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Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study.

老年新型冠状病毒肺炎患者呼吸康复的随机对照研究

  • 影响因子:2.12
  • DOI:10.1016/j.ctcp.2020.101166
  • 作者列表:"Liu K","Zhang W","Yang Y","Zhang J","Li Y","Chen Y
  • 发表时间:2020-05-01
Abstract

BACKGROUND:Different degrees of disorders are reported in respiratory function, physical function and psychological function in patients with corona virus disease 2019 (COVID-19), especially in elderly patients. With the experience of improved and discharged COVID-19 patients, timely respiratory rehabilitation intervention may improve prognosis, maximize functional preservation and improve quality of life (QoL), but there lacks of studies worldwide exploring the outcome of this intervention. OBJECTIVE:To investigate the effects of 6-week respiratory rehabilitation training on respiratory function, QoL, mobility and psychological function in elderly patients with COVID-19. METHODS:This paper reported the findings of an observational, prospective, quasi-experimental study, which totally recruited 72 participants, of which 36 patients underwent respiratory rehabilitation and the rest without any rehabilitation intervention. The following outcomes were measured: pulmonary function tests including plethysmography and diffusing lung capacity for carbon monoxide (DLCO), functional tests (6-min walk distance test), Quality of life (QoL) assessments (SF-36 scores), activities of daily living (Functional Independence Measure, FIM scores), and mental status tests (SAS anxiety and SDS depression scores). RESULTS:After 6 weeks of respiratory rehabilitation in the intervention group, there disclosed significant differences in FEV1(L), FVC(L), FEV1/FVC%, DLCO% and 6-min walk test. The SF-36 scores, in 8 dimensions, were statistically significant within the intervention group and between the two groups. SAS and SDS scores in the intervention group decreased after the intervention, but only anxiety had significant statistical significance within and between the two groups. CONCLUSIONS:Six-week respiratory rehabilitation can improve respiratory function, QoL and anxiety of elderly patients with COVID-19, but it has little significant improvement on depression in the elderly.

摘要

背景: 冠状病毒 2019 病毒新型冠状病毒肺炎) 患者的呼吸功能、躯体功能和心理功能均有不同程度的障碍,尤其是老年患者。随着新型冠状病毒肺炎的改善和出院,及时的呼吸康复干预可改善预后,最大限度地保留功能,提高生活质量。但世界范围内缺乏探索这种干预结果的研究。 目的: 探讨 6 周呼吸康复训练对老年新型冠状病毒肺炎患者呼吸功能、生活质量、活动能力及心理功能的影响。 方法: 本文报道了一项观察性、前瞻性、准实验性研究的结果,共招募了 72 名参与者,其中 36 名患者接受了呼吸康复,其余患者未接受任何康复干预。测量了以下结果: 肺功能测试,包括体积描记和一氧化碳弥散肺活量 (DLCO),功能测试 (6 分钟步行距离测试),生活质量 (QoL) 评估 (SF-36 评分),日常生活活动 (功能独立性测量,FIM评分) 和精神状态测试(SAS焦虑和SDS抑郁评分)。 结果: 干预组呼吸康复 6 周后,FEV1(L) 、FVC(L) 、FEV1/FVC % 、DLCO % 和 6 min步行试验有显著差异。8 个维度的SF-36 评分在干预组内和两组间均有统计学意义。干预组干预后SAS、SDS评分均有所下降,但只有焦虑在两组内和两组间有显著统计学意义。 结论: 6 周呼吸康复治疗可改善老年新型冠状病毒肺炎患者的呼吸功能、生活质量和焦虑情绪,但对老年抑郁症的改善作用不明显。

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METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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