The Effects of Covid-19 in Respiratory Functions and Exercise Capacity: A Pilot Study in Young Adults
DOI:
https://doi.org/10.12974/2312-5470.2021.07.03Keywords:
COVID-19, Respiratory Functions, Exercise Capacity, Prevention.Abstract
Background: The impact of coronavirus (COVID-19) on the pulmonary system and exercise capacity of young adults is important in terms of early detection of the existing or future chronic disease risk and secondary prevention. Objective: To compare the respiratory functions and exercise capacity of young adults who recovered from COVID-19 with healthy peers. Methods: Fifteen individuals (7 male, 8 female) aged 18-25 years, diagnosed with COVID-19 and at least 8 weeks passed after diagnosis (mean time: 239.13±135.77 days; min-max: 67-494 days) were included in the study. Age-sex matched 14 individuals (6 males, 8 females) without any diagnosis of COVID-19 and not been under quarantine because of COVID-19 were invited to the study as a control group. Respiratory functions (FEV1, FVC, FEV1/FVC, PEF) and mouth pressures (maximal inspiratory pressure-MIP, maximal expiratory pressure-MEP) were. Submaximal exercise capacity was evaluated with the “6-minutes walking test”. The lower extremity muscle functions were determined with the “1-minute sit to stand test". Results: All subjects were treated at home and fatigue (46%), persistent (40%) cough were the most reported ongoing symptoms in subjects who had COVID-19. Ground-glass appearance consistent with viral pneumonia was detected in radiological imaging of 3 (20%) subjects. The 6-minutes walking distance (p=0.037) and the number of sit-stands for 1 minute (p=0.007) were significantly lower in patients who had COVID-19 than age-gender matched healthy controls. Conclusion: The results of our study show that exercise capacity and muscle strength may be affected in young adults with mild COVID-19 compared to their peers.
References
Ozma MA, Maroufi P, Khodadadi E, Köse Ş, Esposito I, Ganbarov K, et al. Clinical manifestation, diagnosis, prevention and control of SARS-CoV-2 (COVID-19) during the outbreak period. Infez Med. 2020;28(2):153-165.
Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang TB, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol 2020;92(6):577-583. https://doi.org/10.1002/jmv.25757
Paneroni, M., Simonelli, C., Saleri, M., Bertacchini, L., Venturelli, M., Troosters, T., AmbrosinoN., Vitacca, M. Muscle strength and physical performance in patients without previous disabilities recovering from COVID-19 pneumonia. American Journal of Physical Medicine & Rehabilitation. 2020;100(2):105-109. https://doi.org/10.1097/phm.0000000000001641
İnal İnce D, Vardar Yağlı N, Sağlam M, Çalık Kütükcü E. COVID-19 Enfeksiyonunda Akut ve Post-Akut Fizyoterapi ve Rehabilitasyon. Turk J Physiother Rehabil. 2020; 31(1):81-93.
Barker-Davies RM, O'Sullivan O, Senaratne KP, Baker P, Cranley M, Dharm-Datta S, Norman J. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. British Journal of Sports Medicine. 2020;54(16): 949-959. https://doi.org/10.1136/bjsports-2020-102596
Spruit MA, Holland AE, Singh SJ, Tonia T, Wilson KC, Troosters T. COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society-and American Thoracic Society-coordinated international task force. European respiratory journal. 2020;56 (6). https://doi.org/10.1183/13993003.02197-2020
Klok FA, Boon GJAM, Barco S, et al. The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. Eur Respir J. 2020; 56: 2001494. https://doi.org/10.1183/13993003.01494-2020
Sustainable Development Goals Indicators, Global Database https://unstats.un.org/sdgs/indicators/database/?indicator=3.7.2
World Health Organization. Coronavirus disease ( COVID-19): situation report. 2020;198.
Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020; 370(11):3026. https://doi.org/10.1136/bmj.m3026
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319– 338. https://doi.org/10.1183/09031936.05.00034805
ATS/ERS. Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518–624. https://doi.org/10.1164/rccm.166.4.518
ATS. Statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–117. https://doi.org/10.1164/ajrccm.166.1.at1102
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–381. https://doi.org/10.1249/00005768-198205000-00012
Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Percept Mot Skills. 1995; 80:163–166. https://doi.org/10.2466/pms.1995.80.1.163
Recommendation from ERS Group 9.1 (Respiratory function technologists /Scientists) Lung function testing during COVID-19 pandemic and beyond. 2020. Date last updated: 09 May 2020.
