Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Medical Research Journal
MENU
Shortcuts Submit an article Author Guidelines Reviewers 2023 Focus and Scope

open access

Vol 6, No 3 (2021)
Original article
Published online: 2021-09-07
View PDF Download PDF file
Get Citation

Study on the utility and efficacy of clinical and instrumental tests in the follow-up of COVID-19 patients

Alberto Preda1, Giorgio Fiore1, Carlo Gaspardone1, Silvana Di Maio1, Davide Romagnolo1, Lorenzo Rampa1, Luigia Brugliera2, Andrea Tettamanti2, Carlo Meloni2, Sandro Iannaccone2
DOI: 10.5603/MRJ.a2021.0037
·
Medical Research Journal 2021;6(3):169-176.
Affiliations
  1. Clinical Cardiology Unit, IRCCS Ospedale San Raffaele, Via Olgettina, 20132 Milano, Italy
  2. IRCCS Ospedale San Raffaele, Via Olgettina, 20132 Milano, Italy

open access

Vol 6, No 3 (2021)
ORIGINAL ARTICLES
Published online: 2021-09-07

Abstract

Introduction: The disease caused by the SARS-CoV-2 virus (COVID-19) frequently leads to serious complications and prolonged hospitalizations requiring effective care after discharge.

Aim of the study: Aim of this study was to identify feasible and cost-effective predictors of outcome among clinical characteristics, functional status, laboratory, echocardiographic and lung ultrasound data of COVID-19 patients.

Material and methods: Patients affected by COVID-19 who experienced a prolonged hospitalization due to a severe form of the disease and that have been discharged from the COVID-19 rehabilitation unit (RU) were prospectively enrolled between April 6th and May 22nd, 2020. All the patients underwent a 6-minute walk test (6MWT) at the 30-day follow-up. Baseline characteristics, laboratory, functional exercise tests, echocardiographic and lung ultrasound (LUS) data collected between hospitalization, admission to RU, discharge from RU and follow-up were compared. Correlations with the predicted distance covered at the 6MWT (6MWD) were made.

Results: 40 patients met inclusion criteria and presented to follow-up (13 women [32.5%] and 27 men [67.5%]; mean age 66 ± 10 years). Among all variables analysed, only functional tests at discharge showed a remarkable correlation with the 6MWD. Significant improvement in lung ultrasound score (LUSS) was also observed however without correlation with 6MWD.

Conclusions: functional tests at discharge from RU identified patients with different 30-day outcomes that could deserve a stricter long-term follow-up. This may help in planning a personalized follow-up. The costs and effort were minimal. The severity of the acute phase did not significantly influence functional recovery. LUS was useful to identify subclinical lung damage and its evolution over time, however without clear functional correlation.

Abstract

Introduction: The disease caused by the SARS-CoV-2 virus (COVID-19) frequently leads to serious complications and prolonged hospitalizations requiring effective care after discharge.

Aim of the study: Aim of this study was to identify feasible and cost-effective predictors of outcome among clinical characteristics, functional status, laboratory, echocardiographic and lung ultrasound data of COVID-19 patients.

Material and methods: Patients affected by COVID-19 who experienced a prolonged hospitalization due to a severe form of the disease and that have been discharged from the COVID-19 rehabilitation unit (RU) were prospectively enrolled between April 6th and May 22nd, 2020. All the patients underwent a 6-minute walk test (6MWT) at the 30-day follow-up. Baseline characteristics, laboratory, functional exercise tests, echocardiographic and lung ultrasound (LUS) data collected between hospitalization, admission to RU, discharge from RU and follow-up were compared. Correlations with the predicted distance covered at the 6MWT (6MWD) were made.

Results: 40 patients met inclusion criteria and presented to follow-up (13 women [32.5%] and 27 men [67.5%]; mean age 66 ± 10 years). Among all variables analysed, only functional tests at discharge showed a remarkable correlation with the 6MWD. Significant improvement in lung ultrasound score (LUSS) was also observed however without correlation with 6MWD.

