Respiratory function in subjects recovered from covid-19 with sarcopenia

Introduction: Coronavirus disease 2019 causes severe complications in subjects with risk factors: advanced age, diabetes, hypertension, obesity, among others. Patients with COVID-19 with severe disease have prolonged hospital stays, which causes dynapenia, muscle depletion, and sarcopenia, this induce a worse disease evolution and poor prognosis. Objective(s): Evaluate lung function in recovered COVID-19 with sarcopenia patients. Method(s): Cross-sectional study. 102 patients recovered from COVID-19 who required hospitalization wereincluded. Lung function was assessed using PIMAX, PEMAX, DLCO2 spirometry. Body composition was evaluated by electrical bioimpedance. Sarcopenia was diagnosed by appendicular muscle mass index (men: <7 kg / m, women <5.5 kg) and hand strength (men <27 kg, women <16 kg). Result(s): The population's average age was 44 years +/- 11.66, 58.88% were men, the subjects with sarcopenia had a higher prevalence of diabetes (26.32% vs 7.81%, p=0.039) hypertension (28.95% vs 12.5%, p = 0.039) compared with those without sarcopenia. Subjects with sarcopenia had worse respiratory parameters of FEV1(2.73lt vs 3.19lt, p=0.003), FEV1 post (2.70lt vs 3.24 lt, p=0.0005), FVC (3.19lt vs 3.9lt, p<0.001), FVCpost (3.22lt vs 3.90lt, p<0.001), FEV1/FVC (81.83 vs 84.17, p=0.040), DLCO (25.21 vs 31.83, p<0.001), and exercise tolerance (464.16 m vs 535.84 m, p<0.001) compared to the subjects withoout sarcopenia. Conclusion(s): COVID-19 recovered patients with a higher amount and sarcopenia developed a worse pulmonary and probably poor prognosis.

Prolonged stay and endothelial dysfunction in hospitalized patients with covid-19

Introduction: COVID-19 is not only a respiratory disease, produces a severe systemic and multi-organ response. This illness generates vascular disorders, leading the patient to endothelial dysfunction. It acutely and chronically affects the patient's evolution, prolonging the patient's stay and worsening life prognosis. Objective(s): To evaluate differences in endothelial dysfunction present in patients hospitalized for COVID-19 who had a hospital stay longer than 18 days compared to those who did not. Method(s): A prospective cohort study was conducted. Hospitalized patients with confirmed SARS-COV 2 andolder than 18 years were included. Subjects in whom endothelial function markers could not be processed wereexcluded. Endothelial dysfunction was evaluated using E-selectin, endothelin-1, glutathione-s-transferase, arginase, and MDAM. A prolonged hospital stay was established >=18 days. Result(s): A total of 165 patients were evaluated, the average age of the population was 57.18 +/- 13.37 years, 73.33% were men. Subjects with prolonged hospital stay were older (59.38 +/- 12.08 vs 51.15 +/- 14.96, p=0.004), a higher number of patients required intubation (87.60 % vs 75, p=0.049) and e-selectin (1 [0.79 - 1.32] vs 0.88 [0.68 -1.14], p=0.0323) compared to subjects without prolonged hospital stay. Conclusion(s): Hospitalized patients over 18 days showed elevated levels of E-selectin reflecting endothelial damage, affecting vascular homeostasis, added to this, a significant number of them were intubated, increasing the risk of mortality, as well as future cardiovascular complications.

Serum markers of endothelial dysfunction and invasive mechanical ventilation in COVID-19

