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

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P221 Does virtual group breathing pattern retraining improve symptoms of breathlessness in patients with breathing pattern disorder following COVID-19 infection? P221虚拟组呼吸模式再训练是否能改善COVID-19感染后呼吸模式障碍患者的呼吸困难症状?
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.353
R. Gore, L. Williamson, T. Elliott-Cooper, K. Roze, M. Heightman, T. Hillman, R. Livingston
P221 Table 1Virtual group BPR treatment improved breathing pattern and breathlessness for patients within the post covid BPD. With social distancing regulations, VGT offers an effective alternative to face to face group treatment. This saved clinician time which could enable reduced wait times for treatment.British Thoracic Society. British thoracic society guidance on respiratory follow up of patients with a clinico-radiological diagnosis of COVID-19 pneumonia, 2020.Heightman M, Prashar J, Hillman TE, et al. Post-COVID-19 assessment in a specialist clinical service: a 12-month, single-centre, prospective study in 1325 individuals. BMJ Open Resp Res, 2021;8.
表1虚拟组BPR治疗改善了covid - 19后BPD患者的呼吸模式和呼吸困难。随着社会距离的规定,VGT提供了面对面群体治疗的有效替代方案。这节省了临床医生的时间,从而减少了等待治疗的时间。英国胸科学会。英国胸科学会2020年COVID-19肺炎临床影像学诊断患者呼吸随访指南。刘建军,刘建军,刘建军,等。在专业临床服务中进行covid -19后评估:一项针对1325人的为期12个月的单中心前瞻性研究7 .中华医学杂志,2012;
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引用次数: 0
P230 Assessment of Cardio-pulmonary function in children and adolescents with suspected long COVID P230儿童和青少年疑似长冠肺炎患者的心肺功能评估
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.362
R. Langley, PD Burns, P. Davies, C. Presslie
IntroductionPersistent respiratory symptoms and exercise intolerance following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents is common.1 Our aim was to review the clinical data on patients who had been referred with suspected long COVID (LC). Unfortunately, there is a lack of an agreed definition for LC. The patient cohort were referred with persistent respiratory symptoms/signs (cough, exertional dyspnoea or wheeze) for at least 3 months following confirmed (PCR or antigen test positive) mild SARS-CoV-2 infection that did not require hospitalisation.MethodsThis was a retrospective analysis of clinical data obtained during clinical assessment. Patients had undergone pulmonary function tests (PFTs) including;spirometry, Single breath transfer factor (TLCO) and static lung volume measurements (Vyntus Body – VyaireTM Medical) followed by an incremental maximal ramp cardiopulmonary exercise testing (CPET) performed on a cycle ergometer (Jaeger CPX & Vyntus ONE – VyaireTM Medical).ResultsSeven patients (four male) with suspected LC had undergone PFTs and CPET. Demographics and summary data are presented (table 1). Five had normal PFT results. Of the two that had abnormal PFTs both had co-existing morbidities. One had mild airflow obstruction (previous pneumothorax) and the other had a restrictive defect (Di-George syndrome and obesity). Three patients had a reduced peak Oxygen uptake (VO2peak < 85% predicted). The cardiovascular and gas exchange response to incremental exercise were normal and there was no evidence of ventilatory limitation or dysfunctional breathing in any of the patients.ConclusionsAlthough only a small cohort was examined, this study suggests that SARS-CoV-2 infection does not seem to be causing any longstanding cardiopulmonary function impairment in children and adolescents. Whilst there may be pathophysiological changes following SARS-CoV-2 infection, as previously reported in adults,2 a reduced aerobic capacity is seen in some of these patients and this may due to physical de-conditioning rather than any physiological impairment caused by SARS-CoV-2 infection.ReferencesDobkin S et al. (2021) Protracted respiratory findings in children post-SARS-CoV-2 infection Pediatr Pulmonol.Rinaldo RF et al. (2021). Deconditioning as main mechanism of impaired exercise response in COVID-19 survivors. ERJ 2021 58:2100870.
儿童和青少年感染严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)后持续呼吸道症状和运动不耐受很常见我们的目的是回顾疑似长冠状病毒(LC)转诊患者的临床数据。不幸的是,对于信用证还没有一个统一的定义。患者队列在确诊(PCR或抗原检测阳性)轻度SARS-CoV-2感染后至少3个月出现持续呼吸道症状/体征(咳嗽、用力呼吸困难或喘息),不需要住院治疗。方法回顾性分析临床评估过程中获得的临床资料。患者接受肺功能测试(PFTs),包括肺活量测定、单次呼吸传递因子(TLCO)和静态肺体积测量(Vyntus Body - vyairretm Medical),然后在循环计量器(Jaeger CPX和Vyntus ONE - vyairretm Medical)上进行增量最大爬坡心肺运动测试(CPET)。结果7例疑似LC患者(男性4例)均行pft和CPET治疗。给出了人口统计数据和汇总数据(表1)。5例PFT结果正常。在pft异常的两个人中,他们都有并存的疾病。一名患者有轻度气流阻塞(既往气胸),另一名患者有限制性缺陷(Di-George综合征和肥胖)。3例患者峰值摄氧量降低(vo2峰值<预测值85%)。心血管和气体交换对增量运动的反应是正常的,没有任何患者通气限制或呼吸功能障碍的证据。尽管只对一小部分队列进行了检查,但本研究表明,SARS-CoV-2感染似乎不会导致儿童和青少年的任何长期心肺功能损害。虽然SARS-CoV-2感染后可能会出现病理生理变化(如先前在成人中报道的那样),但其中一些患者的有氧能力下降,这可能是由于身体去适应,而不是由SARS-CoV-2感染引起的任何生理损伤。dobkin S et al. (2021) sars - cov -2感染后儿童的长期呼吸道检查[j]。Rinaldo RF等人(2021)。去适应是COVID-19幸存者运动反应受损的主要机制[j] [j] 2021 58:2100870。
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引用次数: 0
P227 Reduced respiratory muscle strength, lung function, and functional status and symptomology in patients referred to Long COVID clinics, an observational cohort analysis P227:一项观察性队列分析,在Long COVID诊所就诊的患者中,呼吸肌力量、肺功能、功能状态和症状降低
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.359
M. Faghy, R. Ashton, R. Owen, J. Yates, C. Thomas, T. Maden-Wilkinson, S. V. N. Santhosh Kumar, R. Gururaj, C. Ozemek, R. Arena, T. Bewick