Conclusions: functional tests at discharge from RU identified patients with different 30-day outcomes that could deserve a stricter long-term follow-up. This may help in planning a personalized follow-up. The costs and effort were minimal. The severity of the acute phase did not significantly influence functional recovery. LUS was useful to identify subclinical lung damage and its evolution over time, however without clear functional correlation.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

COVID-19, lung ultrasound, rehabilitation, SARS-CoV-2

About this article
Title

Study on the utility and efficacy of clinical and instrumental tests in the follow-up of COVID-19 patients

Journal

Medical Research Journal

Issue

Vol 6, No 3 (2021)

Article type

Original article

Pages

169-176

Published online

2021-09-07

Page views

6611

Article views/downloads

530

DOI

10.5603/MRJ.a2021.0037

Bibliographic record

Medical Research Journal 2021;6(3):169-176.

Keywords

COVID-19
lung ultrasound
rehabilitation
SARS-CoV-2

Authors

Alberto Preda
Giorgio Fiore
Carlo Gaspardone
Silvana Di Maio
Davide Romagnolo
Lorenzo Rampa
Luigia Brugliera
Andrea Tettamanti
Carlo Meloni
Sandro Iannaccone

References (38)
  1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497–506.
    CrossRefPubMed
  2. Marshall M. The lasting misery of coronavirus long-haulers. Nature. 2020; 585(7825): 339–341.
    CrossRefPubMed
  3. Rees EM, Nightingale ES, Jafari Y, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC Med. 2020; 18(1): 270.
    CrossRefPubMed
  4. Iannaccone S, Castellazzi P, Tettamanti A, et al. Role of rehabilitation department for adult individuals with COVID-19: The experience of the San Raffaele Hospital of Milan. Arch Phys Med Rehabil. 2020; 101(9): 1656–1661.
    CrossRefPubMed
  5. Wade DT. Rehabilitation after COVID-19: an evidence-based approach. Clin Med (Lond). 2020; 20(4): 359–365.
    CrossRefPubMed
  6. Brugliera L, Spina A, Castellazzi P, et al. Rehabilitation of COVID-19 patients. J Rehabil Med. 2020; 52(4): jrm00046.
    CrossRefPubMed
  7. Negrini F, de Sire A, Andrenelli E, et al. International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER action. Rehabilitation and COVID-19: a rapid living systematic review 2020 by Cochrane Rehabilitation Field. Update as of October 31st, 2020. Eur J Phys Rehabil Med. 2021; 57(1): 166–170.
    CrossRefPubMed
  8. Balachandar V, Mahalaxmi I, Subramaniam M, et al. Follow-up studies in COVID-19 recovered patients - is it mandatory? Sci Total Environ. 2020; 729: 139021.
    CrossRefPubMed
  9. Taboada M, Cariñena A, Moreno E, et al. Post-COVID-19 functional status six-months after hospitalization. J Infect. 2021; 82(4): e31–e33.
    CrossRefPubMed
  10. Cortinovis M, Perico N, Remuzzi G. Long-term follow-up of recovered patients with COVID-19. Lancet. 2021; 397(10270): 173–175.
    CrossRefPubMed
  11. Du RH, Liang LR, Yang CQ, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020; 55(5).
    CrossRefPubMed
  12. Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing for Coronavirus Disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology. 2020; 296(2): E32–E40.
    CrossRefPubMed
  13. Lanza E, Profili M, Bolengo I, et al. COVID-19 lung alterations still evident at 60-day follow-up chest CT in asymptomatic patients despite negative rRT-PCR testing. 2020.
    CrossRef
  14. Tabata S, Imai K, Kawano S, et al. Clinical characteristics of COVID-19 in 104 people with SARS-CoV-2 infection on the Diamond Princess cruise ship: a retrospective analysis. Lancet Infect Dis. 2020; 20(9): 1043–1050.
    CrossRefPubMed
  15. Peng QY, Wang XT, Zhang LN, et al. Chinese Critical Care Ultrasound Study Group (CCUSG). Findings of lung ultrasonography of novel corona virus pneumonia during the 2019-2020 epidemic. Intensive Care Med. 2020; 46(5): 849–850.
