Benefits of Home-Based Exercise Training Following Critical SARS-CoV-2 Infection: A Case Report

Igor Longobardi; Danilo Marcelo Leite do Prado; Karla Fabiana Goessler; Gersiel Nascimento de Oliveira Júnior; Danieli Castro Oliveira de Andrade; Bruno Gualano; Hamilton Roschel

doi:10.3389/fspor.2021.791703

Benefits of Home-Based Exercise Training Following Critical SARS-CoV-2 Infection: A Case Report

Front Sports Act Living. 2022 Jan 11:3:791703. doi: 10.3389/fspor.2021.791703. eCollection 2021.

Authors

Igor Longobardi¹, Danilo Marcelo Leite do Prado¹, Karla Fabiana Goessler¹, Gersiel Nascimento de Oliveira Júnior¹, Danieli Castro Oliveira de Andrade², Bruno Gualano^{1

2}, Hamilton Roschel^{1

2}

Affiliations

¹ Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
² Rheumatology Division, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Abstract

In the current scenario, in which an elevated number of COVID-19 survivors present with severe physical deconditioning, exercise intolerance, persistent symptoms, and other post-acute consequences, effective rehabilitation strategies are of utmost relevance. In this study, we report for the first time the effect of home-based exercise training (HBET) in a survivor patient from critical COVID-19 illness. A 67-year-old woman who had critical COVID-19 disease [71 days of hospitalization, of which 49 days were in the intensive care unit (ICU) with invasive mechanical ventilation due to respiratory failure] underwent a 10-week HBET aiming to recovering overall physical condition. Before and after the intervention, we assessed cardiopulmonary parameters, skeletal muscle strength and functionality, fatigue severity, and self-reported persistent symptoms. At baseline (3 months after discharge), she presented with severe impairment in cardiorespiratory functional capacity (<50% age predicted VO_2peak). After the intervention, remarkable improvements in VO_2peak (from 10.61 to 15.48 mL·kg^-1·min^-1, Δ: 45.9%), oxygen uptake efficiency slope (OUES; from 1.0 to 1.3 L·min^-1, Δ: 30.1%), HR/VO₂ slope (from 92 to 52 bpm·L^-1, Δ: -43.5%), the lowest VE/VCO₂ ratio (from 35.4 to 32.9 L·min^-1, Δ: -7.1%), and exertional dyspnea were observed. In addition, handgrip strength (from 22 to 27 kg, Δ: 22.7%), 30-s Sit-to-Stand (30-STS; from 14 to 16 repetitions, Δ:14.3%), Timed-Up-and-Go (TUG; from 8.25 to 7.01 s, Δ: -15%) performance and post-COVID functional status (PCFS) score (from 4 to 2) were also improved from baseline to post-intervention. Self-reported persistent symptoms were also improved, and Fatigue Severity Scale (FSS) score decreased (from 4 to 2.7) from baseline to post-intervention. This is the first evidence that a semi-supervised, HBET program may be safe and potentially effective in improving cardiorespiratory and physical functionality in COVID-19 survivors. Controlled studies are warranted to confirm these findings.

Keywords: case report; exercise training; fatigue; long COVID; physical rehabilitation; severe acute respiratory syndrome.

Publication types

Case Reports