Efficacy of stage I rehabilitation of medical workers with moderate course of interstitial lung damage associated with COVID-19
https://doi.org/10.18699/SSMJ20230620
Abstract
Aim of the study was to evaluate the effectiveness of early rehabilitation methods for medical workers with severe or moderate lung damage caused by a new coronavirus infection, who are in intensive care units, to improve lung ventilation, gas exchange and bronchial clearance, correct muscle weakness, increase overall physical endurance, mobility, psycho-emotional stability.
Material and methods. We examined 53 COVID-19 women with moderate lung injury at stage I of rehabilitation, divided into two groups: main (n = 31, medical personnel) and control (n = 22, working outside of contact with pulmotropic risk factors, including no risk of SARS-CoV-2 infection). Early rehabilitation was carried out in the intensive care unit and in the infectious diseases hospital of City Clinical Hospital No. 2, for patients with COVID-19 rehabilitation plan was drawn up in accordance with temporary guidelines for the medical rehabilitation of a new coronavirus infection.
Results and discussion. It was established, that rehabilitation in the conditions of the intensive care unit and the specialized department can significantly reduce the severity of dyspnea, anxiety and depression, positively affects the increase in exercise tolerance, and helps to reduce the activity of systemic inflammation. In patients who have industrial contact with patients with COVID-19, the effectiveness of rehabilitation measures is lower than in the comparison group.
Conclusions. To increase the effectiveness of stage I of the rehabilitation of medical workers with COVID-19 and lung damage, it is necessary to conduct more intensive and longer rehabilitation than indicated in the current guidelines.
About the Authors
L. A. ShpaginaRussian Federation
Lubov A. Shpagina, doctor of medical sciences, professor.
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
V. A. Drobyshev
Russian Federation
Viktor A. Drobyshev - doctor of medical sciences, professor.
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
S. A. Karmanovskaya
Russian Federation
Svetlana A. Karmanovskaya - doctor of medical sciences.
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
E. M. Loktin
Russian Federation
Eugeny M. Loktin - doctor of medical sciences.
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
I. S. Shpagin
Russian Federation
Ilya S. Shpagin - doctor of medical sciences.
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
O. S. Kotova
Russian Federation
Olga S. Kotova - doctor of medical sciences.
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
L. A. Panacheva
Russian Federation
Lyudmila A. Panacheva - doctor of medical sciences.
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
T. V. Musienko
Russian Federation
Tatiana V. Musienko
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
E. A. Zaikina
Russian Federation
Ekaterina A. Zaikina
630091, Novosibirsk, Krasny ave., 5; 630051, Novosibirsk, Polzunova st., 21
References
1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., Liu L., Shan H., Lei C.L., Hui D.S.C., … China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med. 2020;382(18):1708–1720. doi: 10.1056/NEJMoa2002032
2. Temporary guidelines. Prevention, diagnosis and treatment of novel coronavirus infection (COVID-19). Version 7 (03.06.2020). Available at: http://edu.rosminzdrav.ru/fileadmin/user_upload/specialists/COVID-19/MR_COVID-19_v7.pdf [In Russian].
3. Chuchalin A.G., Aysanov Z.R., Chikina S.Yu., Chernyak A.V., Kalmanova E.N. Federal guidelines of Russian Respiratory Society on spirometry. Pulmonology. 2014;(6):11–24. [In Russian]. doi: 10.18093/08690189-2014-0-6-11-24
4. Ivanova G.E., Balandina I.N., Batysheva T.T., Bakhtina I.S., Belkin A.A., Belyaev A.F., Bodrova R.A., Bubnova M.G., Buylova T.V., Valiulina S.A., Shmonin A.A. Medical rehabilitation at a new coronavirus infection (COVID-19). Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya = Physical and Rehabilitation Medicine, Medical Rehabilitation. 2020;2(2):40–189. [In Russian]. doi: 10.36425/rehab34231
5. Ivanova G.E. Principles of organizing medical rehabilitation of patients with a new coronavirus infection COVID-19: report at All-russian scientific and practical forum «Medical rehabilitation in coronavirus infection» (11.06.2020, on-line). [In Russian].
6. Decree of the Government of the Russian Federation of December 15, 2000 № 967 (as amended on July 10, 2020) «On approval of the Regulations on the investigation and registration of occupational diseases». Available at: https://www.consultant.ru/document/cons_doc_LAW_29577/ [In Russian].
7. Order of the Ministry of Health of the Russian Federation of May 28, 2001 № 176 «On improving the system for investigating and recording occupational diseases in the Russian Federation». Available at: http://www.consultant.ru/document/cons_doc_LAW_32716/ [In Russian].
8. Order of the Ministry of Health of the Russian Federation of November 13, 2012 № 911n. Available at: http://www.consultant.ru/document/cons_doc_LAW_140324/ [In Russian].
9. Temporary guidelines. Medical rehabilitation for novel coronavirus infection (COVID-19) Version 3 (01.11.2022). Available at: http://www.consultant.ru/document/cons_doc_LAW_358669/76f4d9e5aebc059b3c9a26fb6e57e2951afc8aca/ [In Russian].
10. Buland R.J., Pang J., Gross E.R., Woodcock A.A., Geddes D.M. Two- , six, and 12-minute walking tests in respiratory disease. BMJ. 1982;284(6329):1607–1608. doi: 10.1136/bmj.284.6329.1607
11. Borg G.A. Psychophysical bases of perceived exertion. Med. Sci. Sports. Exerc. 1982;14(5):377–381.
12. Prisnie J.C., Fiest K.M., Coutts S.B., Patten S., Atta C.A., Blaikie L., Bulloch A.G., Demchuk A., Hill M.D., Smith E.E., Jetté N. Validating screening tools for depression in stroke and transient ischemic attack patients. Int. J. Psychiatry Med. 2016;51(3):262– 277. doi: 10.1177/0091217416652616