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Exercise in Pediatric COVID-19: A Randomized Controlled Trial

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Astley, Camilla ; Drezner, Jonathan a. ; Sieczkowska, Sofia mendes ; Ihara, Amanda ; Franco, Tathiane ; Gil, Saulo ; DO Prado, Danilo marcelo leite ; Longobardi, Igor ; Suguita, Priscila ; Fink, Thais ; Lindoso, Livia ; Matsuo, Olivia ; Martins, Fernanda ; Bain, Vera ; Leal, Gabriela nunes ; Badue, Maria fernanda ; Marques, Heloisa helena ; Silva, Clovis artur ; Roschel, Hamilton ; Gualano, Bruno
Número total de Autores: 20
Tipo de documento: Artigo Científico
Fonte: MEDICINE AND SCIENCE IN SPORTS AND EXERCISE; v. 57, n. 3, p. 10-pg., 2025-03-01.
Resumo

Purpose: This study assessed the impact of a 12-wk, home-based exercise training (HBET) program on health-related quality of life (HRQOL; primary outcome), and cardiovascular and metabolic parameters in pediatric COVID-19 patients. Methods: This was a single-center, randomized controlled trial conducted in a tertiary hospital in Sao Paulo, from October 2020 to January 2022. Thirty-two patients (mean age, 12 +/- 3.3 yr) were randomly assigned to either HBET or standard of care (CONTROL) in a 2:1 ratio 4 months (range: 0.7-6.6 months) after COVID-19 discharge (n = 25 mild, n = 4 moderate, n = 3 severe illness). The HBET group underwent supervised and unsupervised sessions three times a week for 12 wk emphasizing aerobic and body weight exercises, while the CONTROL group received standard care, which included general advice for a healthy lifestyle with no prescribed exercise intervention. HRQOL (evaluated by the Pediatric Quality of Life Inventory), cardiopulmonary exercise test, brachial endothelial function and echocardiography assessments were conducted in both groups. Statistical analysis was performed using an intention-to-treat approach for the primary analysis and complete case (per-protocol) as sensitivity analysis.The significance was set at P <= 0.05 and P <= 0.10 was considered as trend. Results: There was no difference in HRQOL between groups. Intention-to-treat analysis indicated a trend toward increased oxygen uptake (VO2) at anaerobic threshold following the intervention in the HBET group. In addition, a sensitivity analysis showed significant changes in peak heart rate and 1-min recovery, respiratory exchange ratio, and chronotropic response. A trend toward significance was observed in ventilation-to-maximum voluntary ventilation ratio and chronotropic response in the HBET group. No other between-group differences were detected for the cardiopulmonary exercise test, brachial flow-mediated dilation, and echocardiography variables (all P > 0.05). Conclusions: In this randomized controlled trial, a 12-wk HBET intervention did not impact HRQOL in pediatric COVID-19 patients. However, exercise was able to improve the VO2 at the ventilatory anaerobic threshold, heart rate peak and 1-min recovery, ventilation-to-maximum voluntary ventilation ratio, and chronotropic response, with no changes observed in other cardiovascular parameters. Further studies are needed to investigate the long-term effects of exercise interventions on the recovery of pediatric COVID-19 patients with and without preexisting chronic conditions. (AU)

Processo FAPESP: 17/13552-2 - Reduzindo tempo sedentário em populações clínicas: o estudo take a stand for health
Beneficiário:Bruno Gualano
Modalidade de apoio: Auxílio à Pesquisa - Temático
Processo FAPESP: 22/16239-1 - Efeito do treinamento físico sobre a qualidade de vida e saúde geral em crianças e adolescentes após a COVID-19 e síndrome inflamatória multissistêmica pediátrica
Beneficiário:Camilla Astley Amaral Pedroso
Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado
Processo FAPESP: 22/16147-0 - Efeito do treinamento físico sobre a qualidade de vida e saúde geral em crianças e adolescentes após a COVID-19 e síndrome inflamatória multissistêmica pediátrica
Beneficiário:Camilla Astley Amaral Pedroso
Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado
Processo FAPESP: 19/15231-4 - Promoção de estilo de vida saudável em pacientes com Lúpus Eritematoso Sistêmico: efeitos sobre os riscos cardiometabólicos o ensaio clínico randomizado e controlado living well with Lupus
Beneficiário:Sofia Mendes Sieczkowska
Modalidade de apoio: Bolsas no Brasil - Doutorado
Processo FAPESP: 21/02742-0 - Efeito do treinamento físico sobre a qualidade de vida e saúde geral em crianças e adolescentes após a COVID-19 e Síndrome Inflamatória Multissistêmica pediátrica
Beneficiário:Camilla Astley Amaral Pedroso
Modalidade de apoio: Bolsas no Brasil - Doutorado
Processo FAPESP: 21/13580-1 - Efeitos de um programa de treinamento físico domiciliar sobre a qualidade de vida e parâmetros de saúde de pacientes sobreviventes à COVID-19 grave
Beneficiário:Igor Longobardi Amin
Modalidade de apoio: Bolsas no Brasil - Doutorado Direto