Daher A, Balfanz P, Cornelissen C, Mu¨ller A, Bergs I, Marx N et al.: Follow up of patients with severe coronavirus disease 2019 (COVID-19): pulmonary and extrapulmonary disease sequelae. Respir Med 2020, 174. https://doi.org/10.1016/j.rmed.2020.106197
Mo X, Jian W, Su Z, Chen M, Peng H, Peng P et al.: Abnormal pulmonary function in COVID-19 patients at time of hospital discharge. Eur Respir J. 2020; 55. https://doi.org/10.1183/13993003.01217-2020
Rogliani P, Calzetta L, Coppola A, Puxeddu E, Sergiacomi G, D’Amato D, Orlacchio A. Are there pulmonary sequelae in patients recovering from COVID-19? Respiratory Research. 2020;21(1):1-4. https://doi.org/10.1186/s12931-020-01550-6
Bellan M, Soddu D, Balbo PE, Baricich A, Zeppegno P, Avanzi GC et al. Respiratory and psychophysical sequelae among patients with COVID-19 four months after hospital discharge. JAMA network open. 2021;4(1), e2036142-e2036142. https://doi.org/10.1001/jamanetworkopen.2020.36142
Thomas M, Oliver J. P, James H. H. "Pulmonary function and COVID-19." Current opinion in physiology. 2021;21:29-35. https://doi.org/10.1016/j.cophys.2021.03.005
Lv D, Chen X, Wang X, Mao L, Sun J, Wu G et al. Pulmonary function of patients with 2019 novel coronavirus induced pneumonia: a retrospective cohort study. Ann Palliat Med 2020; 9:3447-3452. https://doi.org/10.21037/apm-20-1688
Vitacca M, Paneroni M, Brunetti G, Carlucci A, Balbi B, Spanevello A, Ambrosino N. Characteristics of COVID-19 Pneumonia Survivors With Resting Normoxemia and Exercise-Induced Desaturation. Respiratory Care. 2021 Aug 24; respcare.09029. doi: 10.4187/respcare.09029. Online ahead of print. https://doi.org/10.4187/respcare.09029
Kajal P, Straudi S, Yee SN, Fayed N, Melvin JL, Sivan M. Applying the WHO ICF Framework to the Outcome Measures Used in the Evaluation of Long-Term Clinical Outcomes in Coronavirus Outbreaks. Int J Environ Res Public Health. 2020;17(18):6476. https://doi.org/10.3390/ijerph17186476
Josephine N, Fuglebjerg U, Jensen TO, Hoyer N, Ryrsø CK, Lindegaard B, Harboe ZB. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. Int J Infect Dis. 2020;99:100-101. https://doi.org/10.1016/j.ijid.2020.07.014
Fuglebjerg NJU, Jensen TO, Hoyer N, Ryrsø CK, Lindegaard B, Harboe ZB: Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. Int J Infect Dis. 2020; 99:100-101. https://doi.org/10.1016/j.ijid.2020.07.014
Van den Borst B, Peters J, Brink M, Schoon Y, Bleeker-Rovers C, Schers H et al.: Comprehensive health assessment three months after recovery from acute COVID-19. Ann Med. 2020; 0:1-14. https://doi.org/10.1093/cid/ciaa1750
Casanova C, Celli BR, Barria P, Casas A, Cote C, de Torres JP, Jardim J, Lopez MV, Marin JM, Montes de Oca M, Pinto-Plata V, Aguirre-Jaime A. On behalf of the Six Minute Walk Distance Project (ALAT). The 6-min walk distance in healthy subjects: reference standards from seven countries. European Respiratory Journal. 2011;37:150-156. https://doi.org/10.1183/09031936.00194909
Clavario P, de Marzo V, Lotti R, Barbara C, Porcile A, Russo C et al. Assessment of functional capacity with cardiopulmonary exercise testing in non-severe COVID-19 patients at three months follow-up. MedRxiv. 2020. https://doi.org/10.1101/2020.11.15.20231985
Tanriverdi A, Savci S, Kahraman BO, Ozpelit E. Extrapulmonary features of post-COVID-19 patients: muscle function, physical activity, mood, and sleep quality. Irish Journal of Medical Science 2021. 1-7. https://doi.org/10.1007/s11845-021-02667-3
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. 199-207. https://doi.org/10.23736/s1973-9087.21.06699-5