IntroductionOne in ten people will develop Long COVID (LC) following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite broad-ranging and episodic symptomology, there are no data that demonstrate changes in functional status (FS), respiratory muscle strength and lung function over time. We conducted a sixteen-week cohort observation of LC patients to determine changes in FS, respiratory muscle strength and lung function.MethodSixty-six patients (n=48 females, mean age 51 ± 10 years, n=8 hospitalised, mean time post-infection 6.2 ± 1.8 months) were recruited from LC clinics in the United Kingdom (CPMS ID: 52331). Patients completed five face-to-face visits (day 0, 28, 56, 84 and 110 ± 3 days) and bi-weekly telephone consultations (day 14, 42, 70 and 98 ± 3 days). FS was assessed via the post-COVID functional status scale (PCFS) and the six-minute walk test (6MWT). Maximum inspiratory (MIP) and expiratory (MEP) respiratory muscle pressure and lung function (forced vital capacity (FVC) and forced expired volume in one second (FEV1) were assessed during face-to-face visits according to published standards.ResultsPCFS was 2.7 ± 0.4 AU, P=0.02 at baseline and improved at 16-weeks (2.1 ±1.1 AU) and still highlighted impaired FS. 6MWT was 322 ± 133 meters at baseline and improved at 16 weeks (430 ± 150 meters, P<0.01) but remained lower than normative values for healthy age-matched controls. MIP was 77 ± 21 cmH2O at baseline (86% predicted) and was unchanged post 16 weeks (88 ± 25 cmH2O, 92% predicted, P>0.05). Baseline MEP was 115 ± 41 cmH2O (96% and was unchanged post-16-weeks (119 ± 48 cmH2O, 92% predicted, P>0.05). Lung function data were below predicted values and unchanged over 16 weeks (baseline FVC: 3.10 ± 0.53 L.s-1, 72% predicted, post 16 weeks: 3.16 ± 0.34 L.s-1, 73% predicted, P>0.05 and baseline FEV1: 2.68 ± 0.39 L.s-1, 85% predicted, post 16 weeks: 2.75 ± 0.36 L.s-1, 85% predicted).ConclusionLC patients demonstrate reduced respiratory muscle strength and lung function which could be associated with reduced FS and should be addressed via specific rehabilitation approaches.Please refer to page A216 for declarations of interest related to this .
十分之一的人在感染严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)后会患上长冠状病毒(LC)。尽管有广泛的发作性症状,但没有数据表明功能状态(FS)、呼吸肌力量和肺功能随时间的变化。我们对LC患者进行了为期16周的队列观察,以确定FS、呼吸肌力量和肺功能的变化。方法从英国LC诊所(CPMS ID: 52331)招募66例患者(女性48例,平均年龄51±10岁,住院8例,平均感染后时间6.2±1.8个月)。患者完成5次面对面就诊(第0、28、56、84和110±3天)和两周一次电话咨询(第14、42、70和98±3天)。通过新冠肺炎后功能状态量表(PCFS)和6分钟步行测试(6MWT)评估FS。面对面访问时,根据公布的标准评估最大吸气(MIP)和呼气(MEP)呼吸肌压力和肺功能(用力肺活量(FVC)和用力呼气容积(FEV1)。结果16周时spcfs为2.7±0.4 AU, P=0.02; 16周时spcfs有所改善(2.1±1.1 AU),但仍突出FS受损。6MWT基线时为322±133米,16周时改善(430±150米,P0.05)。基线MEP为115±41 cmH2O(96%), 16周后不变(119±48 cmH2O, 92%预测,P>0.05)。肺功能数据低于预测值,16周内无变化(基线FVC: 3.10±0.53 l -1,预测72%,16周后:3.16±0.34 l -1,预测73%,P>0.05;基线FEV1: 2.68±0.39 l -1,预测85%,16周后:2.75±0.36 l -1,预测85%)。结论lc患者表现为呼吸肌力和肺功能下降,这可能与FS的减轻有关,应通过针对性的康复方法加以解决。有关的利益申报,请参阅A216页。
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引用次数: 0
P220 Thoracic mobilisation techniques combined with stretches improves thoracic compliance and respiratory rate in long COVID P220胸部活动技术结合伸展术可改善长COVID患者的胸部顺应性和呼吸速率
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.352
D. Boiskin, G. Jayasekera
BackgroundA number of patients with COVID-19 experience prolonged symptoms, known as ‘Long COVID’. Fatigue, dyspnoea and chest wall tightness are common symptoms. These symptoms limit exercise tolerance and cause anxiety. They require thorough and costly investigations that do not always provide a pathway to traditional treatments. We present the impact of thoracic mobilisation, a combination of stretches and general advice on abdominal breathing on long COVID symptoms.MethodsConsecutive adult long COVID patients attending a general respiratory physiotherapy clinic with breathlessness and chest wall tightness were included. All patients were assessed for thoracic expansion using a cloth tape, measuring at T6 level from resting expiration to maximum inspiration. Resting respiratory rate (RR) was also measured as breaths per minute (bpm). All patients were then treated with a single application of thoracic mobilisation techniques (muscle energy techniques and/or rib stacking) and combinations of muscle stretches including serratus anterior, pectoralis minor and diaphragm stretches. General advice regarding abdominal breathing was also demonstrated.ResultsThirty four consecutive long COVID patients were included (mean age 52 y, 16♂). Nine patients (26%) had pre-existing respiratory co-morbidities including asthma, COPD and sleep-disordered breathing and 12 patients (35%) had no past medical history. Prior to intervention mean thoracic expansion was 1.92 cm (±1.15) and mean RR was 17.6 bpm (±5.1). After intervention, thoracic expansion improved to 3.89 cm (±1.32) and RR to 11.2 bpm (±4.6). There were significant improvements in both thoracic expansion and respiratory rate (p<0.0001).ConclusionNormal thoracic expansion is approximately 3.5 – 7 cm. This group of long COVID patients displayed suboptimal thoracic expansion at T6. This appears to have had an effect on resting respiratory rate. Post mobilisation both thoracic expansion and resting respiratory rate improved. This is likely due to improved thoracic compliance with mobilisations and stretches, reducing the work of breathing in these patients. The addition of simple breathing advice, rather than longer breathing re-education sessions helped to further reduce and correct respiratory rate.A single application of thoracic mobilisation techniques combined with stretches and simple advice on breathing can improve thoracic expansion and resting respiratory rate in long COVID.
