Progn?sticos de morbidade, mortalidade e recupera??o em pessoas hospitalizadas com covid-19: uma revis?o sistem?tica

O presente trabalho foi realizado com apoio da Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - Brasil (CAPES) - C?digo de Financiamento 001.Introdu??o: A COVID-19 ? uma doen?a causada pelo novo coronav?rus, o SARS-CoV-2, que surgiu na China em 2019. O curso da COVID-19 teve um impacto de grande magnitude na sa?de e na economia mundial, com registro de milh?es de casos confirmados de contamina??o pelo novo v?rus, gerando sobrecarga e colapso nos sistemas de sa?de e muitas mortes ao redor do mundo. Pessoas infectadas podem evoluir com quadros cl?nicos vari?veis, de menor ou maior gravidade. Estudos observacionais t?m sido realizados com o intuito de descrever o curso cl?nico da COVID-19 entre pessoas que evoluem com quadros mais graves. Objetivos: A atual revis?o sistem?tica de estudos coorte prospectivos com inception cohort teve como objetivo descrever os progn?sticos de morbidade, mortalidade e recupera??o em pessoas hospitalizadas com COVID-19. M?todos: As buscas foram conduzidas nas bases de dados MEDLINE, EMBASE, AMED e COCHRANE e as refer?ncias obtidas foram selecionadas para potenciais textos completos. Em seguida, textos completos potencialmente relevantes foram avaliados para nossos crit?rios de elegibilidade. A ferramenta QUIPS foi usada para avaliar o risco de vi?s dos estudos inclu?dos e os dados foram extra?dos para os desfechos. Esta revis?o seguiu os crit?rios do Checklist PRISMA 2020 e recomenda??es Cochrane. Resultados: Ao final, 26 estudos atenderam aos crit?rios e foram inclu?dos nesta revis?o. Em s?ntese, os estudos somaram 12.183 pessoas hospitalizadas em enfermaria ou unidades de terapia intensiva. A m?dia de idade foi de 61,79 (SD 9,19) e 8195 (67,26%) foram homens. As comorbidades mais prevalentes foram hipertens?o (48,03%) e diabetes (28,15). Essa evid?ncia demonstrou uma alta propor??o de ocorr?ncia dos desfechos de mortalidade e morbidade, considerando SFMO e SDRA, maior em pessoas internadas em UTI, conforme esperado. A propor??o de eventos relacionados ao desfecho de recupera??o foi alta nas pessoas internadas em enfermaria e menor nas internadas em UTI. Como limita??es, o alto risco de vi?s no dom?nio dos confundidores do estudo pode influenciar nos desfechos. Al?m disso, os atuais estudos coorte prospectivos n?o apresentaram delineamento adequado e reportaram os dados de maneira heterog?nea ou incompleta, impossibilitando a an?lise da estimativa combinada (pooled estimate) para estabelecer o progn?stico do COVID-19. Conclus?o: Esta revis?o sistem?tica evidencia a necessidade de realiza??o de estudos observacionais prospectivos, com alto rigor metodol?gico e delineamento de estudo adequado para descri??o do progn?stico da COVID-19. Registro: PROSPERO: CRD42021229355 e OSF: DOI 10.17605/OSF.IO/JG5DS.Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES)Disserta??o (Mestrado) ? Programa de P?s-Gradua??o em Reabilita??o e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2021.Introduction: The SARS-CoV-2 is responsible for Coronavirus Disease-2019 (COVID-19). The COVID-19 course has had a major impact on health and economics worldwide. Since pandemic onset, millions confirmed cases of contamination by SARS-CoV-2 have been recorded, with many deaths worldwide. Infected people can develop variable conditions, of lesser or greater severity. Observational studies have been carried with the aim of describing the clinical course of COVID-19 among people who develop more severe conditions. Objective: The current systematic review of prospective inception cohort studies aims to investigate the clinical course of COVID-19 in the outcomes of morbidity, mortality and recovery. Methods: Searches were conducted and retrieved references were screened for potential full texts. Then, potentially relevant full texts were assessed for our eligibility criteria. QUIPS tool was used to assess methodological quality of included studies and data were extracted for prognosis. This review followed the assessment by PRISMA Checklist 2020 and the Cochrane recommendations. Results: At the end, 26 studies met the criteria and were included in this review. In summary, the studies totaled 12,183 people hospitalized. The mean age was 61.79 (SD 9.19) and 8195 (67.26%) were men. The most prevalent comorbidities were hypertension (48.03%) and diabetes (28.15). This evidence showed a high occurrence of mortality and morbidity outcomes, considering MOFS and ARDS, higher in people hospitalized in the ICU, as expected. The proportion of events related to the recovery outcome was high among people admitted to the infirmary and lower among those admitted to the ICU. As limitations, the high risk of bias in the study's confounders domain may influence the outcomes. In addition, the current prospective cohort studies did not present an adequate design and reported the data in a heterogeneous or incomplete manner, making it impossible to analyze the pooled estimate to establish the COVID-19 prognosis. Conclusion: This systematic review highlights the need to carry out prospective observational studies, with high methodological rigor and adequate study design to describe the prognosis of COVID-19. Registration: PROSPERO: CRD42021229355 and OSF: DOI 10.17605/OSF.IO/JG5DS

Cardiorespiratory fitness assessment and prediction of peak oxygen consumption by Incremental Shuttle Walking Test in healthy women.

IntroductionPreliminary studies have showed that the Incremental Shuttle Walking Test (ISWT) is a maximal test, however comparison between ISWT with the cardiopulmonary exercise test (CEPT) has not yet performed in the healthy woman population. Furthermore, there is no regression equation available in the current literature to predict oxygen peak consumption (VO2 peak). Thus, this study aimed to compare the ISWT with CEPT and to develop an equation to predict peak oxygen uptake (VO2 peak) in healthy women participants.MethodsFirst, the VO2 peak, respiratory exchange ratio (R peak), heart rate max (HR max) and percentage of predicted HR max (% predicted HR max) were evaluated in the CEPT and ISWT (n = 40). Then, an equation was developed to predict the VO2 peak (n = 54) and its validation was performed (n = 20).ResultsThere were no significant differences between the ISWT and CEPT of VO2 peak, HR max and % predicted HR max values (P>0.05), except for R peak measure in the ISWT (1.22 ± 0.13) and CEPT (1.18 ± 0.1) (P = 0.022). Therefore, both tests showed a moderate positive correlation of VO2 peak (r = 0.51; P = 0.0007), HR max (r = 0.65; PConclusionISWT is a maximal test showing similar results compared to the CEPT, and the predicted equation was valid and applicable for VO2 peak assessing in young adult healthy women