Soliss Seguros and its Foundation are betting, once again, on Castilian-Manchego talent and a good example of this is this project called Recover to cure the effects of persistent Covid, which is led by researchers who work in Toledo. In this sense, everything seems to point to physical exercise can play a fundamental role in the treatment of patients affected by persistent Covid.
Why do the symptoms of Covid persist after months and months of suffering from the disease and how can these patients be treated? Is the question for which The Research Group that develops this project is looking for an answer, which is led by the doctor Alejandro Berenguel and the commander Manuel Gallango.
One in ten people who have suffered the coronavirus have symptoms months after being infected. They are those affected by the so-called persistent Covid.
An ailment with many variants, which requires personalized attention for each patient. Some suffer from digestive or neurological problems, although the most frequent are respiratory problems
The Covid-19 pandemic has caused, to date, the contagion of more than 154.7 million people around the world, with about 3.2 million deaths according to data collected by Johns Hopkins University. Only in our country the number of people affected by the coronavirus infection is 3.7 million, according to the Ministry of Health (MS).
In Spain, since the beginning of the epidemic, lethality has been calculated on the confirmed cases reported on a daily basis by the Autonomous Communities to the MS and the National Epidemiology Surveillance Network. Based on the data provided by this network, the lethality of this infection ranges from 0.002% in those under 10 years of age to 4.1% in those over 70.
Currently, there is no internationally recognized definition of persistent Covid, although the first Spanish clinical guide for long-term Covid / persistent Covid patient care proposes the following definition: “Multiorgan symptom complex that affects those patients who have suffered from Covid-19 and who remain with symptoms after the considered acute phase of the disease, after 4 and even 12 weeks, with symptoms persisting over time”.
La National Institute of Health and Care Excellence (NICE) 2021, por su parte, considers post-Covid syndrome to be patients with persistent symptoms beyond 12 weeks, that cannot be explained by another cause.
Regarding its epidemiology, a recent meta-analysis estimates that up to 80% of patients present at least one persistent Covid symptom in the course.
Although its incidence seems to be related to the severity of the acute phase of the infection, it affects more than a third of the patients who suffered from Covid-19 with mild symptoms. This is how it is described in a Spanish cohort with 277 patients, in which 58% of patients with severe pneumonia and 36% and 37% with mild pneumonia and without pneumonia had persistent Covid symptoms at 14 weeks.
The term ‘recovered’ may be a misnomer, at least to apply to all patients who have been discharged from hospital, and this can confuse both the public and healthcare managers. Knowledge of the aftermath of Covid-19 remains incomplete, particularly in developing countries. Initially, all measures have focused on preventing the mortality caused by the pandemic, however, it is time to also focus on the comorbidity of those “recovered” patients.
Our group recently described the findings most commonly found in ergo spirometries of patients with persistent dyspnea after suffering from Covid-19.
These findings revealed a probable peripheral origin (not cardiological or respiratory) of the patients’ dyspnea, that is, in the use of O2 at the muscular level, which represented a potential therapeutic target for the improvement of our patients. . Now we intend to show that a structured physical training program, limited in time and designed and directed by specialists in physical training, is capable of mitigating part of the symptoms present in patients with persistent Covid, especially fatigue (the most frequent of them, present in up to 58% of cases) and dyspnea (subjective feeling of shortness of breath, present in up to 24% of cases ).
The improvement in symptoms (subjective) would be accompanied by an improvement in functional capacity (objective) measured through a cardiopulmonary stress test or ergo spirometry., which is the technique of choice for an objective assessment of functional capacity, as well as to discriminate the cause of its deterioration, if it exists. Therefore, the primary objectives of the study would be:
1. Improvement in VO2 levels (objective variable)
2. Improvement in the quality of life perceived through a specific survey (subjective variable)
Material and methods
For it A prospective, randomized, case-control, intervention study will be carried out, which should be evaluated and approved by the Ethics Committee of the Virgen de la Salud Hospital in Toledo.. Participating subjects must meet the following inclusion criteria:
1. Subjects between 18 and 65 years old who have suffered from Covid-19 infection.
2. Present persistent residual symptoms, at least 3 months after infection and that any of them is either fatigue or dyspnea.
3. That they did not present said symptoms prior to infection, nor did they present any other pathology or comorbidity that could justify the presence of said symptoms.
4. That they freely accept their participation in the study and sign the corresponding informed consent.
What Exclusion criteria, participants must:
1. Present any physical or mental limitation that prevents them from participating in a physical training program.
2. Show lack of commitment to comply with the established training program.