许多COVID-19患者的症状持续时间较长,被称为“长COVID”。疲劳、呼吸困难和胸壁紧绷是常见的症状。这些症状限制了运动耐受性并引起焦虑。它们需要彻底而昂贵的调查,而这些调查并不总能提供传统治疗的途径。我们介绍了胸部活动的影响,伸展的组合以及对长时间COVID症状的腹部呼吸的一般建议。方法纳入连续在普通呼吸物理治疗门诊就诊、呼吸困难、胸壁紧致的成年长冠肺炎患者。用布带评估所有患者的胸部扩张情况,测量从静息呼气到最大吸气的T6水平。静息呼吸率(RR)也以每分钟呼吸数(bpm)来测量。然后,所有患者均接受单一胸腔活动技术(肌肉能量技术和/或肋骨堆叠)和包括前锯肌、胸小肌和横膈膜拉伸在内的肌肉拉伸组合的治疗。还演示了关于腹式呼吸的一般建议。结果连续纳入34例长COVID患者,平均年龄52岁,16岁。9名患者(26%)先前患有呼吸合并症,包括哮喘、慢性阻塞性肺病和睡眠呼吸障碍,12名患者(35%)没有既往病史。干预前平均胸围扩张1.92 cm(±1.15),平均RR为17.6 bpm(±5.1)。干预后,胸扩张改善至3.89 cm(±1.32),RR降至11.2 bpm(±4.6)。胸廓扩张和呼吸频率均有显著改善(p<0.0001)。结论正常胸廓扩张约为3.5 ~ 7cm。这组长COVID患者在T6时表现出次优的胸部扩张。这似乎对静息呼吸率有影响。活动后胸廓扩张和静息呼吸率均有改善。这可能是由于这些患者在活动和伸展时胸部顺应性得到改善,从而减少了呼吸的工作量。增加简单的呼吸建议,而不是长时间的呼吸再教育,有助于进一步降低和纠正呼吸频率。单次应用胸腔活动技术,结合伸展和简单的呼吸建议,可以改善长时间COVID患者的胸腔扩张和静息呼吸率。
{"title":"P220 Thoracic mobilisation techniques combined with stretches improves thoracic compliance and respiratory rate in long COVID","authors":"D. Boiskin, G. Jayasekera","doi":"10.1136/thorax-2022-btsabstracts.352","DOIUrl":"https://doi.org/10.1136/thorax-2022-btsabstracts.352","url":null,"abstract":"BackgroundA number of patients with COVID-19 experience prolonged symptoms, known as ‘Long COVID’. Fatigue, dyspnoea and chest wall tightness are common symptoms. These symptoms limit exercise tolerance and cause anxiety. They require thorough and costly investigations that do not always provide a pathway to traditional treatments. We present the impact of thoracic mobilisation, a combination of stretches and general advice on abdominal breathing on long COVID symptoms.MethodsConsecutive adult long COVID patients attending a general respiratory physiotherapy clinic with breathlessness and chest wall tightness were included. All patients were assessed for thoracic expansion using a cloth tape, measuring at T6 level from resting expiration to maximum inspiration. Resting respiratory rate (RR) was also measured as breaths per minute (bpm). All patients were then treated with a single application of thoracic mobilisation techniques (muscle energy techniques and/or rib stacking) and combinations of muscle stretches including serratus anterior, pectoralis minor and diaphragm stretches. General advice regarding abdominal breathing was also demonstrated.ResultsThirty four consecutive long COVID patients were included (mean age 52 y, 16♂). Nine patients (26%) had pre-existing respiratory co-morbidities including asthma, COPD and sleep-disordered breathing and 12 patients (35%) had no past medical history. Prior to intervention mean thoracic expansion was 1.92 cm (±1.15) and mean RR was 17.6 bpm (±5.1). After intervention, thoracic expansion improved to 3.89 cm (±1.32) and RR to 11.2 bpm (±4.6). There were significant improvements in both thoracic expansion and respiratory rate (p<0.0001).ConclusionNormal thoracic expansion is approximately 3.5 – 7 cm. This group of long COVID patients displayed suboptimal thoracic expansion at T6. This appears to have had an effect on resting respiratory rate. Post mobilisation both thoracic expansion and resting respiratory rate improved. This is likely due to improved thoracic compliance with mobilisations and stretches, reducing the work of breathing in these patients. The addition of simple breathing advice, rather than longer breathing re-education sessions helped to further reduce and correct respiratory rate.A single application of thoracic mobilisation techniques combined with stretches and simple advice on breathing can improve thoracic expansion and resting respiratory rate in long COVID.","PeriodicalId":338428,"journal":{"name":"‘Endgame’ – Long term impacts of COVID-19","volume":"79 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":"121379420","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}
引用次数: 0
P226 DYNAMO Covid-19. Dynamic assessment of multi organ level dysfunction in patients recovering from Covid-19: insulin resistance and metabolic flexibility P226发电机Covid-19新冠肺炎恢复期患者多器官功能障碍的动态评估:胰岛素抵抗和代谢灵活性
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.358
A. Gutpa, R. Nicholas, JJ McGing, O. Mougin, CR Bradley, AV Nixon, JE Mallinson, J. Bonnington, T. Mckeever, IP Hall, JM Lord, RA Evans, P. Greenhaff, ST Francis, C. Bolton
P226 Figure 1ConclusionPatients recovering from severe Covid-19 have worse insulin sensitivity compared to controls, but similar metabolic flexibility. Physical inactivity and liver adiposity may play a role in these observations.FundingNIHR Nottingham BRC (NoRCoRP), PHOSP UKRI, Nottingham Hospitals Charity, University of Nottingham alumni donation.
