Cognitive Dysfunction, COVID-19 Recurrent, Fatigue, SARS-CoV-2 Infection
Conditions
Keywords
COVID-19, SARS-CoV-2, Persistent Covid, Cardiac rehabilitation, Respiratory rehabilitation, Physical rehabilitation
Brief summary
The pandemic caused by SARS-CoV-2 infection has resulted, in addition to the well-known acute symptoms, in the emergence of a plethora of persistent, diffuse and heterogeneous symptoms such as fatigue, shortness of breath and cognitive dysfunction among others, that have come to be called persistent COVID. Patients have reported that physical activity, stress and sleep disturbances often trigger exacerbations of their symptoms related by some authors to the so-called Post Exertional Malaise (PEM) characteristic of Myalgic Encephalomyelitis. Similarly, by analogy with other pathologies, it has been hypothesized that optimal exercise prescription would benefit these people with persistent COVID-19 symptoms but in practice, the rehabilitation of these patients runs the risk of collapsing respiratory and physical rehabilitation services. This is why COPERIA proposes the construction of a platform for respiratory, cardiac and muscular telerehabilitation, to compare with face-to-face rehabilitation treatment and to try to predict the influence of physical activity in the prediction of PEM.
Interventions
OTHERCOPERIA-REHAB
After the randomization of the patient there will be some preliminary sessions where the means of self-monitoring training and the Borg 1/10 effort scale will be explained and training videos will be shown. Doubts will also be answered. Afterwards, training will start through the COPERIA-REHAB platform, which will last 8 weeks (6 days per week).
Sponsors
University of Vigo
Galician South Health Research Institute
Fundacin Biomedica Galicia Sur
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 and ≤70 years of age. * Patients with a diagnosis according to WHO criteria of persistent COVID-19 until 03/28/2022 * Patients with a Post Covid Functional Status (PCFS) ≥ 2. * Patients who present a need for physical rehabilitation and agree to perform it. * Patients with capacity to consent and who agree to participate in the study. * Patients who know how to use Smartphone and/or Tablet and have at least one of these devices. * Patients who have access to the rehabilitation tools at home or are willing to go to the gyms proposed in the study to perform the rehabilitation exercises.
Exclusion criteria
* Minors or persons judicially incapacitated. * Previous neurological or psychiatric pathology involving neuropsychological compromise. * Active Covid19 infection. * Home oxygen therapy \> 16 hours or home Cpap- Bipap. * Previous diagnosis of arrhythmia or blockage. * Previous coronary pathology. * Decompensated renal or metabolic disease. * Signs or symptoms of unknown cardiac disease. * Undergoing another physical or cognitive rehabilitation process at the time of inclusion. * Patients who do not agree to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Six Minutes Walking test | 8 weeks | The 6-min walk test is a standard in cardiac rehabilitation, serving both to ecologically determine the patient's functional status and to make recommendations regarding the intensity of rehabilitative exercise. The patient is asked to run the maximum distance he/she can in 6 minutes. The length of one of the hospital corridors has been previously measured so that by counting the number of times the patient walks the distance covered is determined. In addition to the number of meters, the heart rate is monitored by means of a pectoral band, and the saturation level by means of a pulse oximeter; the BP is evaluated before and after the test. In the context of functional assessment of Persistent COVID, it has been used for the evaluation of the impact of rehabilitation measures. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| SF-36 Health Questionnaire | 8 weeks | The SF-36 Health Questionnaire is composed of 36 items that assess both positive and negative states of health. The 36 items of the instrument cover the following scales: Physical Function, Physical Role, Bodily Pain, General Health, Vitality, Social Function, Emotional Role, and Mental Health. Additionally, the SF-36 includes a transition item that asks about the change in general health status from the previous year. |
| Maximal Handgrip Strenght | 8 weeks | Handgrip strength (HGS) is measured by a handgrip dynamometer and is considered an indicator of overall muscle strength. Low muscle strength, also known as dynapenia is an important indicator of health status, as well as an indicator of sarcopenia. Maximal grip strength is determined by performing three grip attempts at maximum power. |
| mMRC dyspnea scale | 8 weeks | The MRC shortness of breath scale consists of five statements that describe almost the entire range of respiratory disability, from none (Grade 1) to almost complete disability (Grade 5). It can be self-administered by asking subjects to choose the statement that best describes their condition, e.g., 'I am only short of breath with strenuous exertion (Grade 1) or I am so short of breath that I cannot leave the house (Grade 5). Alternatively, it can be administered by an interviewer asking the questions, such as Are you short of breath when rushing on level ground or when climbing a gentle slope? (Grade 2). The score is the number that best matches the patient's activity level. |
| P maximal inspiratory and P maximal expiratory | 8 weeks | These tests will be performed by the Pneumology Service. The measurement of maximal inspiratory and expiratory pressures are well tolerated and relatively easy to perform, they allow estimating the neuromuscular function of the diaphragm, as well as the abdominal, intercostal and accessory muscles. In general terms, the Pimax test estimates the strength of inspiratory muscles (diaphragm) and the Pemax test estimates the strength of abdominal and intercostal muscles. The tests consist of the patient having to generate maximum inspiratory and expiratory pressures against an occluded mouthpiece. |
| Insomnia Severity Index. | 8 weeks | This instrument for the assessment of insomnia consists of 7 questions that are rated between 0 and 4 points. It evaluates both the insomnia of conciliation, maintenance and early awakening, as well as its functional repercussions during the day. |
| 1 Minute Sit to Stand test | 8 weeks | Consists of sitting down and getting up from a chair without resting the hands as many times as possible for 1 minute with the patient connected to the saturator and monitored with a chest strap. The minute is timed, the number of repetitions performed is counted, the oxygen saturation value and heart rate are observed and the patient waits 1 minute after the exercise to record again the recovery of the basal parameters. |
Other
| Measure | Time frame | Description |
|---|---|---|
| FVC | 8 weeks | Is the maximum volume of air exhaled, with the maximum possible effort, starting from a maximum inspiration in ml. |
| FEV1 | 8 weeks | The volume of air expelled during the first second of forced expiration in ml |
| Age | 8 weeks | Years |
| CO diffusion test | 8 weeks | To evaluate the transfer of oxygen from the alveolar space to the hemoglobin of the erythrocytes contained in the pulmonary capillaries. Effective alveolar-capillary area available for gas transfer in the lung. (%) |
| FEV1/FVC | 8 weeks | Expressed as a percentage (%), it indicates the proportion of the FVC that is expelled during the first second of the forced expiratory maneuver. |
| Sex | 8 weeks | Male, Female |
| Body mass index | 8 weeks | kg/m\^2 |
| Current treatment | 8 weeks | Treatment taken by the patient at the time of the study. |
| Date of PCR + SARS-CoV-2 | 8 weeks | DD-MMM-YYYY |
| Epidemic wave | 8 weeks | Of the 7 waves of COVID-19 that have occurred in Spain, a description will be given of the wave to which the infection of each patient included belonged. First, second, third, fourth, fifth, sixth, seventh, eighth, ninth or tenth wave. |
| Vaccination status at the time of infection | 8 weeks | Number of vaccine doses at the time of infection |
Countries
Spain
Contacts
Primary ContactAlejandro García Caballero, MD
Outcome results
None listed