Severe loss of mechanical efficiency in COVID‐19 patients

Background: There is limited information about the impact of coronavirus disease (COVID-19) on the muscular dysfunction, despite the generalized weakness and fatigue that patients report after overcoming the acute phase of the infection. This study aimed to detect impaired muscle efficiency by evaluating delta efficiency (DE) in patients with COVID-19 compared with subjects with chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), and control group (CG). Methods: A total of 60 participants were assigned to four experimental groups: COVID-19, COPD, IHD, and CG (n = 15 each group). Incremental exercise tests in a cycle ergometer were performed to obtain peak oxygen uptake (VO2 peak). DE was obtained from the end of the first workload to the power output where the respiratory exchange ratio was 1. Results: A lower DE was detected in patients with COVID-19 and COPD compared with those in CG (P ≤ 0.033). However, no significant differences were observed among the experimental groups with diseases (P > 0.05). Lower VO2 peak, peak ventilation, peak power output, and total exercise time were observed in the groups with diseases than in the CG (P < 0.05). A higher VO2 , ventilation, and power output were detected in the CG compared with those in the groups with diseases at the first and second ventilatory threshold (P < 0.05). A higher power output was detected in the IHD group compared with those in the COVID-19 and COPD groups (P < 0.05) at the first and second ventilatory thresholds and when the respiratory exchange ratio was 1. A significant correlation (P < 0.001) was found between the VO2 peak and DE and between the peak power output and DE (P < 0.001). Conclusions: Patients with COVID-19 showed marked mechanical inefficiency similar to that observed in COPD and IHD patients. Patients with COVID-19 and COPD showed a significant decrease in power output compared to IHD during pedalling despite having similar response in VO2 at each intensity. Resistance training should be considered during the early phase of rehabilitation

Small Island states in crisis: the economic impact of lifestyle diseases in the South Pacific

The article examines the impact of non-communicable diseases (NCD) or lifestyle illnesses to the economy of the South Pacific region. Lifestyle illnesses are attributed to improved living standards as people practices increased consumption of high fat diets and use of alcohol and tobacco. The incidence of diseases is occurring in the younger population who are then restricted of the ability to contribute to the economic well being of his family, in supporting children's education and results in a cycle of poverty that is difficult to break. The illness gives individuals the burden of lost productivity and the emotional burden through the pain and suffering caused

Differences in health-promotion behaviour among the chronically ill in three South Pacific Island countries

In this study, the Health Promoting Lifestyle Profile was used to compare health-promoting behaviours in three groups of chronically ill people being treated as outpatients at clinics and hospitals in Fiji, Nauru, and Kiribati. Significant differences were found between males and females and among groups in relation to practices and attitudes towards health responsibility, physical activity, nutrition, and stress management. Health professionals and educators must develop ways to transmit the message of healthy lifestyles to populations that do not pay much attention to conventional health-education methods