Efeitos de um modelo multiprofissional de intervenção sobre parâmetros de aptidão física relacionados a saúde e biomarcadores de pessoas com excesso de peso ou obesidade pós COVID-19

Abstract

In December 2019, the disease called the new Coronavirus (COVID-19) emerged and was subsequently declared a pandemic. The clinical spectrum of COVID-19 ranges from asymptomatic infection to critical illness. The clinical manifestations of COVID-19 are divided according to their severity: mild (no evidence of viral pneumonia or hypoxia); moderate (clinical signs of pneumonia but no signs of severe pneumonia); severe (clinical signs of pneumonia plus one of the following: respiratory rate >30 breaths/minute, severe respiratory distress, or SatO2 <90%); and critical (Acute Respiratory Distress Syndrome (ARDS), sepsis, septic shock, or acute thrombosis). Obesity is a known risk factor for severe COVID-19. Therefore, overweight individuals diagnosed positive for COVID-19 have an increased risk of complications, hospitalizations, admission to the Intensive Care Unit (ICU), in addition to a greater need for invasive mechanical ventilation (IMV), risk of death and development of Long COVID-19, where affected individuals do not recover for several weeks or months after the onset of symptoms. Therefore, multidisciplinary rehabilitation strategies for COVID-19 survivors are essential to combat a condition with different consequences. The general objective of this study was to analyze the effects of a multi-professional intervention on health-related physical fitness parameters and biomarkers of people with overweight and obesity, after discharge from COVID-19 in different degrees of impairment. In the first article, “Obesity as a risk factor for complications and mortality in individuals with SARS-CoV-2: a systematic review”, the available studies that identified over weight and/or obesity as a risk factor for mortality, use of oxygen support and changes in biochemical markers in individuals hospitalized with SARS-CoV-2 were analyzed. In the second article “Effects of 8 and 16 weeks of multi-professional intervention on body composition, physical fitness, and biomarkers in overweight survivors of covid-19: a clinical trial”, the effects of a multi-professional intervention (physical exercise intervention, nutritional intervention and psychoeducation) on body composition, physical fitness and biomarkers in 59 overweight COVID-19 survivors, divided into three groups according to symptomatology [mild group (n = 31), moderate group (n = 13) and severe (n = 15)], were investugated. The experimental groups underwent a multi-professional program consisting of physical exercise (muscle strength and aerobic exercise, i.e., simultaneous training) twice a week, nutritional intervention and psychoeducation once a week each. Participants were assessed at the beginning of the study (pre-intervention), after eight weeks (post-8 weeks) and after 16 weeks of intervention (post-16 weeks). After eight weeks, significantly higher values for lean mass, musculoskeletal mass, maximum isometric hand grip strength, maximum lumbar traction strength, arm flexion, sit-to-stand test, distance covered in the six-minute walk test (p<0.05), significant reduction in triglycerides, low-density lipoprotein and glycated hemoglobin (p<0.05) were observed. After 16 weeks, systolic and diastolic blood pressure were significantly reduced in the three experimental groups (p<0.05). Therefore, the proposed multi-professional intervention model promoted the improvement of health-related physical fitness parameters, hemodynamic and biochemical aspects of COVID-19 survivors.