Impacto da infecção pelo vírus sars-cOV2 na capacidade funcional de paciente cardiopata participante de programa de reabilitação cardiovascular: relato de caso.

Abstract

Objective: The objective of this case report was to describe the effects of a cardiovascular rehabilitation program in a patient with previous heart disease and after COVID-19 hospitalization, demonstrated through the functional assessment tests used in the routine of the outpatient rehabilitation sector. Methods: A 58-year-old divorced man, professional fisherman, was participating in the Cardiovascular Rehabilitation program due to ischemic heart disease and was already in the final stage of rehabilitation in 2020 when social isolation began due to the COVID-19 pandemic in Brazil. In April 2021, the patient tested positive for COVID-19 and required hospitalization for 11 days. After hospital discharge, the patient was evaluated and started post-covid rehabilitation due to persistent symptoms, such as fatigue, dyspnea and intolerance to small efforts. 6-minute walk and step tests (6MWT and 6MST), in addition to the assessment of inspiratory muscle strength, were performed to obtained the functional capacity. Results: The patient's functional capacity was maintained when he returned to rehabilitation after social isolation, with satisfactory performance in the 6MWT and 6MST and in the parameters of perceived exertion, hemodynamic responses, oxygenation at peak exertion and recovery. However, we observed the functional impact after hospitalization for COVID-19, with a significant drop in oxygen saturation at peak exertion and worse performance in the 6MWT and 6MST and loss of respiratory muscle strength. After 8 weeks of physical training, there was an improvement in functional capacity, in oxygenation and in hemodynamic parameters, reaching predicted values in 6MWT and 6MST and in inspiratory muscle strength. Conclusion: The case report demonstrated that a supervised rehabilitation program within 8 weeks after hospital discharge after COVID-19 infection with persistent moderate symptoms can be a beneficial strategy in the care of post-covid syndrome. The results of the functional tests demonstrated the beneficial effects of aerobic physical training combined with resistance training and inspiratory muscle training. It is important to highlight that this patient has a heart disease and had his functional capacity reestablished after the cardiac event, however, the COVID-19 infection had a negative impact on functional capacity, which was reestablished after the rehabilitation program.