Six Minute Walk Test in Covid 19 Recovery Patients

Document Type : Original Article

Authors

1 Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Lung Diseases Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Orthopedics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: COVID-19 pneumonia  is a respiratory disease caused by a novel and terrible coronavirus, which usually presents with lung involvement and symptoms range from cough , shortness of breath to respiratory distress syndrome and hypoxemia .Some persistent symptoms such as dyspnea and fatigue represented in covid 19 patients following disease improvement. In the current study, we evaluated the pulmonary status of COVID-19 patients who had lung involvement after 3 months relief ,utilizing a 6-minute walking test (6MWT).
Method: In this single center cross-sectional study, we recruited 60 COVID-19 confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR)), patients who were cured three months ago and collected their demographic information, modified medical research council (MMRC)questionnaire , pulmonary involvement percentage (based on CT-scan reports), 6MWT, heart rate, gender, height, weight, body mass index (BMI), and saturation of O2 (SPO2)% before and after 6MWT. The study used frequency tests to describe qualitative variables and mean ± standard deviation (SD) for quantitative variables. Data analysis included t-tests, chi-squares, and ANOVA. SPSS 26 is used for all analytic processes.
Result: The participants  had  mean age 44.27± 11.5 years included 32 men (53.3%) , 28 women (46.7%). The mean 6MWTdistance was 454.97±95.32 meters(range:219-620 meters). The CT scan score  was 6.58±2.60 (3-13)out of 24. Age and functional dyspnea showed a significant reverse association with 6MWT, although SPO2% before and after 6MWT showed a straight association (p-value< 0.05). There was no significant association between 6MWT and BMI, heart rate, gender, or score of pulmonary involvement CT scan(p-value > 0.05).
Conclusion: 6MWT is a simple and benefit  tool for prediction physical pulmonary function. Exertional  dyspnea and Spo2%  showed adverse effect before and after walking in 6MWT in Covid 19 patients recovery .