Introduction: Sars-Cov-2 infection induces vascular endothelium damage at pulmonary and systemic level. Alterations on immunity response generate inappropriate endothelial activation through pro-inflammatory cytokines release, up-regulated expression of adhesion molecules, leukocyte migration, increased nitric oxide requirements and oxidative stress. Endothelial function is a key feature in the pathogenesis of COVID-19. Objective(s): To evaluate circulating markers associated with endothelial activation in hospitalized patients with COVID-19 and determine the difference between patients who required invasive mechanical ventilation (IMV) and those who did not. Method(s): Cross-sectional study. Subjects with a confirmed diagnosis of COVID-19 and >18 years old were included. Patients who did not require hospitalization were excluded. Serum markers of endothelial function were tested during hospitalization and protein adjustment was performed. Result(s): A total of 390 patients were studied, with an average age of 57+/-13 years old. Patients who required invasive mechanical ventilation had higher prevalence of diabetes (34.53% vs 11.54%;p=0.020), higher serum nitrite levels (0.028 mmol/L [0.094-0.647] vs 0.07 [0.03-0.24];p=0.003), nitrates (0.363mmol/L [0.100- 0.591] vs 0.130[0.003-0.374];p=0.004) and E-selectin (1.00 ng/mg [0.79-1.32] vs 0.84 [0.55-1.09];p=0.019) when compared to non-IMV patients. Higher levels of nitrites adjusted by proteins were associated with an increased risk for IMV (OR 5.59, CI 95 1.15-27.00, p=0.032). Conclusion(s): Patients with increased nitrites and E-selectin levels had worse endothelial dysfunction and a higher risk for IMV during hospitalization.

Impact of endothelial function on the prognosis of COVID19 patients

Introduction: The pathophysiological mechanisms related to the severity of the clinical picture of Sars-Cov-2 infection remain questions that the medical community seeks to resolve and whose knowledge will allow the design of therapeutic strategies. Purpose(s): To evaluate the association between endothelial function and mortality in patients with COVID-19. Material(s) and Method(s): Prospective cohort study. Patients with confirmed diagnosis of COVID-19, who required hospitalization, oxygen saturation <60% and laboratory data of endothelial function markers were included;all those with incomplete data were excluded. Result(s): The age of the population was 57.06 +/- 13.405, 69% were intubated, those who died had poorer ventilatory parameters;peak pressure (30.06 +/- 6.13 vs 24.82 +/- 6.06, p<0.001), Fi02 (57.5 [40 - 80] vs 45 [40 -80], p <0.001) and PaO2/FiO2 calculation (127.84 +/- 50.08 vs 163.36 +/- 45.47, p<0.001). In addition, they had greater laboratory alterations: procalcitonin (0.49 [0.16 - 4] vs. 18 [0.07 - 0.52], p=0.03) and CRP (13.34[7.67 - 19.03] vs 6.69 [2.4 - 15 89], p=0.05), higher levels of clotting times, PT(14.8 [14 - 16.6] vs 14.4 [13.7 -15.6], p=0.5) and INR (1.04 [0.98 - 1.17] vs 1.01 [.95 - 1.1], p=0.05). In blood biometry, higher numbers of leukocytes of (11.3 [8.65 - 14.4] vs. 9.9 [6.7 - 13], p=0.041), neutrophils (8.8 [7.4 - 12.5] vs. 8.1 [4.74 - 11.1], p=0.01) and lower numbers of lymphocytes (. 7 [.40 - 1.1] vs 1.1 [.7 - 1.5], p<0.001) and with significant statistical trend, hemoglobin(11.26 +/- 2.55 vs 12.42 +/- 2.4, p=0.07) compared to surviving subjects. Conclusion(s): Hematological and liver alterations are markers of higher mortality in patients with COVID-19 as an expression of multiorgan disease.

Effect of physical conditioning evaluated in the 6-minute walk in subjects recovered from COVID-19

Introduction: Physical conditioning develops conditional and coordinative capacities to improve physical performance through exercise. The 6-minute walk test (PC6M) assesses in an integrated manner the response of the respiratory, cardiovascular, metabolic, musculoskeletal, and neurosensory systems to the stress imposed by exercise. Functional integration is analyzed by the maximum distance an individual can cover during six minutes of walking as fast as possible. Objective(s): To evaluate the effect of physical conditioning on the physical capacity of subjects recovered from COVID 19. Method(s): Clinical trial in subjects recovered from COVID-19 who required hospitalization during the acute phase, > 18 years were included. Subjects with musculoskeletal lesions were excluded. Physical capacity was assessed by PC6M. The intervention had a duration of 20 sessions of physical conditioning on cycle ergometer for arms and legs, treadmill and elliptical trainer. Result(s): Forty-two patients were evaluated, 56.41% of whom were men, with a mean age of 53.48 +/- 14.3 years. After 20 physical conditioning sessions, increase the physical capacity (434.58 +/- 89.10 vs. 546.63 +/- 101.34;p < 0.001), assessing dyspnea, fatigue, and saturation where no significant differences were found observed. Conclusion(s): An improvement in functional capacity was observed after 20 sessions.