Functional exercise rehabilitation guidance improves the prognosis for COVID-19 patients

2019年冠状病毒病(COVID-19) 康复 2019-20冠状病毒爆发 严重急性呼吸综合征冠状病毒2型(SARS-CoV-2) 医学 物理医学与康复 物理疗法 内科学 病毒学 疾病 爆发 传染病(医学专业)
作者
Haonan Qian,Seongno LEE,Tianwei LI,Dong Li,Wanyu Shu
出处
期刊:Gazzetta medica italiana. Archivio per le scienze mediche [Edizioni Minerva Medica]
卷期号:183 (1-2)
标识
DOI:10.23736/s0393-3660.23.05106-9
摘要

BACKGROUND: To investigate the effectiveness of a supervised exercise program in caring for patients with novel coronavirus pneumonia (NCP) during lung function recovery and determine functional exercise’s impact on immune cell indicators in NCP.METHODS: A descriptive observational study was conducted on 50 patients with NCP admitted between January 2020 and January 2021. Furthermore, they were randomized into two groups: a supervised exercise program group (Gym, n25) and a no-exercise control group (Home, n25), with the experimental intervention lasting eight weeks. Demographic and clinical characteristics, diagnostic tests, and treatment data were collected, patients were given health education, knowledge, and psychological care prior to instruction, physical function was measured before and after the intervention and their elbow venous blood samples were collected before and after the race preparation period for 8 weeks. Cytokine concentrations were measured, and the percentage of various lymphocytes was measured using flow cytometry.RESULTS: We analysed serum chemokine (CXCL8/IL-8, CCL5/RANTES, CXCL9/ MIG, CCL2/MCP-1 and CXCL10/IP-10) and cytokine (IL-2, IL-4, IL-6, IL-10, IL17A, TNF-a and IFN-g) levels. There was no significant difference in serum chemokine and cytokine levels between the supervised and unsupervised home exercise groups before the intervention. IL-8, CXCL10, IL-6, IL-10, TNF-a, and IL-17A decreased after eight weeks of supervised exercise, and the difference was statistically significant. Also, after eight weeks of an unsupervised home exercise program, there was a statistically significant difference (P<0.05) in the number of leukocytes, monocytes, and basophils in the supervised exercise group compared to the unsupervised home exercise group in the pre-test compared to the post-test. The bureau showed a trend toward a decrease. The cardiopulmonary rehabilitation group showed an increase in maximum exercise tolerance, an 18.62% increase in peak oxygen consumption (VO2peak), and a 29.05% increase in time to peak oxygen consumption. VE/VCO2 slope decreased by 5.21% after the intervention. We also observed increased sub-maximal exercise tolerance (70.57 m in the 6-minute walk test, P=0.001), improved quality of life, and reduced postintervention fatigue.CONCLUSIONS: Given these results, the present study observed that supervised exercise modulates the immune response in individuals after COVID-19, decreasing levels of inflammatory factors such as IL-8, CXCL10, IL-6, IL-10, TNF-a, and IL-17A and preventing excessive inflammatory damage. After 8 weeks of supervised exercise, supervised exercise reduced leukocyte counts, monocyte, and basophil count in young athletes. In this work, supervised exercise improved cardiopulmonary function, respiratory physiology, muscle strength, maximal and secondary exercise tolerance, fatigue, and quality of life in patients.
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