ABSTRACT
Background: Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatments of this syndrome is still poorly understood. In literature there is currently a lack of data on the real effectiveness of a multidisciplinary rehabilitation program based on structured physical exercise (SPE) in these patients. Purpose: To evaluate safety, effectiveness and feasibility of a structured individualized rehabilitation program in improving physical and psychological parameters in patients with LCS. Methods: Twenty-eight patients with LCS (19 males, mean age 57 years) underwent an accurate medical screening process, body composition evaluation, cardiopulmonary exercise test (CPET), muscular strength assessment, quality of life (QoL), psychological assessment and counselling, before and after a 12-sessions SPE program. Results: At baseline, all LCS patients showed severe impairments in physical performance, QoL and psychological parameters. No adverse effects and dropouts were observed during training session. After the rehabilitation program, significant improvement in CPET parameters, upper and lower limb muscular strength, perceived physical and mental health, body composition, depression and anxiety and Covid residual symptoms was observed. Conclusions: The present study confirms severe impairment of patients with LCS and suggest that a multidisciplinary rehabilitation program based on SPE could promote their physical and psychological recovery.
ABSTRACT
The occurrence of ischemic ST-segment elevation during an ergometric test is rare. Here we present the case of a 58-year-old male master athlete, deaf-mute since birth, without cardiovascular risk factors and asymptomatic, undergoing a medical examination for competitive athletics. During the maximal ergometric test (MET), performed with a surgical mask as required by the COVID-19 protocol of the Italian Sports Medicine Federation (FMSI), the athlete presented the onset of an ischemic type of ST-segment elevation in the V1-V6 leads, associated with angina symptoms, which resolved within a few minutes. The presence of critical but not occlusive coronary stenosis on urgent coronarography, the fact that the ST elevation and angor were of short duration, and the lack of raised troponin levels, suggest coronary spasm on a non-critical stenosis as a pathophysiological hypothesis, related to emotivity and use of a mask. In conclusion, ST-segment elevation during ergometric testing is rare, but it still must be taken into account during the sports medicine examination of a master athlete. The sports physician must be prepared to recognize such emergencies and act accordingly