ABSTRACT
The aim of this study was to investigate the effects of different protocols of moderate-intensity intermittent hypoxic training in patients who had recovered from COVID-19 on quality of life (QoL) and mental health. The sample of this clinical trial-controlled double-blind study consisted of 67 participants aged 30-69 years, who were organized randomly according to Normoxia, Hypoxia, Hypoxia Recovery or Control Group. Eight weeks of cycle ergometer training were performed with a frequency of three training sessions per week in normoxic or hypoxic conditions (with or without hypoxic recovery). Health-related QoL and Mental Health Status were evaluated by 12-Item Short Form Survey and Depression Anxiety and Stress Scale instruments, respectively. All training groups improved the QoL's physical dimensions (Baseline-Post: Normoxia Group 42.1 (11.0)-48.7 (7.0), Hypoxia Group 46.9 (11.8)-53.5 (6.6) and Hypoxia Recovery Group 45.8 (9.2)-51.1 (5.3)) and mental dimensions (Baseline-Post: Normoxia Group 48.8 (7.9)-54.6 (4.6), Hypoxia Group 45.2 (7.7)-53.2 (3.8) and Hypoxia Recovery Group 46.5 (9.7)-52.0 (9.9)). Regarding mental health outcomes, all training groups decreased depressive symptoms (66.7% Normoxia, 31.2% Hypoxia Recovery and 31% Hypoxia groups), anxiety symptoms (46.5% Normoxia, 45.9% Hypoxia Recovery and 39.5% in the Hypoxia groups) and stress symptoms (40.6% Normoxia, 36.3% Hypoxia Recovery and 22.1% Hypoxia groups). Significant statistical difference was not found between groups. Normoxic and hypoxic training showed a similar effect on QoL and the mental health of Brazilian adults who had recovered from COVID-19.
ABSTRACT
The aims were to identify the symptoms and comorbidities predictive for severe illness and analyse the mild-term health sequelae in Brazilian recovered from COVID-19. Eighty-four participants were divided into mild (n = 16), moderate (n = 51), severe (n = 9) or critical (n = 8) gravity. A standardized assessment included: anamnesis to identify the symptoms and comorbidities; and cardiorespiratory system, body composition, haematological and immunological indicators, and physical fitness to analyze the mild-term health sequelae. Participants with higher gravity presented fever, fatigue and dyspnoea. Diabetes (p = 0.003), hypertension (p < 0.001) and metabolic syndrome (p = 0.010) were the comorbidities significantly associated for severe or critical illness. People with critical gravity reported a significant higher waist/hip ratio and level of visceral fat compared with mild and moderate severity. Severe and critical participants reported worst results in agility and balance test compared with mild (p = 0.015; p = < 0.001, respectively) and moderate (p = 0.014; p = < 0.001, respectively) gravity. Fever, fatigue and dyspnoea; and diabetes, hypertension and metabolic syndrome were the symptoms and comorbidities associated with higher gravity. Mild-term, altered values of body composition, physical functioning, enhanced glucose, reticulocytes, and lymphocytes levels were reported. (AU)
Subject(s)
Humans , Aftercare , Health , ComorbidityABSTRACT
During the COVID-19 pandemic, several late-onset impairments have been observed, affecting the health and functionality of those involved. On the other hand, lower SARS-CoV-2 infection rates and severity of symptoms were observed in high-altitude cities. In this sense, the AEROBICOVID project was developed with the hypothesis that exercise would be an important opportunity for health improvement and that hypoxia would promote additional benefits in the recovery process. The cohort was about 84 participants with approximately 30 days since the COVID-19 symptoms recovery, 25 in the control group, and 59 divided into three moderate physical training groups. The project had good results in teaching, research, and extension, but also faced difficulties in operationalization. This experience is the basis for future proposals through an extension project at the University of São Paulo and in a Family Health Unit, besides a research project that will develop a new low-cost hypoxia technology (AU)
Durante a pandemia de COVID-19 estão sendo observados vários efeitos tardios, afetando a saúde e a funcionalidade dos acometidos. Por outro lado, foram observadas menores taxas de infecção pelo SARS-CoV-2 e gravidade dos sintomas em cidades de elevada altitude. Neste sentido, o projeto AEROBICOVID foi desenvolvido com a hipótese de que o exercício seria uma proposta importante para a melhoria da saúde e que a hipóxia promoveria benefícios adicionais no processo de recuperação. Participaram 84 pessoas com aproximadamente 30 dias desde a recuperação dos sintomas da COVID-19, 25 no grupo de controle e 59 divididos em três grupos de treinamento físico moderado. O projeto teve bons resultados no ensino, pesquisa e extensão, mas também enfrentou dificuldades na operacionalização. Estas experiências são a base para propostas futuras através de um projeto de extensão na Universidade de São Paulo e em uma Unidade de Saúde da Família, além de um projeto de pesquisa que desenvolverá uma nova tecnologia de hipóxia de baixo custo (AU)
Subject(s)
Humans , Exercise , Altitude Sickness , Clinical Study , COVID-19/rehabilitationABSTRACT
Introduction Opioids are the mainstay of pain management in critically ill patients. However, recent attention to their adverse effects in the intensive care unit (ICU) has led to the use of strategies that aim to reduce these side effects. Among these strategies, there are multimodal analgesia protocols, which prioritize pain management and employ a combination of different analgesics to spare excessive doses of opioids and sedatives in continuous infusion. Objective The objective of this study is to evaluate the impact of a multimodal analgesia protocol on clinical outcomes and consumption of sedatives and analgesics in two intensive care units. Methods We conducted a single-center, quasi-experimental, retrospective, and prospective cohort study comparing clinical outcomes and consumption of sedatives and analgesics before and after the implementation of a multimodal pain management protocol in critically ill adult patients. We included 465 patients in 2017 (pre-intervention group) and 1508 between 2018 and 2020 (post-intervention group). Results In the analysis of the primary outcome, there was a significant reduction in mortality between 2017 and 2020 (27.7% - 21.7%, p=0.0134). There was no statistical difference in mechanical ventilation time or concerning the infection rate. Patients who received the multimodal analgesia protocol had a decrease of 24% regarding mean fentanyl intake and a progressive reduction in morphine milligram equivalents (MME) (8.4% - 19%). There was an increasing trend in the use of adjuvant analgesics and morphine in preemptive and therapeutic analgesia. Conclusion The implementation of a multimodal pain control protocol significantly reduced morbidity and mortality and the use of opioids in the ICU.
