Capacidade funcional, hemodinâmica cardíaca e oxigenação tecidual em pacientes pós Covid-19

Abstract

Introduction: Scientific and clinical evidence points to a persistent impairment of functional capacity in post-COVID-19 individuals, however the cause of functional limitation and symptomatology still need to be elucidated. Objective: to evaluate and compare functional capacity in post-Covid-19 patients versus a control group and to analyze cardiac hemodynamics and tissue muscle oxygenation response during assessment protocols in both groups. Methodology: Cross-sectional study in patients diagnosed with COVID-19 who were hospitalized or not (≥18 years) compared to a control group. The volunteers were submitted to two tests of functional capacity: the one-minute sit-stand test (1-STS) and the six-minute walk test (6MWT). In addition to the performance variables, we evaluated the cardiac hemodynamics response by impedance during the 1-STS and tissue perfusion responses in the oxygenation of the vastus lateralis muscle were recorded during and after both tests. For intragroup comparisons of variables, we performed the Friedman test while for intergroup comparisons Mann-Whitney. Results: Thirty-six patients (36.11% women, median age 36.00 (29.00-51.00) years, BMI 26.51 kg/m² (24.06-30.32)) in the post-COVID-19 group were included in the study and 11 individuals in the control group (72.72% women, median age 25.00(23.00-39.00) years, BMI 23.71 kg/m² (22.54-28.28)). The post-COVID-19 group showed a 20% reduction in performance versus control in the distance covered in the 6MWT (p=0.0001) and a 28% reduction in the number of repetitions of the 1-STS (p=0.01) compared to the control. Furthermore, there were intergroup differences in cardiac hemodynamics variables during the 1-STS protocol, where the post-COVID-19 group showed a reduction of 18% in VSi (p=0.004), of 21% in CI (p=0.0009), of 78% in ICT (p=0.0001) and 29% in EF (p=0.0003) and an increase in SVR by 25% (p=0.03) and 27% in RVSi (p=0, 0007). The tissue oxygenation variables during the 6MWT and 1-STS tests and in the recovery phase presented responses of similar magnitude in both groups, with no statistically significant difference between them. Conclusion: Our results suggest that the post-COVID-19 group when compared to the control showed (I) a reduction in functional capacity identified by both tests, by 28% in the 1-STS and 20% in the 6MWT, (II) changes in hemodynamic responses cardiac and systemic vascular resistance (III) similar pattern of supply and consumption of muscle oxygen in both tests similar in both groups. We suggest that other studies with a larger sample size and stratification of groups post COVID-19 to complement these findings.