    CrossRefPubMed
  16. Soldati G, Smargiassi A, Inchingolo R, et al. Is there a role for lung ultrasound during the COVID-19 pandemic? J Ultrasound Med. 2020; 39(7): 1459–1462.
    CrossRefPubMed
  17. Gaspardone C, Meloni C, Preda A, et al. Lung ultrasound in COVID-19 a role beyond the acute phase? J Ultrasound Med. 2021; 40(3): 503–511.
    CrossRefPubMed
  18. Giannitsi S, Bougiakli M, Bechlioulis A, et al. 6-minute walking test: a useful tool in the management of heart failure patients. Ther Adv Cardiovasc Dis. 2019; 13: 1753944719870084.
    CrossRefPubMed
  19. Dajczman E, Wardini R, Kasymjanova G, et al. Six minute walk distance is a predictor of survival in patients with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation. Can Respir J. 2015; 22(4): 225–229.
    CrossRefPubMed
  20. Rasekaba T, Lee AL, Naughton MT, et al. The six-minute walk test: a useful metric for the cardiopulmonary patient. Intern Med J. 2009; 39(8): 495–501.
    CrossRefPubMed
  21. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39(2): 142–148.
    CrossRefPubMed
  22. Mesquita R, Wilke S, Smid DE, et al. Measurement properties of the Timed Up & Go test in patients with COPD. Chron Respir Dis. 2016; 13(4): 344–352.
    CrossRefPubMed
  23. Vaidya T, Chambellan A, de Bisschop C. Sit-to-stand tests for COPD: A literature review. Respir Med. 2017; 128: 70–77.
    CrossRefPubMed
  24. Kidd D, Stewart G, Baldry J, et al. The Functional Independence Measure: a comparative validity and reliability study. Disabil Rehabil. 1995; 17(1): 10–14.
    CrossRefPubMed
  25. Gillen G. Overview of Cognitive and Perceptual Rehabilitation. Cognitive and Perceptual Rehabilitation. 2009: 1–31.
    CrossRef
  26. Sasanuma N, Takahashi K, Tanaka T, et al. Functional independence measure analysis in patients undergoing phase I of cardiac rehabilitation. European Heart Journal. 2013; 34(suppl 1): P5801–P5801.
    CrossRef
  27. Pandit R, Vaity C, Mulakavalupil B, et al. Unmasking Hypoxia in COVID 19 - Six Minute Walk Test. J Assoc Physicians India. 2020; 68(9): 50–51.
    PubMed
  28. Fuglebjerg NJ, Jensen TO, Hoyer N, et al. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. Int J Infect Dis. 2020; 99: 100–101.
    CrossRefPubMed
  29. Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021; 397(10270): 220–232.
    CrossRefPubMed
  30. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020; 95(7): 834–847.
    CrossRefPubMed
  31. Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020; 5(7): 811–818.
    CrossRefPubMed
  32. Zangrillo A, Beretta L, Scandroglio AM, et al. COVID-BioB Study Group , COVID-BioB Study Group. Characteristics, treatment, outcomes and cause of death of invasively ventilated patients with COVID-19 ARDS in Milan, Italy. Crit Care Resusc. 2020 [Epub ahead of print]; 22(3).
    PubMed
  33. Szekely Y, Lichter Y, Topilsky Y, et al. Spectrum of cardiac manifestations in COVID-19: A systematic echocardiographic study. Circulation. 2020; 142(4): 342–353.
    CrossRefPubMed
  34. Mongodi S, Bouhemad B, Orlando A, et al. Modified lung ultrasound score for assessing and monitoring pulmonary aeration. Ultraschall Med. 2017; 38(5): 530–537.
    CrossRefPubMed
  35. Bouhemad B, Mongodi S, Via G, et al. Ultrasound for "lung monitoring" of ventilated patients. Anesthesiology. 2015; 122(2): 437–447.
    CrossRefPubMed
  36. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166(1): 111–117.
    CrossRefPubMed
  37. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998; 158(5 Pt 1): 1384–1387.
    CrossRefPubMed
  38. Alemanno F, Houdayer E, Parma A, et al. COVID-19 cognitive deficits after respiratory assistance in the subacute phase: A COVID-rehabilitation unit experience. PLoS One. 2021; 16(2): e0246590.
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl