virus-specific pathophysiological variations that affect many mechanisms but specifically oxidative stress, immune function, and inflammation. Further research is needed to elucidate the pathophysiology, pathogenesis, and longer term consequences involved in post-COVID-19 syndrome. This recent research summarizes the current literature regarding the pulmonary complications in post-COVID syndrome and the management of these conditions with regular physical exercise. Multicomponent exercise-intervention program (4-5 days per weeks, 35-60% HRR, 100-250 minutes aerobic exercise) considered especially for the post-COVID syndrome patients were recommended with all forms of psychological support such as meditation and MBI. Adopting life style changes will be helpful to reduce post-COVID-19 syndromes
Read CV YI SUB KWAKECSS Paris 2023: OP-MH15
INTRODUCTION: Between 6.5 and 28.5% of people infected with SARS-CoV-2 experience long-lasting sequelae described as the Post-COVID-19 Syndrome (PCS). Recently, exercise has been investigated as a non-pharmacological therapy and it has shown to improve physical function, health-related quality of life and symptom severity. Nevertheless, some experts raised concerns about the implementation of exercise therapy in this population as post-exertional malaise (PEM) is a frequent symptom. This data analysis describes the characteristics of a study sample that discontinued an exercise intervention in order to identify possible predictors for dropout. METHODS: As part of a randomized controlled trial, 47 patients with PCS were allocated to 12 weeks of endurance or concurrent training. Patients with PEM or a Post-COVID-19 Functional Status Score of ≥3 were excluded. The sample was grouped into subjects that finished the intervention (n=28) and dropouts (n=19) and subsequently analyzed via a group comparison of metric (independent t-Test or U-Test) and categorical data (chi-squared test). Furthermore, a logistic regression model with several predictors (BMI, age, days since COVID-19 infection, VO2peak, SF36 score, fatigue score and number of symptoms) as well as the odds ratios for dropout of the most prevalent symptoms were calculated. RESULTS: Reasons for dropout were viral or bacterial infection (n=7), COVID-19 reinfection (n=5), compliance issues (n=4), worsening of symptoms (n=2) and injury (n=1). Dropouts and non-dropouts did not significantly differ in any demographic or outcome variable at baseline. A trend towards significance was found for the number of PCS symptoms reported at inclusion (non-dropouts: 4.7±2.6, dropouts: 6.4±3.2, p=0.058). No independent risk or protective factors were identified in the logistic regression (p=0.345). Dizziness was the only symptom significantly associated with dropout (OR: 7.6, 95% CI: 1.4; 42.1, p=0.021). CONCLUSION: Two subjects discontinued the training due to a worsening of their symptoms. Despite screening for exercise intolerance before enrollment, this could possibly be related to PEM. Otherwise, the overall high dropout-rate in this sample might be attributed to increased rates of respiratory tract infections and possible PCS-related alterations in immune function which increase susceptibility to infections. Dizziness could be a predictor for poor exercise tolerance, however further investigation and larger samples are needed.
Read CV Johanna SickECSS Paris 2023: OP-MH15
INTRODUCTION: Long-Covid symptoms affect approximately 3% of the UK population (1.9 million people), highlighting the pressing need for an effective and scalable rehabilitation intervention. This study aimed to assess the efficacy of a novel blended rehabilitation programme on physical fitness and functional capacity of individuals with self-reported long-Covid. METHODS: Participants enrolled on a 12-week rehabilitation programme, consisting of two distinct phases. The initial 6 weeks involved remote live group-based and on-demand exercise sessions, while the subsequent 6 weeks transitioned to in-person rehabilitation sessions at local council leisure centres. Throughout the programme participants received telephone consultations and engaged in educational and social activities. Physical fitness and functional capacity were measured using the 30 second sit-to-stand (STS) test and the Duke Activity Status Index (DASI) at baseline and after 6- and 12-weeks of rehabilitation. RESULTS: 141 participants enrolled, 69% were female, mean (SD) 50 (12) years. Significant improvements were observed in physical fitness and functional capacity. Mean (SD) 30 second STS repetitions increased from 10 (6) at baseline, to 12 (6) at 6-weeks and 14 (5) at 12-weeks of rehabilitation (P<0.001, η2= 0.173), with 62% of participants demonstrating an improvement of more than the minimally clinically important difference (MCID) of 2 repetitions over the course of the rehabilitation programme. Similarly, DASI scores improved from 34 (15) at baseline to 39 (14) at 6-weeks and 42 (14) at 12-weeks of the programme (P<0.001, η2= 0.268), with 58% of individuals demonstrating improvements of more than the MCID (5 units). CONCLUSION: A blended digital and face-to-face rehabilitation programme resulted in statistically and clinically important differences in physical fitness and functional capacity in patients with self-reported long-Covid and may provide a scalable solution to assist in widescale treatment of long-Covid.
Read CV Andrew SimpsonECSS Paris 2023: OP-MH15