Readaptación funcional basada en ejercicio físico terapéutico en pacientes con COVID persistente (RECOVER) / Functional rehabilitation based on therapeutic exercise training in patients with postacute COVID syndrome (RECOVER)

Introduction and objectives Postacute COVID syndrome (PACS) is common after acute SARS-CoV-2 infection. One of the most frequent and disabling symptoms is exercise intolerance (EI). Recent evidence suggests that EI in PACS has a peripheral (metabolic-neuromuscular) origin, suggesting that exercise training may be an effective treatment. The aim of this study was to assess the role a therapeutic physical exercise program (TPEP) in PACS with EI. Method This single-center, open-label, randomized clinical trial compared an exercise training program (intervention group) with regular physical activity recommendations (control group) in patients with PACS and EI. The intervention group underwent an 8-week TPEP. The primary endpoint was improvement in functional capacity, assessed as the change in peak VO2. Results We included 50 participants with PACS (73% women, mean age 47±7.1 years). The intervention group showed a 15% improvement in peak VO2 (peak VO2 pre- and postintervention: 25.5±7.7mL/kg/min and 29.3±4.7 mL/kg/min; P <.001) and a 13.2% improvement in predicted values (92.1±14.3% and 108.4±13.4%; P <.001). No significant changes in VO2 values were observed in the control group. Unlike the control group, the intervention group also showed improvements in all secondary outcomes: quality of life scales, muscle power, maximum inspiratory power, metabolic flexibility, and body fat percentage. Conclusions The program improved functional capacity in patients with PACS and EI (AU)

Introducción y objetivos El síndrome de COVID persistente (SCP) es frecuente tras la infección aguda por SARS-CoV-2, y la intolerancia al ejercicio (IE) uno de los síntomas más frecuentes y limitantes. La evidencia reciente indica que el origen de los síntomas es periférico (muscular), por lo que el ejercicio físico podría ser un tratamiento eficaz. Este estudio evalúa la eficacia de un programa de ejercicio físico terapéutico (PEFT) en la mejora de la capacidad funcional de los pacientes con SCP e IE. Métodos Estudio aleatorizado, unicéntrico, controlado y abierto que compara un PEFT (grupo de intervención) con recomendaciones de actividad física estándar (grupo de control) en pacientes con SCP con IE. El grupo de intervención recibió 8 semanas de PEFT. El objetivo principal fue el cambio en la capacidad funcional medido mediante el consumo pico de oxígeno (VO2 pico). Resultados Se incluyó a un total de 50 pacientes con SCP (el 73% mujeres; media de edad, 47±7,1 años). El grupo de intervención presentó una mejora en el VO2 pico del 15% (VO2 pico inicial y final: 25,5±7,7 y 29,3±4,7ml/kg/min; p <0,001) y del 13,2% en valores del %VO2 máximo predicho (el 92,1±14,3% y el 108,4±13,4%; p <0,001), sin cambios significativos en el grupo de control. Todos los objetivos secundarios también mejoraron exclusivamente en el grupo de intervención: escalas de calidad de vida, potencia muscular desarrollada, potencia inspiratoria máxima, flexibilidad metabólica y porcentaje de grasa corporal. Conclusiones El PEFT mejora la capacidad funcional de los pacientes con SCP e IE (AU)

Functional rehabilitation based on therapeutic exercise training in patients with postacute COVID syndrome (RECOVER).

INTRODUCTION AND OBJECTIVES: Postacute COVID syndrome (PACS) is common after acute SARS-CoV-2 infection. One of the most frequent and disabling symptoms is exercise intolerance (EI). Recent evidence suggests that EI in PACS has a peripheral (metabolic-neuromuscular) origin, suggesting that exercise training may be an effective treatment. The aim of this study was to assess the role a therapeutic physical exercise program (TPEP) in PACS with EI. METHODS: This single-center, open-label, randomized clinical trial compared an exercise training program (intervention group) with regular physical activity recommendations (control group) in patients with PACS and EI. The intervention group underwent an 8-week TPEP. The primary endpoint was improvement in functional capacity, assessed as the change in peak VO2. RESULTS: We included 50 participants with PACS (73% women, mean age 47±7.1 years). The intervention group showed a 15% improvement in peak VO2 (peak VO2 pre- and postintervention: 25.5±7.7mL/kg/min and 29.3±4.7 mL/kg/min; P <.001) and a 13.2% improvement in predicted values (92.1±14.3% and 108.4±13.4%; P <.001). No significant changes in VO2 values were observed in the control group. Unlike the control group, the intervention group also showed improvements in all secondary outcomes: quality of life scales, muscle power, maximum inspiratory power, metabolic flexibility, and body fat percentage. CONCLUSIONS: The program improved functional capacity in patients with PACS and EI.

Herpetic esophagitis in immunocompentent host: cases report.

BACKGROUND: Herpetic esophagitis (EH) usually affects those who are immunocompromised and is uncommon in immunocompetent patients. In these cases, EH may occasionally present as an acute and self-limited illness. Such cases are rare and only a few have beenreported and limited published reviews exist making the benefits of antiviral therapy in immunocompetent patients unknown. CASE PRESENTATION: We report four cases of young patients who presented dysphagia, odynophagia and epigastric pain. Endoscopic findings revealed lesions in the distal esophagus and histopathological changes compatible with herpes virus infection confirmed by viral DNA in every case. After treatment, every patient showed significant improvement and tolerated oral intake after discharge. CONCLUSIONS: In this publication, we present four immunocompetent patients with EH, without relevant alterations in laboratory workup and with negative HIV status. This disease is infrequent in patients with such characteristics and there are few cases published. In order to better understand this pathology, we present the symptoms, the endoscopic alterations and the clinical evolution with treatment. In our series, 50% of patients had serology compatible with acute HVS type 1 infection, 25% had a subacute infection pattern (IgM and IgG positive antibodies) and in another 25% of patients, serology was not done. No patient presented leukocyte alterations, while all patients presented with anatomopathological findings compatible with acute herpetic esophagitis and responded to acyclovir therapy.