Clusters of Survivors of COVID-19 Associated Acute Respiratory Failure According to Response to Exercise

Michele Vitacca, Mara Paneroni, Alberto Malovini, Annalisa Carlucci, Chiara Binda, Vincenzo Sanci and Nicolino Ambrosino
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Michele Vitacca: Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy
Mara Paneroni: Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy
Alberto Malovini: Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Annalisa Carlucci: Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Chiara Binda: Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Vincenzo Sanci: Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Nicolino Ambrosino: Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy

IJERPH, 2021, vol. 18, issue 22, 1-11

Abstract: COVID-19 survivors are associated with acute respiratory failure (ARF) and show a high prevalence of impairment in physical performance. The present studied aimed to assess whether we may cluster these individuals according to an exercise test. The presented study is a retrospective analysis of 154 survivors who were admitted to two hospitals of Istituti Clinici Scientifici Maugeri network, Italy. Clinical characteristics, walked distance, heart rate (HR), pulse oximetry (SpO 2 ), dyspnoea, and leg fatigue (Borg scale: Borg-D and Borg-F, respectively) while performing the six-minute walking test (6MWT) were entered into unsupervised clustering analysis. Multivariate linear regression identified variables that were informative for the set of variables used for cluster definition. Cluster 1 (C1: 86.4% of participants) and Cluster 2 (C2: 13.6%) were identified. Compared to C1, the individuals in C2 were significantly older, showed significantly higher increase in fatigue and in dyspnoea, greater reduction in SpO 2 , and a lower HR peak during the test. The need of walking aids, time from admission to acute care hospitals, age, body mass index, endotracheal intubation, baseline HR and baseline Borg-D, and exercise-induced SpO 2 change were significantly associated with the variables that were used for cluster definition. Different characteristics and physiological parameters during the 6MWT characterise survivors of COVID-19-associated ARF. These results may help in the management of the long-term effects of the disease.

Keywords: acute respiratory failure; dyspnoea; exercise test; exercise tolerance; fatigue; pulmonary rehabilitation; six-minute walking test (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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