在当前场景中,其中COVID-19幸存者数量增加,出现严重的身体失调,锻炼不容忍,持续的症状,和其他急性后后果,有效的康复策略至关重要。在这项研究中,我们首次报道了家庭运动训练(HBET)对一名重症COVID-19患者的影响.一名67岁女性患有危重的COVID-19疾病[住院71天,其中49天因呼吸衰竭而在重症监护病房(ICU)接受有创机械通气]接受了10周的HBET,旨在恢复整体身体状况。干预前后,我们评估了心肺参数,骨骼肌的力量和功能,疲劳严重程度,和自我报告的持续症状。在基线(出院后3个月),她表现为心肺功能能力严重受损(年龄预测VO2peak<50%)。干预之后,VO2峰显著改善(从10.61到15.48mL·kg-1·min-1,Δ:45.9%),吸氧效率斜率(OUES;从1.0到1.3L·min-1,Δ:30.1%),HR/VO2斜率(从92到52bpm·L-1,Δ:-43.5%),最低的VE/VCO2比(从35.4到32.9L·min-1,Δ:-7.1%),观察到劳力性呼吸困难。此外,握力(从22到27公斤,Δ:22.7%),30-s坐下来站立(30-STS;从14到16次重复,Δ:14.3%),定时上行(TUG;从8.25到7.01s,Δ:-15%)的表现和COVID后功能状态(PCFS)评分(从4到2)也从基线到干预后有所改善。自我报告的持续症状也得到了改善,从基线到干预后,疲劳严重程度量表(FSS)评分降低(从4降低到2.7)。这是半监督的第一个证据,HBET计划可能是安全的,并可能有效地改善COVID-19幸存者的心肺和身体功能。有必要进行对照研究以证实这些发现。
In the current scenario, in which an elevated number of COVID-19 survivors present with severe physical deconditioning, exercise intolerance, persistent symptoms, and other post-acute consequences, effective rehabilitation strategies are of utmost relevance. In this study, we report for the first time the effect of home-based exercise training (HBET) in a survivor patient from critical COVID-19 illness. A 67-year-old woman who had critical COVID-19 disease [71 days of hospitalization, of which 49 days were in the intensive care unit (ICU) with invasive mechanical ventilation due to respiratory failure] underwent a 10-week HBET aiming to recovering overall physical condition. Before and after the intervention, we assessed cardiopulmonary parameters, skeletal muscle strength and functionality, fatigue severity, and self-reported persistent symptoms. At baseline (3 months after discharge), she presented with severe impairment in cardiorespiratory functional capacity (<50% age predicted VO2peak). After the intervention, remarkable improvements in VO2peak (from 10.61 to 15.48 mL·kg-1·min-1, Δ: 45.9%), oxygen uptake efficiency slope (OUES; from 1.0 to 1.3 L·min-1, Δ: 30.1%), HR/VO2 slope (from 92 to 52 bpm·L-1, Δ: -43.5%), the lowest VE/VCO2 ratio (from 35.4 to 32.9 L·min-1, Δ: -7.1%), and exertional dyspnea were observed. In addition, handgrip strength (from 22 to 27 kg, Δ: 22.7%), 30-s Sit-to-Stand (30-STS; from 14 to 16 repetitions, Δ:14.3%), Timed-Up-and-Go (TUG; from 8.25 to 7.01 s, Δ: -15%) performance and post-COVID functional status (PCFS) score (from 4 to 2) were also improved from baseline to post-intervention. Self-reported persistent symptoms were also improved, and Fatigue Severity Scale (FSS) score decreased (from 4 to 2.7) from baseline to post-intervention. This is the first evidence that a semi-supervised, HBET program may be safe and potentially effective in improving cardiorespiratory and physical functionality in COVID-19 survivors. Controlled studies are warranted to confirm these findings.