‘Endgame’ – Long term impacts of COVID-19最新文献

{"title":"P225 Pulmonary Rehabilitation in Long COVID – The impact of social deprivation and treatment delay on outcomes","authors":"J. Gallois, N. McWirter, A. Windith, D. Barber, S. Pilsworth, D. Wat","doi":"10.1136/thorax-2022-btsabstracts.357","DOIUrl":"https://doi.org/10.1136/thorax-2022-btsabstracts.357","url":null,"abstract":"P225 Figure 1ConclusionsThis study is a real-world delivery of PR in patients with Post COVID-19 syndrome, illustrating the improvements in physical conditioning. Unlike previous studies in the COPD population, socioeconomic status and the delays in starting PR did not affect the outcome of PR.1 As such this PR should be offered to any eligible patients following COVID-19 infection to improve their physical fitness.ReferenceSteiner MC, Lowe D, Beckford K, et al. Socioeconomic deprivation and the outcome of pulmonary rehabilitation in England and Wales, Thorax 2017;72:530–537.","PeriodicalId":338428,"journal":{"name":"‘Endgame’ – Long term impacts of COVID-19","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124184339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P222 Health-related quality of life symptom burden after COVID-19","authors":"F. Knight, N. McLeod, T. Akinola, F. Kamal","doi":"10.1136/thorax-2022-btsabstracts.354","DOIUrl":"https://doi.org/10.1136/thorax-2022-btsabstracts.354","url":null,"abstract":"IntroductionPatients hospitalised with COVID-19 are susceptible to chronic symptoms that can impact their health-related quality of life (HRQL). There is a limited understanding of the timeline of these symptoms or predictors of poorer HRQL outcomes in this patient cohort.We compared HRQL symptoms;specifically mobility, breathlessness, and anxiety and depression in patients pre- and post- hospitalisation with COVID-19, to identify any predictors of persistent symptoms.Method350 patients admitted with COVID-19 to Royal Berkshire Hospital between March 2020 and September 2021 were included. Symptom data was captured using the validated EQ-5D-5L questionnaire with pre-COVID scores (week 0), recorded retrospectively at time of discharge or at 6 weeks, compared with scores at 6- and 12-weeks post hospital discharge. Statistical analyses used a one-tailed dependent t-test to compare scores between the time points and logistic regression examined the influence of comorbidity burden, ICU admission and length of stay.ResultsComplete data was available for n=350 (61% male, mean age 57.8 years, SD 12.81). All patients required supplementary oxygen therapy with 79% requiring non-invasive ventilation and 16.62% mechanical ventilation. A statistically significant improvement was found in mobility, breathlessness and anxiety and depression scores at 12 weeks compared to 6 weeks. Overall HRQL scores were lower at week 0 than at week 12 (mean=5.6, SD 2.66 vs. mean=5.78, SD 5.46, p=0.0434), indicating a poorer HRQL outcome at 12 weeks compared to pre-COVID. Thus, the t-test result for the null hypothesis (HRQL at 0 weeks ≤HRQL at 12 weeks) was not statistically significant. There was no statistically significant difference on score outcomes of patients who required ICU compared to ward-based care. Pre-existing pulmonary disease was the only statistically significant risk factor identified to increase breathlessness scores at 12 weeks.ConclusionHospitalised patients who survived COVID-19 have impaired HRQL symptoms at 12 weeks compared to their pre-COVID baseline, though were on an improving trajectory. The data highlights that COVID-19 rehabilitation services may need to consider longer programme durations with appropriate psychological and physical support and targeting individuals with pre-existing pulmonary disease may help to address the symptom chronicity. Further research is required to tailor rehabilitation services.","PeriodicalId":338428,"journal":{"name":"‘Endgame’ – Long term impacts of COVID-19","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126353321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P229 Cardiopulmonary exercise testing in patients with long covid","authors":"SB Mistry, AK Banerjee","doi":"10.1136/thorax-2022-btsabstracts.361","DOIUrl":"https://doi.org/10.1136/thorax-2022-btsabstracts.361","url":null,"abstract":"ObjectiveExamine the relationship between symptoms and exercise physiological parameters in patients with long covid.MethodsPatients with long covid symptoms 6–12 months after covid19 infection referred to the long covid clinic were invited for Cardiopulmonary Exercise Testing (CPET). None had required ventilatory support during covid19 infection. All patients had normal transthoracic echocardiograms and normal resting flow-volume curves and gas transfer measurements. All patients underwent standard cycle ergometer symptom-limited CPET. Treatment guided by the CPET was offered and follow-up CPET was performed at 3 months.Results32 patients had a first CPET. The commonest symptoms were breathlessness (30/32), fatigue (26/32), cough (7/32), ‘brain fog’ (6/32) and chest pain (5/32). The main CPET physiological abnormalities were a borderline low peak oxygen uptake (mean 82.5% predicted), a low anaerobic threshold (AT, mean 47.6% of predicted maximal oxygen uptake) and a low oxygen uptake/work rate slope (mean 9.4 ml/min/W). The oxygen pulse curve flattened early in exercise, but peak oxygen pulse was normal (mean 88.9%).20 patients underwent a second CPET. 14 patients had improved symptoms: breathlessness (11/20), fatigue (9/20), cough (2/20), ‘brain fog’ (3/20) and chest pain (0/20). Symptom improvement was associated with a rise in peak oxygen uptake (to mean 85.3% predicted) and oxygen pulse (to mean 94.1% predicted) although both remained within the normal range. The AT remained low (mean 46.4% predicted maximal oxygen uptake). The ventilatory equivalent for carbon dioxide (VE/VCO2) was normal 28.6 L/L at AT.6 patients with unchanged symptoms had a reduction in oxygen pulse to mean 81.5% predicted compared to the first CPET but a rise in VE/VCO2 to 33.7 L/L at AT.ConclusionsLong covid is associated with impaired peak oxygen uptake, AT and oxygen pulse. This suggests an oxygen delivery or uptake disorder or deconditioning. The transthoracic echocardiograms were normal suggesting a disorder at the muscle level.A targeted treatment programme based on CPET improves symptoms and physiological parameters in long covid patients.Patients with unchanged symptoms after 3 months of treatment had persistent physiological abnormalities but appeared to develop features of dysfunctional breathing syndrome.","PeriodicalId":338428,"journal":{"name":"‘Endgame’ – Long term impacts of COVID-19","volume":"214 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122374860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}