Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial.
COVID-19 is a disease that broke out in late 2019 in China and became a pandemic in March 2020 to the present day. It is worrying that COVID-19 is a disease that mainly causes changes in the cardiorespiratory system with a deficit in respiratory muscle function and exercise tolerance, which can l...
| Autor principal: | LIMA, Priscila Bezerra de |
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| Grau: | Dissertação |
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Universidade Federal do Oeste do Pará
2023
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https://repositorio.ufopa.edu.br/jspui/handle/123456789/705 |
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ir-123456789-7052023-01-05T22:12:26Z Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. LIMA, Priscila Bezerra de SANTANA, Maxwell Barbosa de Avaliação Cardiopulmonar COVID-19 Fisioterapia CNPQ:: Ciências da Saúde COVID-19 is a disease that broke out in late 2019 in China and became a pandemic in March 2020 to the present day. It is worrying that COVID-19 is a disease that mainly causes changes in the cardiorespiratory system with a deficit in respiratory muscle function and exercise tolerance, which can lead to long-term sequelae. Objective: to evaluate the cardiopulmonary function of patients surviving COVID-19 in outpatient rehabilitation in the city of Santarém. Material and Method: After approval by the Research Ethics Committee with human beings, an analytical-descriptive, longitudinal, prospective and quantitative study was carried out. The evaluation stages were: interview through a semi-structured questionnaire; spirometry; sixminute step test (6MDT), in addition to dyspnea (MRC), functional independence (FIM) and perceived exertion (Borg scale) scales. Statistical analyzes were performed using Microsoft Excel 2010 software and R software. Results and Discussion: The sample consisted of 30 post-COVID-19 patients who underwent outpatient physical therapy treatment. The male sex was prevalent (73%), the mean age was 53 ± 13 years, 60% had the disease in its severe form. Compensatedly controlled comorbidities were found not to be risk factors for disease severity. The clinical manifestation and relevance of a pathological condition can be heterogeneous: whether the hypertension was treated or not; whether the stage of chronic lung disease was only mild or very severe with low blood oxygen levels, there are confounding factors to consider. The first symptoms of the disease did not define nor were related to the hospitalization history, making the patient's stability during the disease unpredictable. Pulmonary involvement through chest tomography and the history of hospitalization generated a strong impact with the ventilatory support used, where the latter and the length of hospital stay were directly related to the severity of the disease. Spirometry as an evaluative criterion for outpatient rehabilitation showed restrictive disorders. The functionality scales showed a mild degree of MRC, cognitive alterations in category 6 of the FIM. When the 6MWD was evaluated, predictive variables showed that the decrease in 6MWD performance with advancing age is strongly associated, since there is a reduction in physical capacity with aging. Final considerations: In this research, it was considered that patients sought outpatient physical therapy treatment early, about 2 months after the first symptoms of COVID-19, but still had the persistence of debilitating symptoms, for an average period of 8 months. months after the onset of COVID-19, however with significant improvement in the morbidity stage of the disease, even after the use of ventilatory support in therapy (mainly non-invasive). It is essential to associate physical capacity tests with pulmonary function tests, in order to maintain the follow-up of patients, as well as measure the functional impact in the long term. Therefore, there is a need to welcome the survivors of the first waves, as the premise of the post-COVID-19 syndrome is increasingly strengthened. A COVID-19 é uma doença que eclodiu no final de 2019, na China, e se tornou pandêmica em março de 2020 até os dias atuais. Preocupa o fato da COVID-19 ser uma doença que causa, principalmente, alterações do sistema cardiorrespiratório com déficit da função muscular respiratória e da tolerância ao exercício, podendo levar a sequelas a longo prazo. Objetivo: avaliar a função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial no município de Santarém. Material e Método: Após aprovação do Comitê de Ética em Pesquisa com seres humanos, foi realizado um estudo analíticodescritivo, longitudinal prospectivo e quantitativo. As etapas da avaliação foram: entrevista através de questionário semiestruturado; espirometria; teste do degrau de seis minutos (TD6), além das escalas de dispneia (MRC), de medida de independência funcional (MIF) e de percepção subjetiva de esforço (Escala de Borg). As análises estatísticas foram feitas no software Microsoft Excel 2010 e no software R. Resultados e Discussão: A amostra foi composta por 30 pacientes pós-COVID-19 que realizaram tratamento fisioterapêutico ambulatorial. O sexo masculino foi prevalente (73%), a média de idade foi 53 ± 13 anos, 60% apresentaram a doença em sua forma grave. Avaliou-se que as comorbidades compensadamente controladas não são fatores de risco para a gravidade da doença. A manifestação clínica e a relevância de uma condição patológica podem ser heterogêneas: se a hipertensão era tratada ou não tratada; se o estágio da doença pulmonar crônica era apenas leve ou muito grave com baixos níveis de oxigênio no sangue, existem fatores de confusão a serem considerados. Os primeiros sintomas da doença não definiram nem apresentaram relação com o histórico de internação, tornando-se imprevisível a estabilidade do paciente durante o curso da doença. O comprometimento pulmonar através da tomografia de tórax e o histórico de internação geraram forte impacto com o suporte ventilatório utilizado, onde este último e o tempo de internação estavam diretamente relacionados à gravidade da doença. A espirometria como critério avaliativo para a reabilitação ambulatorial evidenciou distúrbios restritivos. As escalas de funcionalidade demonstraram grau leve da MRC, alterações cognitivas