结论与对照组相比,重症Covid-19恢复期患者的胰岛素敏感性较差,但代谢灵活性相似。缺乏运动和肝脏肥胖可能在这些观察中起作用。资助国家卫生研究院诺丁汉BRC (NoRCoRP), PHOSP UKRI,诺丁汉医院慈善机构,诺丁汉大学校友捐赠。
{"title":"P226 DYNAMO Covid-19. Dynamic assessment of multi organ level dysfunction in patients recovering from Covid-19: insulin resistance and metabolic flexibility","authors":"A. Gutpa, R. Nicholas, JJ McGing, O. Mougin, CR Bradley, AV Nixon, JE Mallinson, J. Bonnington, T. Mckeever, IP Hall, JM Lord, RA Evans, P. Greenhaff, ST Francis, C. Bolton","doi":"10.1136/thorax-2022-btsabstracts.358","DOIUrl":"https://doi.org/10.1136/thorax-2022-btsabstracts.358","url":null,"abstract":"P226 Figure 1ConclusionPatients recovering from severe Covid-19 have worse insulin sensitivity compared to controls, but similar metabolic flexibility. Physical inactivity and liver adiposity may play a role in these observations.FundingNIHR Nottingham BRC (NoRCoRP), PHOSP UKRI, Nottingham Hospitals Charity, University of Nottingham alumni donation.","PeriodicalId":338428,"journal":{"name":"‘Endgame’ – Long term impacts of COVID-19","volume":"62 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":"114484252","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}
引用次数: 0
P224 Using the Sit to Stand tests to assess functional status and oxygen desaturations following COVID-19 P224使用坐立测试评估COVID-19后的功能状态和氧饱和度
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.356
E. Dickerson, O. Revitt, L. Houchen-Wolloff, S. Singh, E. Daynes
IntroductionCOVID-19 leads to persistent symptoms and in some instances oxygen desaturation (>3%) (Greenhalgh et al, 2020). Field walking tests are used in respiratory diseases to assess oxygen desaturation and exercise capacity due to their high reliability (Hernandes et al, 2014). However, under COVID-19 restrictions these tests became problematic to perform due to limitations of space, time, and equipment. This project aims to investigate sit to stand test’s (1STS & 5STS) in comparison to the Incremental shuttle walk test (ISWT) to assess function and oxygen desaturation (SpO2) in patients following COVID19 infection. In addition, to investigate if there is a difference in results to patients who received hospital care during the acute stage of COVID-19, to those who were managed in the community.MethodsPatients attending out-patient COVID-19 rehabilitation comprised of those hospitalised for acute COVID-19 and community managed referrals. Oxygen saturation was recorded directly before and after the tests. An independent T- test was used to measure group means for statistical difference and Pearson’s correlation was used to compare 5STS, 1STS and ISWT performance outcomes.ResultsTwenty-nine patients were eligible for analysis, mean (SD) age 54 (7.8) years (65.5% female and 69% White British) 7 (24%) participants had hospital admissions with a mean time from discharge to assessment of 347 days. There were desaturations of >3% in 3 (10%) participants during the 1STS and 9 (38%) in the ISWT and no desaturations of >3% during the 5STS. The difference between patient groups and SPO2 desaturations are non-significant at 0.559 for ISWT, 0.447 for 1STS and 0.447 5STS. There was no significant difference between SpO2, RPE and BORG for patient groups in each test condition. There was a strong correlation (R=-0.88) between the 1STS repetitions and 5STS time. There was a moderate correlation between ISWT and both STS tests (5STS R=-0.53 and 1STSR=-0.66).ConclusionsThe 5STS does not detect desaturation, whilst the ISWT detected meaningful desaturation in 38% of the population. There was a strong correlation with respect to performance on both STS tests, but not with the ISWT.
covid -19会导致持续的症状,在某些情况下会导致氧饱和度降低(>3%)(Greenhalgh等人,2020年)。由于实地步行测试的高可靠性,它被用于呼吸系统疾病,以评估氧饱和度和运动能力(Hernandes等人,2014)。然而,在COVID-19的限制下,由于空间、时间和设备的限制,这些测试变得难以执行。该项目旨在研究坐立试验(1STS和5STS)与增量穿梭行走试验(ISWT)的比较,以评估covid - 19感染后患者的功能和氧饱和度(SpO2)。此外,调查在COVID-19急性期接受医院护理的患者与在社区管理的患者的结果是否存在差异。方法COVID-19门诊康复患者包括急性COVID-19住院患者和社区管理转诊患者。在试验前后直接记录氧饱和度。统计学差异采用独立T检验,比较5STS、1STS和ISWT绩效结果采用Pearson相关。结果29例患者符合分析条件,平均(SD)年龄54(7.8)岁(女性65.5%,英国白人69%)7例(24%)患者入院,从出院到评估的平均时间为347天。在第1次sts和第5次sts中,分别有3名(10%)和9名(38%)参与者的血饱和度>3%,而在第5次sts中没有超过3%的血饱和度。患者组间SPO2去饱和度差异无统计学意义,ISWT组为0.559,1STS组为0.447,5STS组为0.447。各组SpO2、RPE、BORG在各测试条件下均无显著差异。1STS重复数与5STS时间有很强的相关性(R=-0.88)。ISWT与两项STS测试之间存在中等相关性(5STS R=-0.53, 1STSR=-0.66)。结论5STS不能检测到脱饱和度,而ISWT在38%的人群中检测到有意义的脱饱和度。在两项STS测试中的表现有很强的相关性,但与ISWT无关。
{"title":"P224 Using the Sit to Stand tests to assess functional status and oxygen desaturations following COVID-19","authors":"E. Dickerson, O. Revitt, L. Houchen-Wolloff, S. Singh, E. Daynes","doi":"10.1136/thorax-2022-btsabstracts.356","DOIUrl":"https://doi.org/10.1136/thorax-2022-btsabstracts.356","url":null,"abstract":"IntroductionCOVID-19 leads to persistent symptoms and in some instances oxygen desaturation (>3%) (Greenhalgh et al, 2020). Field walking tests are used in respiratory diseases to assess oxygen desaturation and exercise capacity due to their high reliability (Hernandes et al, 2014). However, under COVID-19 restrictions these tests became problematic to perform due to limitations of space, time, and equipment. This project aims to investigate sit to stand test’s (1STS & 5STS) in comparison to the Incremental shuttle walk test (ISWT) to assess function and oxygen desaturation (SpO2) in patients following COVID19 infection. In addition, to investigate if there is a difference in results to patients who received hospital care during the acute stage of COVID-19, to those who were managed in the community.MethodsPatients attending out-patient COVID-19 rehabilitation comprised of those hospitalised for acute COVID-19 and community managed referrals. Oxygen saturation was recorded directly before and after the tests. An independent T- test was used to measure group means for statistical difference and Pearson’s correlation was used to compare 5STS, 1STS and ISWT performance outcomes.ResultsTwenty-nine patients were eligible for analysis, mean (SD) age 54 (7.8) years (65.5% female and 69% White British) 7 (24%) participants had hospital admissions with a mean time from discharge to assessment of 347 days. There were desaturations of >3% in 3 (10%) participants during the 1STS and 9 (38%) in the ISWT and no desaturations of >3% during the 5STS. The difference between patient groups and SPO2 desaturations are non-significant at 0.559 for ISWT, 0.447 for 1STS and 0.447 5STS. There was no significant difference between SpO2, RPE and BORG for patient groups in each test condition. There was a strong correlation (R=-0.88) between the 1STS repetitions and 5STS time. There was a moderate correlation between ISWT and both STS tests (5STS R=-0.53 and 1STSR=-0.66).ConclusionsThe 5STS does not detect desaturation, whilst the ISWT detected meaningful desaturation in 38% of the population. There was a strong correlation with respect to performance on both STS tests, but not with the ISWT.","PeriodicalId":338428,"journal":{"name":"‘Endgame’ – Long term impacts of COVID-19","volume":"60 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":"122763642","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}
引用次数: 0
P219 Evaluation of the utility of the breathing pattern assessment tool in a post-covid syndrome MDT assessment clinic P219呼吸模式评估工具在新冠肺炎综合征MDT评估诊所中的效用评估
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.351
L. Grillo, J. Turnbull, JS Lee, L. Froome, J. Maxwell, L. Webber, L. Weatherly, A. Curtis, L. Osman
P219 Table 1Patient demographicsDemographics Age 43.14 (13.21) Gender Male n=22, Female n=51 Ethnicity White n=47 Black n=12 Asian n=7 Mixed n=7 Outcome measures from post covid clinic BPAT 3.44 (3.02) Nijmegen 27.82 (13.79) EQ5D 12.48 (11.71) Breathlessness NRS 4.17(2.39) Cough NRS 2.31 (2.93) Fatigue NRS 5.92 (2.41) Pain NRS 3.57 (3.41) Sleep NRS 4.74 (2.84) 1 minutes Sit to Stand 22.97 (11.47) GAD7 5.72 (6.96) PHQ9 5.97 (7.60) BPAT >4 n=28 (38%) Mean (standard deviation) unless otherwise stated;NRS: Numerical Rating ScaleConclusionThe BPAT Tool is a useful component of breathlessness assessment in the context of a PCS assessment clinic. It can provide a useful screening tool to identify patients with BPD who may benefit from specialist intervention with respiratory physiotherapists. Further understanding is required of how BPD responds to therapy and which type of treatments are important for this cohort.ReferencesHylton H, Long A, Francis C, et al. Real-world use of the Breathing Pattern Assessment Tool in assessment of breathlessness post-COVID-19. Clin Med (Lond). 2022 Jun 27.Todd S, Walsted ES, Grillo L et al. Novel assessment tool to detect BPD in patients with refractory asthma. Respirology. 2018;23(3).
