Exercise-Driven Comprehensive Recovery: Pulmonary Rehabilitation's Impact on Lung Function, Mechanics, and Immune Response in Post-COVID-19 Patients

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Brandao-Rangel, Maysa Alves Rodrigues ; Brill, Boris ; Furtado, Guilherme Eustaquio ; Freitas-Rolim, Catharine Cassia Lanna ; Silva-Reis, Anamei ; Souza-Palmeira, Victor Hugo ; Moraes-Ferreira, Renilson ; Lopes-Silva, Vanessa ; Albertini, Regiane ; Fernandes, Wendel Simoes ; Ferreira, Sergio Cesar ; Ferreira, Ricardo Cesar Alves ; Mateus-Silva, Jose Roberto ; Oliveira, Carlos Rocha ; Frison, Claudio Ricardo ; Vieira, Rodolfo P.

• Tipo de documento: Artigo Científico
• Fonte: INFECTIOUS DISEASE REPORTS; v. 17, n. 1, p. 16-pg., 2025-02-01.

Resumo

Introduction: We sought to evaluate the effects of a 12-week pulmonary rehabilitation (PR) program on lung function, mechanics, as well as pulmonary and systemic inflammation in a cohort of 33 individuals with moderate to severe post-COVID-19. Material and Methods: The pulmonary rehabilitation (PR) program employed a combination of aerobic and resistance exercises. Thirty minutes of treadmill training at 75% of the maximum heart rate, combined with 30 min resistance training consisting of 75% of one maximum repetition, three times a week throughout 12 weeks. Results: PR improved the lung function, FVC (p < 0.02), FEV1 (p < 0.02), FEV1/FVC (p < 0.01), MEF25% (p < 0.006), MEF50% (p < 0.03), and MEF75% (p < 0.02). PR also positively influenced lung mechanics, reducing respiratory impedance (Z5Hz, p < 0.03), respiratory reactance (X5Hz, p < 0.01), resistance of the entire respiratory system (R5Hz, p < 0.03), central airway resistance (RCentral, p < 0.03), and peripheral airway resistance (RPeripheral, p < 0.02). Moreover, muscle strength gains were evident, with significant improvements observed in hand grip strength for both the right (p < 0.02) and left (p < 0.01) hands, as well as maximal inspiratory (p < 0.02) and expiratory (p < 0.03) pressures. Additionally, PR exhibited anti-inflammatory effects by reducing the pro-inflammatory cytokines IL-1 beta (p < 0.0001) and IL-6 (p < 0.0001) and increasing the anti-inflammatory IL-1RA (p < 0.0004) and IL-10 (p < 0.003) and anti-viral IFN-gamma (p < 0.0002) and IFN-beta (p < 0.008) cytokines in breath condensate and serum samples. Conclusions: Collectively, these findings highlight the effectiveness of PR in ameliorating COVID-19 sequel across respiratory system, skeletal muscle, and immune responses. This highlights its promising potential as a therapeutic intervention for individuals recovering from COVID-19. (AU)

• Processo FAPESP: 12/15165-2 - Papel da sinalização purinérgica e da sinalização SOCS-JAK-STAT nos efeitos antiinflamatórios do treinamento aeróbio em modelos experimentais de asma e em indivíduos asmáticos
• Beneficiário: Rodolfo de Paula Vieira
• Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores
• Processo FAPESP: 19/11008-9 - O papel do treinamento físico nas respostas pró e anti-fibróticas pulmonares de indivíduos asmáticos
• Beneficiário: Renilson Moraes Ferreira
• Modalidade de apoio: Bolsas no Brasil - Mestrado
• Processo FAPESP: 19/05739-0 - Papel das cininas nos efeitos anti-inflamatórios do treinamento aeróbio em modelo experimental de Asma
• Beneficiário: Maysa Alves Rodrigues Brandão Rangel
• Modalidade de apoio: Bolsas no Brasil - Doutorado