背景:COVID-19后综合征已经影响了数百万人,康复是非药物治疗的中心。然而,许多已发表的研究显示出相互矛盾的结果,在其他因素中,学科特征有很大差异。目前,年龄的影响,性别,实施时间,和先前疾病严重程度对COVID-19后监督康复计划结果的影响仍然未知。
方法:这是一项非随机病例对照研究。纳入患有COVID-19后遗症的受试者。在研究参与者中,那些可以参加8周的人,监督康复计划由干预组组成,而那些不能作为对照组的人。在基线和其后8周收集测量结果。
结果:研究组(N=119)具有相似的基线测量值。参与康复(n=47)与6分钟步行测试(6MWT)距离的临床重要改善有关,调整后(对于潜在的混杂因素)比值比(AOR)4.56(95%CI1.95-10.66);1分钟坐立测试,AOR4.64(1.88-11.48);短物理性能电池,AOR7.93(2.82-22.26);健康相关生活质量(HRQOL)5级EuroQol-5D(视觉模拟量表),AOR3.12(1.37-7.08);蒙特利尔认知评估,AOR6.25(2.16-18.04);国际身体活动问卷,AOR3.63(1.53-8.59);疲劳严重程度量表,AOR4.07(1.51-10.98);Chalder疲劳量表(双峰评分),AOR3.33(1.45-7.67);改良医学研究委员会呼吸困难量表(mMRC),AOR4.43(1.83-10.74);COVID-19后功能量表(PCFS),AOR3.46(1.51-7.95);和COPD评估测试,AOR7.40(2.92-18.75)。疾病发作时间仅与6MWT距离相关,AOR0.99(0.99-1.00)。先前住院与mMRC呼吸困难量表的临床重要改善相关,AOR3.50(1.06-11.51);和PCFS,AOR3.42(1.16-10.06)。年龄,性别,和ICU入住与上述任何测试/分级量表的结果均不相关.
结论:在这项非随机研究中,病例对照研究,COVID-19后康复与身体功能改善有关,活动,HRQOL,呼吸道症状,疲劳,和认知障碍。观察到这些关联与康复时间无关,年龄,性别,之前住院,ICU入院。
BACKGROUND: Post-COVID-19 syndrome has affected millions of people, with rehabilitation being at the center of non-pharmacologic care. However, numerous published studies show conflicting results due to, among other factors, considerable variation in subject characteristics. Currently, the effects of age, sex, time of implementation, and prior disease severity on the outcomes of a supervised rehabilitation program after COVID-19 remain unknown.
METHODS: This was a non-randomized case-control study. Subjects with post-COVID-19 sequelae were enrolled. Among study participants, those who could attend an 8-week, supervised rehabilitation program composed the intervention group, whereas those who couldn\'t the control group. Measurements were collected at baseline and 8 weeks thereafter.
RESULTS: Study groups (N = 119) had similar baseline measurements. Participation in rehabilitation (n = 47) was associated with clinically important improvements in the 6-min walk test (6MWT) distance, adjusted (for potential confounders) odds ratio (AOR) 4.56 (95% CI 1.95-10.66); 1-min sit-to-stand test, AOR 4.64 (1.88-11.48); Short Physical Performance Battery, AOR 7.93 (2.82-22.26); health-related quality of life (HRQOL) 5-level EuroQol-5D (Visual Analog Scale), AOR 3.12 (1.37-7.08); Montreal Cognitive Assessment, AOR 6.25 (2.16-18.04); International Physical Activity Questionnaire, AOR 3.63 (1.53-8.59); Fatigue Severity Scale, AOR 4.07 (1.51-10.98); Chalder Fatigue Scale (bimodal score), AOR 3.33 (1.45-7.67); Modified Medical Research Council dyspnea scale (mMRC), AOR 4.43 (1.83-10.74); Post-COVID-19 Functional Scale (PCFS), AOR 3.46 (1.51-7.95); and COPD Assessment Test, AOR 7.40 (2.92-18.75). Time from disease onset was marginally associated only with 6MWT distance, AOR 0.99 (0.99-1.00). Prior hospitalization was associated with clinically important improvements in the mMRC dyspnea scale, AOR 3.50 (1.06-11.51); and PCFS, AOR 3.42 (1.16-10.06). Age, sex, and ICU admission were not associated with the results of any of the aforementioned tests/grading scales.
CONCLUSIONS: In this non-randomized, case-control study, post-COVID-19 rehabilitation was associated with improvements in physical function, activity, HRQOL, respiratory symptoms, fatigue, and cognitive impairment. These associations were observed independently of timing of rehabilitation, age, sex, prior hospitalization, and ICU admission.