Aptidão física em sobreviventes da COVID-19 com excesso de peso ou obesidade em diferentes sintomatologias: ações de avaliação, observação e intervenção

Abstract

COVID-19 has presented major public health challenges. Many of the population has developed short, medium, and long-term sequelae called “long-term COVID”. Because of this, observations of the impacts resulting from COVID-19 can guide actions to recover health conditions to improve the quality of life of the population, especially for risk groups, such as overweight and obese people. Considering the listed aspects, the present study aimed to evaluate, observe, and intervene in aspects of physical fitness related to the health of people with overweight or obesity after COVID-19 in different symptomatology’s. The study was divided into three stages, the first of which verified the impacts between the different symptoms of COVID-19, that is, mild, moderate, and severe. The second reassessed the participants of Study 1 after one year, and finally, study 3 aimed to promote a multidisciplinary intervention for eight weeks. 171 volunteers of both sexes (men, n = 93 and women, n = 78) between 19 and 65 years old were allocated into three groups according to the severity of their COVID-19 symptoms: people not hospitalized/mild symptoms (n = 61), hospitalized (n = 58) and hospitalized in an intensive care unit-ICU (n = 52). Self-reported parameters of possible sequelae of COVID-19, health-related physical fitness, and blood biomarkers were evaluated. In Article 1, hospitalized individuals showed higher fat mass and body fat percentage values than non-hospitalized individuals (p<0.05). Significantly higher values were detected for peak oxygen consumption (VO2peak) in outpatients vs. hospitalized in the ICU (p<0.05). In addition, significantly higher values were observed for distance, ventilation, and the ratio between respiratory quotient for non-hospitalized individuals vs. hospitalized (p<0.05). After the stress test, peripheral oxygen saturation (SpO2) and diastolic blood pressure remained significantly higher (p<0.05) in individuals hospitalized in the ICU. In Article 2, the major sequelae found were: memory deficit (66.7%), fatigue (65.6%), difficulty concentrating (51.7%), and dyspnea (40.0%). An increase in the distance walked after one year was observed for all experimental groups in the Bruce test (p<0.05). SpO2 was reduced for the severe/critical group compared to the other groups after 5 minutes of the test (p<0.05). Temporally observed an increase in muscle mass, fat-free mass, and a reduction in body fat percentage for non-hospitalized and hospitalized individuals after one year (p<0.05). Finally, diastolic pressure was higher in severe/critical cases vs. mild (p<0.05). In article 3, after eight weeks of multidisciplinary intervention, it was observed that the moderate (hospitalized without the need for oxygen support) and control groups improved lower limb strength (p<0.05), in addition to presenting a reduction in the concentration C-reactive protein in the same groups and a reduction in diastolic blood pressure in the moderate group after eight weeks of intervention (p<0.05). Based on these results, proposals for the recovery of physical fitness, especially body composition, with increased muscle mass and reduced fat mass, increased cardiorespiratory fitness, and, above all, encouraging behavior change with the adoption of regular practice and systematic physical activity, eating a healthy and balanced diet and controlling stress are essential for promoting the health and quality of life of people who have been affected by COVID-19, especially those who have been hospitalized.