P219表1患者人口统计学年龄43.14(13.21)性别男n=22;女性n=51种族白人n=47黑人n=12亚洲人n=7混合n=7冠状病毒病后临床结果测量BPAT 3.44(3.02)奈megen 27.82 (13.79) EQ5D 12.48(11.71)呼吸困难NRS 4.17(2.39)咳嗽NRS 2.31(2.93)疲劳NRS 5.92(2.41)疼痛NRS 3.57(3.41)睡眠NRS 4.74(2.84) 1分钟坐起身22.97 (11.47)GAD7 5.72 (6.96) PHQ9 5.97 (7.60) BPAT bbb4 n=28(38%)平均值(标准差)结论BPAT工具是临床PCS评估中呼吸困难评估的有用组成部分。它可以提供一个有用的筛选工具,以确定可能受益于呼吸物理治疗师的专科干预的BPD患者。需要进一步了解BPD对治疗的反应以及哪种类型的治疗对该队列很重要。参考文献hylton H, Long A, Francis C,等。呼吸模式评估工具在评估covid -19后呼吸困难中的实际应用。临床医学(长)。2022年6月27日。Todd S, Walsted ES, Grillo L等。难治性哮喘患者BPD检测的新评估工具。Respirology。2018;23(3)。
{"title":"P219 Evaluation of the utility of the breathing pattern assessment tool in a post-covid syndrome MDT assessment clinic","authors":"L. Grillo, J. Turnbull, JS Lee, L. Froome, J. Maxwell, L. Webber, L. Weatherly, A. Curtis, L. Osman","doi":"10.1136/thorax-2022-btsabstracts.351","DOIUrl":"https://doi.org/10.1136/thorax-2022-btsabstracts.351","url":null,"abstract":"P219 Table 1Patient demographicsDemographics Age 43.14 (13.21) Gender Male n=22, Female n=51 Ethnicity White n=47 Black n=12 Asian n=7 Mixed n=7 Outcome measures from post covid clinic BPAT 3.44 (3.02) Nijmegen 27.82 (13.79) EQ5D 12.48 (11.71) Breathlessness NRS 4.17(2.39) Cough NRS 2.31 (2.93) Fatigue NRS 5.92 (2.41) Pain NRS 3.57 (3.41) Sleep NRS 4.74 (2.84) 1 minutes Sit to Stand 22.97 (11.47) GAD7 5.72 (6.96) PHQ9 5.97 (7.60) BPAT >4 n=28 (38%) Mean (standard deviation) unless otherwise stated;NRS: Numerical Rating ScaleConclusionThe BPAT Tool is a useful component of breathlessness assessment in the context of a PCS assessment clinic. It can provide a useful screening tool to identify patients with BPD who may benefit from specialist intervention with respiratory physiotherapists. Further understanding is required of how BPD responds to therapy and which type of treatments are important for this cohort.ReferencesHylton H, Long A, Francis C, et al. Real-world use of the Breathing Pattern Assessment Tool in assessment of breathlessness post-COVID-19. Clin Med (Lond). 2022 Jun 27.Todd S, Walsted ES, Grillo L et al. Novel assessment tool to detect BPD in patients with refractory asthma. Respirology. 2018;23(3).","PeriodicalId":338428,"journal":{"name":"‘Endgame’ – Long term impacts of COVID-19","volume":"25 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":"126016579","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}
引用次数: 0
P218 The needs of long COVID service users in hampshire and isle of wight ICS: a prospective mixed methods evaluation P218汉普郡和怀特岛ICS长期COVID服务用户需求:前瞻性混合方法评估
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.350
R. Barker, A. Sibley, R. Wheeler, R. Russell
P218 Table 1The types of support people 1a) received or 1b) self-sought, 2) felt were essential, and 3) felt were desirable from the surveys, interviews, and focus groupsType of support* Examples Data source(I & FG: interviews and focus groups;S: survey) 1. a) Support people received Referred for or recommended by healthcare professionals: • ‘Your Covid recovery’ and ‘Living with’ app: https://www.yourcovidrecovery.nhs.uk/https://www.livingwith.health/products/covid-recovery/ I & FG;S • Steps to wellbeing service https://www.steps2wellbeing.co.uk/ S • Local authority helpline S • Mental health (virtual/telephone/app) programmes and/or counselling (virtual and face-to-face) (iTalk;Talking Change;Talking Therapies;private counselling [unknown providers] and psychotherapy [including Physiotherapy mental health unit and Primary Care Mental Health team]) I & FG;S • Medical reviews (general practitioner;respiratory;cardiology;neurological [private and NHS];gastroenterology;rheumatology [private];dermatology;chronic fatigue) I & FG;S • Non-medical professional reviews (physiotherapy;occupational therapy;social services [including reablement];dietetics;speech and language therapy) I & FG;S • Specialist Long COVID service referrals (Hobbs Rehabilitation Clinic [private] and NHS) I & FG • Sleepio app (insomnia) https://www.sleepio.com/#howSleepioWorks I & FG • Fatigue management advice (pacing;boom-bust cycle) I & FG • Co-morbid condition support groups (stroke – unnamed group) I & FG • Occupational health services I & FG;S • Human Resources support (e.g., keeping workplace updated and workplace rehabilitation support) S • Research projects: Portsmouth Long COVID Study Coverscan research project including webinars: https://perspectum.com/news/perspectum-launches-the-first-covid-19-recovery-study S 1. b) Support people self-sought Self-sought and available: • Personal training/physiotherapy/exercising (unnamed sources) I & FG;S • Restorative yoga (unnamed sources) I & FG • Walking groups (unnamed sources) I & FG • Walking App (unnamed) S • Swimming/aqua aerobics (unnamed sources) I & FG • Chiropody (unnamed source) S • Massage S • Counselling (private) I & FG;S • Social media support groups and advice forums (e.g., Facebook Long COVID Support Forum;Facebook group for doctors with Long COVID [unnamed];Long COVID Instagram pages [unnamed])‘AbSent’: https://www.facebook.com/AbScent.org/https://www.facebook.com/groups/longcovid/ I & FG;S • ShutEye app (sleep quality monitoring)https://www.shuteye.ai/ I & FG • ZOE COVID app (symptom monitoring)https://covid.joinzoe.com/about I & FG;S • Gupta programmehttps://www.guptaprogram.com/ I & FG;S • YouTube and other online Long COVID bloggers and podcasters (some unnamed sources)GezMedinger: https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXw I & FG;S • TV documentaries (unnamed source) S • Online/virtual exercise and stretching programmes (unnamed sources) I & FG • Support groups (for both the person living with L
P218表1从调查、访谈和焦点小组得到的支持类型:1a)获得的支持类型或1b)自我寻求的支持类型,2)认为是必要的支持类型,以及3)认为是需要的支持类型。支持类型*示例数据来源(I & FG:访谈和焦点小组;S:调查)a)为医疗保健专业人员推荐或推荐的人员提供支持:•“您的Covid康复”和“与病友同行”应用程序:https://www.yourcovidrecovery.nhs.uk/https://www.livingwith.health/products/covid-recovery/ I & FG;S•健康服务的步骤https://www.steps2wellbeing.co.uk/ S•地方当局帮助热线S•心理健康(虚拟/电话/应用程序)方案和/或咨询(虚拟和面对面)(iTalk;谈话改变;谈话疗法;私人咨询[未知提供者]和心理治疗[包括物理治疗精神卫生单位和初级保健精神卫生小组])I & FG;S•医学审查(全科医生;呼吸;心脏病;神经(私人和NHS);胃肠病学;风湿病(私人);皮肤;慢性疲劳)我& FG; S•非医学专业的评论(物理治疗,职业治疗;社会服务(包括复原);营养学;语言疗法)我& FG; S•专家长COVID服务推荐(霍布斯康复诊所(私人)和NHS)我& FG•Sleepio应用(失眠)https://www.sleepio.com/ howSleepioWorks我& FG•疲劳管理建议(节奏;繁荣-衰退周期)I & FG•共病支持小组(中风-未命名组)I & FG•职业健康服务I & FG;S•人力资源支持(例如,保持工作场所更新和工作场所康复支持)S•研究项目:Portsmouth Long COVID Study covercan研究项目包括网络研讨会:https://perspectum.com/news/perspectum-launches-the-first-covid-19-recovery-study s1。b)支持人们自我寻求自我寻求和可用:•个人培训/理疗运动(未具名消息人士)我& FG; S•养生瑜伽(未具名消息人士)我& FG•走组(未具名消息人士)我& FG•走程序(匿名)•游泳/水中有氧运动(未具名消息人士)我& FG•脚病治疗(不愿透露姓名的来源)•S•咨询(私人)按摩我& FG; S•社交媒体支持团体和建议论坛(例如,Facebook长COVID支持论坛;Facebook群组为医生长COVID(匿名);长COVID Instagram页面(匿名))“缺席”:https://www.facebook.com/AbScent.org/https://www.facebook.com/groups/longcovid/ I & FG;S•ShutEye应用程序(睡眠质量监测)https://www.shuteye.ai/ I & FG•ZOE COVID应用程序(症状监测)https://covid.joinzoe.com/about I & FG;S•Gupta程序https://www.guptaprogram.com/ I & FG;S•YouTube和其他在线Long COVID博主和播客(一些未命名的来源)GezMedinger:https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXw & FG; S•电视纪录片(具名消息人士)S•在线/虚拟运动和伸展运动项目(未具名消息人士)我& FG•支持小组(两人一起生活久COVID及其家庭成员直接)https://www.vosuk.org/about-us/我& FG•慢性疲劳综合症和纤维肌痛信息和建议(对人疲劳/ post-exertional不适和他们的家人和朋友)我& FG•精神指导S•放松技巧(例如,瑜伽,太极,正念)S•呼吸课程S•2021年长期Covid和ME/CFS整体治疗峰会S•补充疗法和补救措施(草药茶,口服片剂,维生素,B12注射,反射疗法,针灸)I & FG;S•志愿服务olent MS治疗中心:https://solentmstc.org.uk/ Just About You家庭帮助(Age UK, Isle of wright):https://www.ageuk.org.uk/isleofwight/our-services/just-about-you-home-help/ S 2)支持人们感到重要•同伴支持我从症状日记& FG•反馈更好的自营/理解触发器我& FG•定期随访和长COVID专家我& FG•COVID具体educati n /建议:▪进行日常生活活动能力下降▪/运动/锻炼post-exertional不适▪疲劳管理(包括工作活动/任务)▪导航申请可用的经济支持(包括残疾徽章)▪非长期COVID专家医疗保健专业人员▪雇主和同事▪家人和朋友▪压力管理(并处理潜在的压力源)▪内疚管理(并处理潜在的内疚原因)▪悲伤管理(并处理潜在的悲伤原因)▪创伤后应激障碍/恐惧管理(并处理创伤后应激障碍的潜在原因)I & FG•处理孤独/社会孤立I & FG•更广泛与志愿部门的联系(例如: •在线或社交媒体同伴支持团体I &FG的社区经理和管理员的教育/资源•确定/游说正在进行的当地财政支持,如休假计划,但对于那些长期COVID的人*此表报告了所有参与者报告的支持类型,即使只有一个参与者报告。因此,本表是集体经验的代表,可能不能反映每个参与者的经验;本表不是按照参与者感知到的重要程度排序的,也不是按照报告次数的时间顺序排列的;本表合并了提供的支助,没有根据正式的NHS医疗保健服务、私营医疗保健、人力资源服务和自愿部门提供的支助具体区分支助。虽然这是包含在已知情况下。这些发现证实了NICE最近发表的关于管理长冠状病毒的建议,因此为快速采纳NICE建议提供了进一步的理由。这些发现也可能为今后有效实施NICE建议提供适应性模型。