na categoria 6 da MIF. Quando avaliado o TD6, variáveis preditoras mostraram que a diminuição do desempenho no TD6 com o avançar da idade estão fortemente associados, uma vez que há a redução na capacidade física com o envelhecimento. Considerações finais: Nesta pesquisa, considerou-se que os pacientes buscaram realizar tratamento fisioterapêutico a nível ambulatorial de forma precoce, cerca de 2 meses após os primeiros sintomas da COVID-19, mas ainda assim apresentavam persistência de sintomas debilitantes, num período médio de 8 meses após o acometimento da COVID-19, todavia com melhora importante da etapa de morbidade da doença, inclusive após o uso de suporte ventilatório na terapêutica (principalmente não invasivo). Torna-se fundamental, a associação de testes de capacidade física às provas de função pulmonar, a fim de se manter o acompanhamento dos pacientes, bem como mensurar o impacto funcional a longo prazo. Logo, há a necessidade de acolher os sobreviventes das primeiras ondas, pois cada vez se fortalece a premissa da síndrome pós-COVID-19. 2023-01-05T22:06:53Z 2023-01-05T22:06:53Z 2022 Dissertation LIMA, Priscila Bezerra de. Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. Orientador: Maxwell Barbosa de Santana. 2022. 84 f.:il. Dissertação (Mestrado) – Universidade Federal do Oeste do Pará, Pró-reitoria de Pesquisa, Pós Graduação e Inovação Tecnológica, Instituto de Saúde Coletiva, Programa de Pós-Graduação em Ciências da Saúde, , Santarém, 2022. Disponível em: Acesso em: https://repositorio.ufopa.edu.br/jspui/handle/123456789/705 https://repositorio.ufopa.edu.br/jspui/handle/123456789/705 pt_BR Acesso Aberto application/pdf Universidade Federal do Oeste do Pará Brasil Programa de Pós-Graduação em Ciências da Saúde UFOPA Instituto de Saúde Coletiva 1 CD-ROM |
| institution |
Repositório Institucional - Universidade Federa ldo Oeste do Pará - UFOPA |
| collection |
DSpace |
| language |
pt_BR |
| topic |
Avaliação Cardiopulmonar COVID-19 Fisioterapia CNPQ:: Ciências da Saúde |
| spellingShingle |
Avaliação Cardiopulmonar COVID-19 Fisioterapia CNPQ:: Ciências da Saúde LIMA, Priscila Bezerra de Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. |
| topic_facet |
Avaliação Cardiopulmonar COVID-19 Fisioterapia CNPQ:: Ciências da Saúde |
| description |
COVID-19 is a disease that broke out in late 2019 in China and became a pandemic in March
2020 to the present day. It is worrying that COVID-19 is a disease that mainly causes changes
in the cardiorespiratory system with a deficit in respiratory muscle function and exercise
tolerance, which can lead to long-term sequelae. Objective: to evaluate the cardiopulmonary
function of patients surviving COVID-19 in outpatient rehabilitation in the city of Santarém.
Material and Method: After approval by the Research Ethics Committee with human beings,
an analytical-descriptive, longitudinal, prospective and quantitative study was carried out. The
evaluation stages were: interview through a semi-structured questionnaire; spirometry; sixminute step test (6MDT), in addition to dyspnea (MRC), functional independence (FIM) and
perceived exertion (Borg scale) scales. Statistical analyzes were performed using Microsoft
Excel 2010 software and R software. Results and Discussion: The sample consisted of 30
post-COVID-19 patients who underwent outpatient physical therapy treatment. The male sex
was prevalent (73%), the mean age was 53 ± 13 years, 60% had the disease in its severe form.
Compensatedly controlled comorbidities were found not to be risk factors for disease severity.
The clinical manifestation and relevance of a pathological condition can be heterogeneous:
whether the hypertension was treated or not; whether the stage of chronic lung disease was
only mild or very severe with low blood oxygen levels, there are confounding factors to
consider. The first symptoms of the disease did not define nor were related to the
hospitalization history, making the patient's stability during the disease unpredictable.
Pulmonary involvement through chest tomography and the history of hospitalization
generated a strong impact with the ventilatory support used, where the latter and the length of
hospital stay were directly related to the severity of the disease. Spirometry as an evaluative
criterion for outpatient rehabilitation showed restrictive disorders. The functionality scales
showed a mild degree of MRC, cognitive alterations in category 6 of the FIM. When the
6MWD was evaluated, predictive variables showed that the decrease in 6MWD performance
with advancing age is strongly associated, since there is a reduction in physical capacity with
aging. Final considerations: In this research, it was considered that patients sought outpatient
physical therapy treatment early, about 2 months after the first symptoms of COVID-19, but
still had the persistence of debilitating symptoms, for an average period of 8 months. months
after the onset of COVID-19, however with significant improvement in the morbidity stage of
the disease, even after the use of ventilatory support in therapy (mainly non-invasive). It is
essential to associate physical capacity tests with pulmonary function tests, in order to
maintain the follow-up of patients, as well as measure the functional impact in the long term.
Therefore, there is a need to welcome the survivors of the first waves, as the premise of the
post-COVID-19 syndrome is increasingly strengthened. |
| author_additional |
SANTANA, Maxwell Barbosa de |
| author_additionalStr |
SANTANA, Maxwell Barbosa de |
| format |
Dissertação |
| author |
LIMA, Priscila Bezerra de |
| title |
Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. |
| title_short |
Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. |
| title_full |
Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. |
| title_fullStr |
Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. |
| title_full_unstemmed |
Avaliação da função cardiopulmonar de pacientes sobreviventes à COVID-19 em reabilitação ambulatorial. |
| title_sort |
avaliação da função cardiopulmonar de pacientes sobreviventes à covid-19 em reabilitação ambulatorial. |
| publisher |
Universidade Federal do Oeste do Pará |
| publishDate |
2023 |
| url |
https://repositorio.ufopa.edu.br/jspui/handle/123456789/705 |
| _version_ |
1829179695241887744 |
| score |
11.755432 |