Keywords

References

  1. Najjar-Debbiny R, Gronich N, Weber G, Khoury J, Amar M, Stein N, et al. Effectiveness of paxlovid in reducing severe coronavirus disease 2019 and mortality in high-risk patients. Clinical Infectious Diseases. 2023 Feb 1;76(3):e342-9.
  2.  Venkatesan P. NICE guideline on long COVID. The lancet Respiratory medicine. 2021 Feb 1;9(2):129.
  3. Chen C, Haupert SR, Zimmermann L, Shi X, Fritsche LG, Mukherjee B. Global prevalence of post-coronavirus disease 2019 (COVID-19) condition or long COVID: a meta-analysis and systematic review. The Journal of infectious diseases. 2022 Nov 1;226(9):1593-607.
  4. Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re'em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 2021 Aug 1;38.
  5. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Scientific reports. 2021 Aug 9;11(1):1-2.
  6. Castanares-Zapatero D, Chalon P, Kohn L, Dauvrin M, Detollenaere J, Maertens de Noordhout C, Primus-de Jong C, et al. Pathophysiology and mechanism of long COVID: a comprehensive review. Annals of medicine. 2022 Dec 31;54(1):1473-87.
  7. Shanbehzadeh S, Tavahomi M, Zanjari N, Ebrahimi-Takamjani I, Amiri-Arimi S. Physical and mental health complications post-COVID-19: Scoping review. Journal of psychosomatic research. 2021 Aug 1;147:110525.
  8. Ferioli M, Prediletto I, Bensai S, Betti S, Daniele F, Di Scioscio V, et al. Spontaneous evolution of COVID-19 lung sequelae: results from a double-step follow-up. Respiration. 2022 Jan 18;101(4):381-93.
  9. Van den Borst B, Peters JB, Brink M, Schoon Y, Bleeker-Rovers CP, Schers H, et al. Comprehensive health assessment 3 months after recovery from acute coronavirus disease 2019 (COVID-19). Clinical Infectious Diseases. 2021 Sep 1;73(5):e1089-98.
  10. Curci C, Pisano F, Bonacci E, Camozzi DM, Ceravolo C, Bergonzi R, et al. Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 Rehabilitation Unit and proposal of a treatment protocol. European journal of physical and rehabilitation medicine. 2020 Jul 15;56(5):633-41.
  11. Chang YC, Yu CJ, Chang SC, Galvin JR, Liu HM, Hsiao CH, et al. Pulmonary sequelae in convalescent patients after severe acute respiratory syndrome: evaluation with thin-section CT. Radiology. 2005 Sep;236(3):1067-75.
  12. American Thoracic Society. 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):111-7.
  13. Huang L, Li X, Gu X, Zhang H, Ren L, Guo L, et al. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. The Lancet Respiratory Medicine. 2022 Sep 1;10(9):863-76.
  14. Nopp S, Moik F, Klok FA, Gattinger D, Petrovic M, Vonbank K, et al. Outpatient pulmonary rehabilitation in patients with long COVID improves exercise capacity, functional status, dyspnea, fatigue, and quality of life. Respiration. 2022 Jun 1;101(6):593-601.
  15. Parotto M, Gyöngyösi M, Howe K, Myatra SN, Ranzani O, Shankar-Hari M, et al. Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations. The Lancet Respiratory Medicine. 2023 Aug 1;11(8):739-54.
  16. Klanidhi KB, Chakrawarty A, Bhadouria SS, George SM, Sharma G, Chatterjee P, et al. Six-minute walk test and its predictability in outcome of COVID-19 patients. Journal of Education and Health Promotion. 2022 Jan 1;11(1):58.
  17. Strumiliene E, Zeleckiene I, Bliudzius R, Samuilis A, Zvirblis T, Zablockiene B, et al. Follow-up analysis of pulmonary function, exercise capacity, radiological changes, and quality of life two months after recovery from SARS-CoV-2 pneumonia. Medicina. 2021 Jun 3;57(6):568.
  18. Bardakci MI, Ozturk EN, Ozkarafakili MA, Ozkurt H, Yanc U, Yildiz Sevgi D. Evaluation of long‐term radiological findings, pulmonary functions, and health‐related quality of life in survivors of severe COVID‐19. Journal of medical virology. 2021 Sep;93(9):5574-81.
  19. Paradowska-Nowakowska E, Łoboda D, Gołba KS, Sarecka-Hujar B. Long COVID-19 Syndrome Severity According to Sex, Time from the Onset of the Disease, and Exercise Capacity—The Results of a Cross-Sectional Study. Life. 2023 Feb 11;13(2):508.
  20. Rao CM, Behera D, Mohapatra AK, Mohapatra SK, Jagaty SK, Banu P, et al. Supervised hospital based pulmonary rehabilitation outcome in long COVID–experience from a tertiary care hospital. Journal of Family Medicine and Primary Care. 2022 Dec 1;11(12):7875-81.
  21.  Yanamandra U, Saxena P, Srinath R, Sawant A, Singh A, Aggarwal N, et al. Assessment of Six-Minute Walk Test Among Discharge-Ready Severe COVID-19 Patients: A Cross-Sectional Study. Cureus. 2022 May;14(5).
  22. Cecchetto A, Guarnieri G, Torreggiani G, Vianello A, Baroni G, Palermo C, et al. Dyspnea in post-acute COVID-19: A multi-parametric cardiopulmonary evaluation. Journal of Clinical Medicine. 2023 Jul 13;12(14):4658.
  23. Omar A, Ferreira AD, Hegazy FA, Alaparthi GK. Cardiorespiratory Response to Six-Minute Step Test in Post COVID-19 Patients—A Cross Sectional Study. InHealthcare 2023 May 11 (Vol. 11, No. 10, p. 1386). MDPI.
  24.  Vijayakumar B, Tonkin J, Devaraj A, Philip KE, Orton CM, Desai SR, et al. CT lung abnormalities after COVID-19 at 3 months and 1 year after hospital discharge. Radiology. 2022 May;303(2):444-54..
  25. Prestes GD, Simon CS, Walz R, Ritter C, Dal-Pizzol F. Respiratory outcomes after 6 months of hospital discharge in patients affected by COVID-19: A prospective cohort. Frontiers in Medicine. 2022 Mar 7;9:795074.
  26. Rincon-Alvarez E, Gonzalez-Garcia M, Ali-Munive A, Casas A, Proaños NJ, Giraldo-Cadavid LF, et al. Risk factors for persistent tomographic abnormalities at 6 months of follow-up in a cohort of hospitalized patients with moderate and severe COVID-19 living at high altitude. Frontiers in Medicine. 2023 Feb 8;10:1110535.
  27. Eksombatchai D, Wongsinin T, Phongnarudech T, Thammavaranucupt K, Amornputtisathaporn N, Sungkanuparph S. Pulmonary function and six-minute-walk test in patients after recovery from COVID-19: A prospective cohort study. PLoS One. 2021 Sep 2;16(9):e0257040.
  28. Hussein AA, Saad M, Zayan HE, Abdelsayed M, Moustafa M, Ezzat AR, et al. Post-COVID-19 functional status: Relation to age, smoking, hospitalization, and previous comorbidities. Annals of thoracic medicine. 2021 Jul 1;16(3):260-5.
  29. Emecen AN, Keskin S, Turunc O, Suner AF, Siyve N, Basoglu Sensoy E, et al. The presence of symptoms within 6 months after COVID-19: a single-center longitudinal study. Irish Journal of Medical Science (1971-). 2023 Apr;192(2):741-50.
  30. Agarwal B, Shah M, Sawant B, Bagwe H, Murkudkar P, Mullerpatan R. Predictive equation for six-minute walk test in Indian children, adolescents, and adults. Lung India. 2023 Mar 1;40(2):143-8.
  31. Stavrou VT, Tourlakopoulos KN, Vavougios GD, Papayianni E, Kiribesi K, Maggoutas S, et al. Eight weeks unsupervised pulmonary rehabilitation in previously hospitalized of SARS-CoV-2 infection. Journal of Personalized Medicine. 2021 Aug 18;11(8):806.
  32. Klanidhi KB, Chakrawarty A, Bhadouria SS, George SM, Sharma G, Chatterjee P, et al. Six-minute walk test and its predictability in outcome of COVID-19 patients. Journal of Education and Health Promotion. 2022 Jan 1;11(1):58.
  33. Beyer S, Haufe S, Meike D, Scharbau M, Lampe V, Dopfer-Jablonka A, et al. Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life. Plos one. 2023 Oct 23;18(10):e0292928.
Journal of Cardio-Thoracic Medicine
Volume 12, Issue 4
December 2024
Pages 1418-1426

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