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引用次数: 0
P228 Comparing cardiometabolic risk indicators between adults post-hospitalisation with COVID-19 and healthy controls P228感染COVID-19的成人住院后与健康对照者心脏代谢风险指标的比较
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.360
M. Bakali, T. Yates, M. Steiner, R. Evans
P228 Table 1Comparing cardiometabolic measures between adults post-hospitalisation with COVID-19 and healthy controlsMeasure N= Adults post-hospitalisation with COVID-19 N= Adult Healthy controls Mean between group difference [SD] Age, years 38 62 [9] 17 62 [9] Comorbidities01More than 2 38 12 (31.6%)13 (34.2%)13 (34.2%) 17 15 (88.2%)1 (5.9%)1 (5.9%) Body mass index, kg/m2 38 30.1 [26.7–33.6] 17 24.9 [22.4–26.4] 5.86 [4.15] Resting systolic blood pressure, mmHg 38 142 [133–151] 16 114 [104–132] 25 [18] Resting diastolic blood pressure, mmHg 38 74 [68–80] 16 84 [77–87] -7 [5] Resting heart rate, beats/min 38 63 [59–73] 16 71 [61–77] -4 [3] Glucose, mmol/L 34 5.3 [4.9–5.7] 12 4.8 [4.5–5.1] 1.2 [0.9] Haemoglobin A1c, mmol/L 36 5.8 [5.3–6.2] 11 5.4 [5.3–5.6] 0.5 [0.4] HOMA-IR 23 2.8 [1.8–5.6] 11 1.1 [0.5–2.1] 4.8 [3.4] VO2 peak (ml/min/kg) 24 13.9 [11.6–19.7] 13 33.7 [24.8–36.4] -16.5 [11.7] Carotid-femoral pulse wave velocity, m/s 37 9.50 [8.15–11.50] 9 7.30 [6.75–10.45] 1.44 [1.02] Brachial-ankle pulse wave velocity, m/s 35 15.80 [13.60–17.50] 9 11.80 [11.0–14.90] 2.62 [1.85] Data presented as mean [SD] or median [IQR] depending on distributionOne participant in the post-COVID-19 group was taking beta-blockersConclusionsThis exploratory cross-sectional study shows that routinely used clinical tests of cardiometabolic risk indicate higher future risk for adults post-COVID compared to healthy controls. More detailed measures of cardiometabolic risk support this finding. It is unclear whether acute COVID-19 further contributes to pre-existing cardiometabolic risk. However, our small exploratory study supports the need for interventions such as aerobic exercise training which are proven to reduce aortic stiffness in adults with cardiometabolic disease or who are at future risk of cardiometabolic disease.
P228表1 2019冠状病毒病住院后成人与健康对照的心脏代谢指标比较测量值N= 2019冠状病毒病住院后成人N=健康对照成人组间平均差异[SD]年龄,年龄38 62[9]17 62[9]合并症2 38 12(31.6%)13(34.2%)13(34.2%)17 15(88.2%)1(5.9%)1(5.9%)体重指数,kg/m2 38 30.1[26.7-33.6] 17 24.9[22.4-26.4] 5.86[4.15]静息收缩压,mmHg 38 142[133 - 151] 114[104 - 132] 25[18]休息舒张压,74[68 - 80]16毫米汞柱84[77 - 87]7[5]静息心率,节拍/分钟38 63[59 - 73]16 71[61 - 77][3]葡萄糖,更易与L 34 5.3(4.9 - -5.7) 12 4.8 1.2(4.5 - -5.1)(0.9)血红蛋白A1c,更易与L 36 5.8 [5.3 - -6.2] 11 5.4 (5.3 - -5.6) 0.5 [0.4] HOMA-IR 23 2.8[1.8 - -5.6] 11 1.1(0.5 - -2.1), 4.8(3.4)最大峰值(24 ml / min /公斤)13.9 (11.6 - -19.7)13 33.7 (24.8 - -36.4)-16.5 [11.7]Carotid-femoral脉搏波速度,m/s 37 9.50[8.15-11.50] 9 7.30[6.75-10.45] 1.44[1.02]臂-踝关节脉搏波速度,m/s 35 15.80[13.60-17.50] 9 11.80[11.0-14.90] 2.62[1.85]数据根据分布以平均值[SD]或中位数[IQR]表示。新冠肺炎后组中有一名参与者正在服用β受体阻滞剂。结论本探索性横断面研究显示,常规使用的心脏代谢风险临床试验表明,新冠肺炎后成人的未来风险高于健康对照组。更详细的心脏代谢风险测量支持这一发现。目前尚不清楚急性COVID-19是否会进一步增加原有的心脏代谢风险。然而,我们的小型探索性研究支持干预措施的必要性,如有氧运动训练,已被证明可以降低患有心脏代谢疾病或未来有心脏代谢疾病风险的成年人的主动脉僵硬。
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引用次数: 0
P223 ‘I never felt like this before’ clinical presentations of patients referred to a tertiary airways service following Covid-19 infection P223“我以前从未有过这种感觉”,患者在Covid-19感染后转介到第三气道服务的临床表现
Pub Date : 2022-11-01 DOI: 10.1136/thorax-2022-btsabstracts.355
C. Slinger, K. Derbyshire, K. Prior, R. Slinger, H. Lever
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引用次数: 0
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‘Endgame’ – Long term impacts of COVID-19
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